bluuebunny/crossref_metadata_2025 huggingface dataset:
A new simplified fluid dynamic model for digital twins of electrohydraulic servovalves
Authors: Dalla Vedova Matteo Davide Lorenzo , Berri Pier Carlo
Published: July 2021

Purpose

The purpose of this paper is to propose a new simplified numerical model, based on a very compact semi-empirical formulation, able to simulate the fluid dynamics behaviors of an electrohydraulic servovalve taking into account several effects due to valve geometry (e.g. flow leakage between spool and sleeve) and operating conditions (e.g. variable supply pressure or water hammer).

Design/methodology/approach

The proposed model simulates the valve performance through a simplified representation, deriving from the linearized approach based on pressure and flow gains, but able to evaluate the mutual interaction between boundary conditions, pressure saturation and leak assessment. Its performance was evaluated comparing with other fluid dynamics numerical models (a detailed physics-based high-fidelity one and other simplified models available in the literature).

Findings

Although still showing some limitations attributable to its simplified formulation, the proposed model overcomes several deficiencies typical of the most common fluid dynamic models available in the literature, describing the water hammer and the nonlinear dependence of the delivery differential pressure with the spool displacement.

Originality/value

Although still based on a simplified formulation with reduced computational costs, the proposed model introduces a new nonlinear approach that, approximating with suitable precision the pressure-flow fluid dynamic characteristic of a servovalve, overcomes the shortcomings typical of such models.
The mediating effect of consumers’ price level perception and emotions towards supermarkets
Authors: Cakici A. Celil , Tekeli Sena
Published: July 2021

Purpose

This study aims to reveal the impact of consumers’ price sensitivity on their purchase intention within the scope of supermarkets. Besides, the study aims to examine the impact of consumers’ price sensitivity on their price perception level and emotions and the impact of consumers’ price level perception and emotions toward supermarkets on their purchase intention. It also aims to detect the mediating effects of consumers’ price level perception and emotions toward supermarkets between their price sensitivity and purchase intention.

Design/methodology/approach

The quota sampling method was used to form the study sample. The population was 20–69-year-old consumers. The study sample included 513 consumers, 276 of whom were men, and 237 of whom were women. Data were collected via a questionnaire by the researchers in Mersin’s (Turkey) five central counties. Explanatory and confirmatory factor analyses and structural equation models were used to analyze data.

Findings

Consumers’ price sensitivity, perception of cheapness, perception of expensiveness and positive emotions toward supermarkets affect their purchase intention. Besides, price sensitivity affects their perception of cheapness while it does not affect their perception of expensiveness. It influences negative emotions, but not on positive emotions. Consumers’ perception of cheapness and perception of expensiveness have impacts on positive emotions toward supermarkets. It was additionally discovered that perception of cheapness and perception of expensiveness affected negative emotions toward supermarkets. A contributed finding was that perception of cheapness had a partial mediating role between price sensitivity and purchase intention.

Practical implications

The study provides managerial implications in terms of understanding consumers’ behavioral changes, developing effective pricing strategies and achieving competitive advantages over the other retailing companies.

Originality/value

The study illustrates that consumer behavior can be explained by a theoretical construct considering the price perception levels and emotions toward supermarkets in examining the effect of consumers’ price sensitivity on their purchase intention. Therefore, it contributes to explain consumers’ behavior by bringing the stimulus–organism–response (SOR) model into a theoretical construct.
COVID-19 and the new forms of employment relationship: implications and insights for human resource development
Authors: Hamouche Salima , Chabani Zakariya
Published: July 2021

Purpose

The labor market has witnessed the increase of the new forms of employment relationship (freelancers, contingent workers, and gig workers) due to the COVID-19 outbreak, generating new workforce patterns that represent a significant challenge for human resource development (HRD) professionals in organizations. Studies that have addressed these new forms of employment relationship and HRD during this pandemic are sparse. This paper aims to broaden the scope of HRD research by exploring the implications of these new forms of employment relationship for HRD in the time of COVID-19. It also provides insights for HRD professionals as well as governments into how to address this challenge.

Design/methodology/approach

This paper is a viewpoint that addresses the new workforce patterns generated by the COVID-19 pandemic and their implications for HRD at the organizational, individual and national levels.

Findings

COVID-19 sheds light on the importance of atypical workers who can create a competitive advantage for organizations, ensure their continuity and significantly benefit national and societal well-being in times of health crisis. However, these atypical workers are often overlooked when it comes to training and development. Whence the importance, for HRD professionals and governments, to address their situation and to integrate them into organizational and national HRD plans and programs, by going beyond traditional models of HRD which focus mainly on standard employees.

Originality/value

This paper examines a relatively unexplored topic. Besides examining the implications of the new forms of employment relationship, for HRD, it provides insights for HRD professionals and governments into how to address the challenges related to these new forms of employment relationship.
Continuing care retirement community senior housing in Shanghai: an analysis of the development barriers
Authors: Lam Terence Y.M. , Yan Junjie
Published: July 2021

Purpose

Shanghai is currently faced with a rapid increase in the ageing population and demand for elderly homes. Continuing care retirement community (CCRC) has been emerging as a high-end alternative to offer specialised accommodation to the elderly in major cities. Since the first development in 2008, the industry is now still at the infancy stage. This study aims to examine the investment barriers hindering the supply and demand of CCRCs with an aim to recommend practical and senior housing policy measures to facilitate CCRC developments.

Design/methodology/approach

Multiple-case study method was used to confirm whether the literature findings on investment barriers apply to the context of Shanghai. Four representative CCRC development cases in Shanghai were examined, in which qualitative data were collected from interviews with experienced CCRC development managers and quantitative data from a questionnaire survey of the CCRC residents.

Findings

Operation management experience, financial risks and government support policy were found to be the main supply barriers. Chinese traditional family-oriented culture and affordability were not the main demand barriers of CCRCs in Shanghai. Poor quality of services and living environment were identified as the main barriers suppressing the demand for CCRC.

Research limitations/implications

Although common trends and views can be drawn from the representative cases in Shanghai to provide valid results, further research should be conducted on other major cities in China so that the results can be widely applied.

Practical implications

Successful CCRC investment strategy should focus on partnering with experienced professional eldercare management companies, provisions of high-quality medical professionals and trained care personnel and delivery of flexible care service, along with intensive capital flows for land, construction and operating costs.

Social implications

Additional senior housing policy support should be established to promote the CCRC supply to address the ageing needs, particularly granting lands for CCRC developments at Tiers 1 and 2 major cities where the land cost is high.

Originality/value

This research’s practical and policy measures can be applied to enable and promote CCRC developments in Shanghai, thus benefitting both housing investors and the government. The findings also form a baseline for CCRC developments in other major cities.
Revisiting the contingency theory: dissection of entrepreneurial orientation elements in retail franchisee performance
Authors: Naidu Samantha , Singh Gurmeet , Narayan Jashwini
Published: July 2021

Purpose

This study aims to analyze how various contingencies within the contingency theory influence the entrepreneurial orientation (EO) elements and performance of retail franchisees in a South Pacific Island nation.

Design/methodology/approach

This study employs a quantitative approach of data collection from 203 managers in a total of 89 retail franchise outlets. Convenience and snowball sampling techniques were used with data analysis through SPSS AMOS and covariance-based structural equation modelling (CB-SEM).

Findings

The results confirmed that technology, innovation and promotion; competitive edge and value co-creation; high return opportunity capitalization; and empowerment and support influenced franchisee performance, while responsive customer focused leadership and competitor knowledge proved to be insignificant. The findings supported EO's influence on both financial and non-financial indicators, with greater influence on financial indicators. The result revealed that EO accounts for partial impact on franchisee performance, while the remaining impact could be attributed to organization and environment contingencies.

Originality/value

The study proposes a novel context of EO in franchising, where we dissect key elements within the EO dimensions. It also adds to the extant literature on how the broader context of environmental and organizational factors termed as “strategic fit” affects entrepreneurial franchisee performance.
Analysis of temperature field and convection heat transfer of oil-air two-phase flow for ball bearing with under-race lubrication
Authors: Bao Heyun , Hou Xiaonan , Tang Xin , Lu Fengxia
Published: July 2021

Purpose

Under-race lubrication can increase the amount of lubricating oil entering a bearing and greatly improve lubrication and cooling effects. The oil-air two-phase flow and heat transfer characteristics inside a ball bearing with under-race lubrication play a key role in lubrication and cooling performance. The purpose of this paper is to study these two characteristics, and then provide guidance for lubrication and heat dissipation of bearing with under-race lubrication.

Design/methodology/approach

In this paper, a simplified three-dimension heat transfer model of ball bearing with under-race lubrication is established; the coupled level set volume of fluid method is used to track the oil-air two-phase flow, and the Palmgren method is used to calculate the heat generation. The influence of rotation speed and inlet velocity on oil volume fraction, temperature and convection heat transfer is investigated. A temperature test for under-race lubrication is carried out.

Findings

Because of the centrifugal force, lubricating oil is located more on the outer ring raceway. As the rotation speed decreases and the inlet velocity increases, the oil volume fraction increases and the temperature decreases. Furthermore, the area with high oil volume fraction has a large convection heat transfer coefficient and low temperature. The error between the simulation temperature and the test temperature is within 10%.

Originality/value

The research on the temperature field and convection heat transfer characteristics of under-race lubrication ball bearings at different rotation speeds and inlet velocities is rarely involved.
Managing trolling in online communities: an organizational perspective
Authors: Dineva Denitsa , Breitsohl Jan
Published: July 2021

Purpose

The literature lacks knowledge on how organizations can manage trolling behaviors in online communities. Extant studies tend to either focus on user responses to trolling behaviors (i.e. a micro-level perspective) or how the trolling infrastructure is governed by platforms (i.e. a macro-level perspective), paying less attention to the organizational community host. With more organizations hosting online communities on social media networks and trolling behaviors increasingly disrupting user engagement within these communities, the current understanding of trolling management practices has become inapt. Given the commercial and social damage caused by trolling behaviors, it is important to understand how these can be best managed. The purpose of this study, therefore, is to examine the meso-level perspective of trolling management by focusing on organizational practice.

Design/methodology/approach

The research design consists of an in-depth non-participatory netnography based on a case study of PETA’s (“People for the Ethical Treatment of Animals”) Facebook community.

Findings

Six distinct trolling management strategies are identified and categorized by their direct versus indirect communication approach: non-engaging, educating, bolstering, expurgating, asserting and mobilizing. Some strategies are deemed to be more successful than others in generating positive community outcomes such as reduced trolling frequency or further support from like-minded community members.

Originality/value

The findings contribute to the meso-level perspective in the trolling management literature by introducing a novel, empirically informed typology of organizational trolling management strategies.
Liquidity management and monetary transmission: empirical analysis for India
Authors: Charmal Vikas , Goyal Ashima
Published: July 2021

Purpose

A change in monetary operating procedures provides a natural experiment which is used to evaluate, first, whether Indian monetary policy transmission is better when durable liquidity is in surplus or when it is in deficit; second whether it is better with interest rates as the policy instrument or quantity of money or a mixture of the two.

Design/methodology/approach

This study first shows that the period of analysis can be divided into two separate regimes one of liquidity surplus (2002–2010) and the other of deficit (2011–2019).This study then estimates separate structural vector auto-regressions (SVARs) for the financial and real sector, with relevant exogenous foreign, policy and other variables for each of the periods as well as SVARs for the whole period with alternative operating instruments.

Findings

Monetary transmission from the repo rate was better during the period the liquidity adjustment facility (LAF) was in surplus with the central bank in absorption mode denoting excess durable liquidity. Pass through was faster and the repo rate had a greater influence on other variables. The impact of the rate on output gap exceeds that on inflation. The weighted average call money rate was found to outperform others as the operating target. Monetary policy has evolved so that policy rates are more effective in transmission compared to money supply, but best results are when durable liquidity is also in surplus.

Originality/value

The results contribute to ongoing debates on the Indian monetary policy framework and give useful inputs for policy in emerging markets where research is scarce. They suggest keeping the LAF in deficit mode over 2011–19 was not optimal.
Commodity price fluctuations and development: perspective from emerging economies
Authors: Abaidoo Rexford , Agyapong Elvis Agyapong
Published: July 2021

Purpose

This paper aims to examine the impact of commodity price changes (crude oil, cocoa, coffee, cotton and gold) on the international market on development (development proxied by the human development index) (HDI) among emerging economies in Sub-Saharan Africa (SSA).

Design/methodology/approach

Empirical estimates verifying theorized relationships in question were performed using the two-step system generalized method of moments framework.

Findings

Results from the empirical estimates suggest that a percentage increase in the prices of crude oil, cocoa and gold in the world market have a significant positive influence on development among economies in the sub-region all things being equal; however, similar price changes in cotton and coffee showed a negative effect on development. Further empirical estimates suggest that the extent to which prices of key commodities such as crude oil, influence development in the sub-region benefit less from institutional variables such as government effectiveness, corruption control and political stability. The same institutional variables, however, were found to augment how changes in cocoa prices influence development among economies in the sub-region.

Originality/value

This study specifically examines the extent to which commodity price fluctuations impact a holistic measure of development, (HDI which inherently captures economic growth) among emerging economies such as those in the SSA region, and how such relationship may be moderated by conditions such as corruption control and government effectiveness. The review suggests that such a study is rare, did not find any specific empirical inquiry focusing on what this study is designed to accomplish. A major gap or deficit identified among most reviewed studies is the failure to verify how the surmised relationship between movements in prices of commodities traded on the international market and development is moderated by institutional factors such as corruption control, government effectiveness and political stability. This study specifically examines such interaction effects in its empirical analysis.
Effects of using the management control system on individual performance with the intervenience of feedforward and organizational learning
Authors: Beuren Ilse Maria , Santos Vanderlei dos , Bernd Daniele Cristina
Published: July 2021

Purpose

This study aims to empirically examine the effects of using the management control system (MCS) on individual performance mediated by organizational learning. Complementarily, it evaluates the moderating effect of feedforward on the relationship between MCS use and organizational learning.

Design/methodology/approach

Structural equation modeling and mediation and moderation analyses were used in a sample of 194 managers from Brazilian companies listed in theExame Magazine’s“Best and Biggest” ranking.

Findings

The results reveal that using the MCS from a cybernetic perspective contributes to organizational learning, contradicting theoretical arguments and empirical evidence that this hinders learning and that feedforward can strengthen this relationship, as long as it is in line with the way of using the MCS. A mediating effect of organizational learning on the relationship between MCS use and individual performance has also been confirmed.

Practical implications

The results demonstrate the effects of MCS use on individual performance and organizational learning by taking a taxonomy of cybernetic use and comprehensive MCS use as a basis. The results provide insights to managers by revealing that MCS use not only influences task performance through organizational learning but also tends to generate cooperative, persistent and initiative-taking behaviors.

Originality/value

The study provides an approach to the behavioral consequences of using the MCS (score-keeping use and comprehensive MCS use) and the role of specific cognitive and motivational mechanisms in individual performance from a multidimensional perspective (task-based, contextual and general).
Evaluation of service quality using SERVQUAL scale and machine learning algorithms: a case study in healthcare
Authors: Altuntas Serkan , Dereli Türkay , Erdoğan Zülfiye
Published: July 2021

Purpose

This study aims to propose a service quality evaluation model for health-care services.

Design/methodology/approach

In this study, a service quality evaluation model is proposed based on the service quality measurement (SERVQUAL) scale and machine learning algorithm. Primarily, items that affect the quality of service are determined based on the SERVQUAL scale. Subsequently, a service quality assessment model is generated to manage the resources that are allocated to improve the activities efficiently. Following this phase, a sample of classification model is conducted. Machine learning algorithms are used to establish the classification model.

Findings

The proposed evaluation model addresses the following questions: What are the potential impact levels of service quality dimensions on the quality of service practically? What should be prioritization among the service quality dimensions and Which dimensions of service quality should be improved primarily? A real-life case study in a public hospital is carried out to reveal how the proposed model works. The results that have been obtained from the case study show that the proposed model can be conducted easily in practice. It is also found that there is a remarkably high-service gap in the public hospital, in which the case study has been conducted, regarding the general physical conditions and food services.

Originality/value

The primary contribution of this study is threefold. The proposed evaluation model determines the impact levels of service quality dimensions on the service quality in practice. The proposed evaluation model prioritizes service quality dimensions in terms of their significance. The proposed evaluation model finds out the answer to the question of which service quality dimensions should be improved primarily?
Quality control for the geophone reorientation of ocean bottom seismic data using k‐means clustering
Authors: Jeong Woodon , Almubarak Mohammed S. , Tsingas Constantinos
Published: July 2021

During ocean bottom seismic acquisition, seafloor multicomponent geophones located in rugose and sloping water bottom can be affected by skewed energy distribution, such as leaked shear energy on the vertical geophones and leaked compressional energy on the horizontal geophones. To correct for the tilted energy distribution, which is one of most effective preprocessing steps, a geophone reorientation step is applied. This is a simple and straightforward process that applies a 3‐dimensional rotation matrix with respect to the orientation angles. Since the reorientation process highly affects the outcome of the entire data processing workflow, it has to be accompanied by a careful quality control process to verify its validity for the whole survey area. In this study, we propose a quality control workflow for the geophone reorientation by using unsupervised machine learning. A correlation analysis is employed to compare numerical versus analytical solutions of both the azimuth and the incidence angles for the direct arrivals. A comparison of both solutions aims to generate correlation coefficients that are indicative of the accuracy of geophone orientation. The correlation coefficients are subsequently investigated by the k‐means clustering algorithm to differentiate and identify normally and abnormally deployed/reoriented geophones. Numerical experiments on a field ocean bottom seismic data set confirm that the proposed workflow effectively provides reliable labels for normally and abnormally deployed/reoriented geophones. The labelling assigned by the proposed quality control workflow is a suitable indicator for abnormalities in the geophone reorientation step and will be helpful for further investigation, such as re‐correction or removal of abnormally reoriented geophones.
States' use of Medicaid to meet the needs of autistic individuals
Authors: Shea Lindsay Lawer , Koffer Miller Kaitlin H. , Verstreate Kate , Tao Sha , Mandell David
Published: July 2021

Objective

To assess the use of Medicaid programs, including waivers, to address the needs of aging autistic individuals.

Data sources

We gathered data on Medicaid programs in place between 2004 and 2015 for 50 states and the District of Columbia from the Centers for Medicare and Medicaid Services website, by contacting state Medicaid administrators and advocacy groups, and by reviewing the Medicaid Analytic eXtract Waiver Crosswalk.

Study design

This retrospective analysis classified each Medicaid program and documented state changes over time in eligibility criteria: those serving autism spectrum disorder only, autism spectrum disorder or intellectual disability, and intellectual disability only.

Data collection/extraction methods

We captured age and diagnosis eligibility criteria for Medicaid programs serving any of the three target groups.

Principal findings

A total of 269 Medicaid programs met our criteria and most programs (51%) were 1915(c) waivers. The number of autism‐specific 1915(c) waivers grew more than fivefold during the study period, outpacing increases in waivers serving individuals with intellectual disability.

Conclusions

States varied in their use of Medicaid to address the needs of the aging autism population. Further study of characteristics of states that changed their Medicaid programs, and of the health care use and outcomes associated with these changes, are needed to identify opportunities to replicate effective approaches to meeting the needs of this population.
Isobutylene contamination of blood collected in 10‐ml evacuated blood collection tubes with gray conventional rubber stoppers
Authors: Kosecki Patrick Allan , Autret Amy , Abbott Lori , Keller‐Brooke Katie
Published: July 2021

Dual‐column headspace gas chromatographic analysis with two flame‐ionization detectors is a commonly used analytical technique for forensic blood ethanol quantitation. This technique is also applicable to the identification and quantitation of other volatile organic compounds such as methanol in biological samples. Compound identification by retention time is limited to those compounds with known retention times programmed into the instrument method. Historically, an early‐eluting peak from an unidentified compound has been observed in both chromatograms from antemortem blood samples analyzed for ethanol concentration with this technique. The unidentified compound's retention time matches that of methanol on one column but not on the second column. This previously unidentified compound has been identified as isobutylene. The proposed source of the isobutylene contamination historically observed in antemortem blood samples collected in 10‐ml gray‐top blood collection tubes is the conventional rubber stopper. Isobutylene was detected in deionized water stored in each of the seven lots of 10‐ml blood tubes tested; the expiration dates of the tubes tested spanned the years 2002–2022. Misidentification of isobutylene as methanol is possible when using a single‐column gas chromatographic system. The presence of isobutylene in blood collected in a gray‐top collection tube does not represent laboratory contamination, is not an interferent with blood ethanol quantitation, and does not affect the ethanol concentration in the blood. A 0.150 g/dl aqueous ethanol standard was stored in a gray‐top tube to evaluate the potential impact of isobutylene on ethanol quantitation. The solution's average ethanol concentration measured after storage was 0.150 g/dl.
Clinical characteristics of non‐radiographic axial spondyloarthritis: Results of the Korean Nonradiographic Axial SPondyloArthritis (KONASPA) data
Authors: Jeong Hyemin , Kim Yong‐Gil , Kim Tae‐Hwan , Kim Tae‐Jong , Park Min‐Chan , Seo Mi Ryoung , Shin Kichul , Oh Ji Seon , Lee Sang‐Hoon , Lee Yeon‐Ah , Lee Eun Young , Baek Han Joo , Cha Hoon‐Suk
Published: July 2021

Aim

To evaluate clinical characteristics and natural history of non‐radiographic axial spondyloarthritis (nr‐axSpA) using KOrean Nonradiographic Axial SPondyloArthritis (KONASPA) data.

Methods

Data were collected from 11 centers in South Korea. A total of 278 patients with nr‐axSpA from January 2018 to July 2020 were included. Demographic data, clinical features, comorbidities, disease activity, medications, and laboratory results were collected.

Results

Mean age at symptom onset was 28.2 ± 14.2 years. Of 278 patients, 152 (54.7%) were male. Mean Bath Ankylosing Spondylitis Disease Activity Index at diagnosis was 3.5 ± 2.1. Dyslipidemia was the most common comorbidity (8.4%), followed by hypertension (6.1%). Mean age at diagnosis of nr‐axSpA was older in female patients than in male patients (31.8 ± 15.8 years vs 24.9 ± 12.0 years, P < 0.001). Enthesitis and uveitis were more frequently found in female patients than in male patients. Thirty‐one (11.1%) participants with nr‐axSpA progressed to ankylosing spondylitis. The median follow‐up duration was 48 months. In multivariable Cox regression analysis, age at symptom onset (hazard ratio [HR] 0.93, 95% confidence interval (CI) 0.88‐0.97, P = 0.006), body mass index (BMI) (HR 1.24, 95% CI 1.06‐1.44, P = 0.005) and sacroiliitis grade (HR 1.86, 95% CI 1.19‐2.92, P = 0.006) were associated with progression to ankylosing spondylitis.

Conclusions

Results of nationwide data revealed that women with nr‐axSpA showed a late disease onset and more extra‐articular manifestations than men. Young age at symptom onset, high BMI, and presence of radiographic sacroiliitis at diagnosis were risk factors for progression to AS.
mTORC2: The other mTOR in autophagy regulation
Authors: Ballesteros‐Álvarez Josué , Andersen Julie K.
Published: July 2021

The mechanistic target of rapamycin (mTOR) has gathered significant attention as a ubiquitously expressed multimeric kinase with key implications for cell growth, proliferation, and survival. This kinase forms the central core of two distinct complexes, mTORC1 and mTORC2, which share the ability of integrating environmental, nutritional, and hormonal cues but which regulate separate molecular pathways that result in different cellular responses. Particularly, mTORC1 has been described as a major negative regulator of endosomal biogenesis and autophagy, a catabolic process that degrades intracellular components and organelles within the lysosomes and is thought to play a key role in human health and disease. In contrast, the role of mTORC2 in the regulation of autophagy has been considerably less studied despite mounting evidence this complex may regulate autophagy in a different and perhaps complementary manner to that of mTORC1. Genetic ablation of unique subunits is currently being utilized to study the differential effects of the two mTOR complexes. RICTOR is the best‐described subunit specific to mTORC2 and as such has become a useful tool for investigating the specific actions of this complex. The development of complex‐specific inhibitors for mTORC2 is also an area of intense interest. Studies to date have demonstrated that mTORC1/2 complexes each signal to a variety of exclusive downstream molecules with distinct biological roles. Pinpointing the particular effects of these downstream effectors is crucial toward the development of novel therapies aimed at accurately modulating autophagy in the context of human aging and disease.
Emergency medicine faculty serving on standing NIH and AHRQ study sections from 2019 to 2020
Authors: Moore Andrew B. , Puskarich Mike , Vogel Jody A. , Brown Jeremy , Sharp Willard W.
Published: July 2021

Emergency medicine (EM) investigators lag in research funding from the National Institutes of Health (NIH) when compared to other specialties. NIH funding determinations are made in part by a process of NIH study section peer review. Low participation by EM investigators in NIH peer review could be one explanation for low levels of NIH funding by EM investigators. The objective of this study was to establish a current‐state metric of EM faculty researchers serving on standing NIH study sections from 2019 to 2020. Publicly available lists of NIH study section membership rosters within the Center for Scientific Review and within individual NIH institutions were reviewed for standing members. Committee members listed as being members of a department of emergency medicine were identified as emergency care researchers. Special emphasis panels and ad hoc members were excluded. Members degrees were categorized as PhD, MD (with or without non‐PhD degree), MD/PhD, and other. Similar analysis was performed of AHRQ study sections. A total of 6,113 members on NIH study sections were identified. Degrees held by committee members included PhDs 74% (4,547), MDs 14%(883), MD/PhDs 10% (584), and other (99). Twenty (0.3%) NIH study section members were identified as members of an emergency department (ED). A total of 20% (four) held PhDs, 75% (15) held MDs, and 5%(one) held MD/PhD degrees. A total of 25% (five) of EM faculty were pediatric and 75% (15) were adult. Clustering of study sections within similar institutions was noted with 40% (two) of the pediatric faculty at the same institution while 27% (four) of the adult faculty were at the same institution. AHRQ study section review identified 3% (four/127) as members of an ED. Our data show that 20 EM faculty comprised 0.3% of NIH standing study section members and four EM faculty comprised 3% of AHRQ standing study section members from 2019 to 2020 and that these members were clustered at a few institutions.
Widespread ST‐segment elevation due to diffuse coronary artery spasm: A case report
Authors: Bai Lin , Chen Fei , Peng Yong
Published: July 2021

Coronary artery spasm (CAS) is considered an important mechanism of acute coronary syndrome but not very common in the clinical setting. We report a case of a 42‐year‐old woman with chest pain lasting for 4 h due to diffuse CAS, which led to widespread ST‐segment elevation in multiple leads of the electrocardiogram and elevated cardiac troponin T. Emergency coronary angiography at admission showed significantly different morphological results from the second angiography during hospitalization, indicating the patient's discomfort was due to CAS rather than stenosis. Our case illustrates that diffuse CAS can cause widespread ST‐segment elevation and severe ACS.
Health equality, race and pharmacogenomics
Authors: Magavern Emma F. , Gurdasani Deepti , Ng Fu L. , Lee Sandra Soo‐Jin
Published: July 2021

Pharmacogenomics is increasingly moving into mainstream clinical practice. Careful consideration must be paid to inclusion of diverse populations in research, translation and implementation, in the historical and social context of population stratification, to ensure that this leads to improvements in healthcare for all rather than increased health disparities. This review takes a broad and critical approach to the current role of diversity in pharmacogenomics and addresses potential pitfalls in order to raise awareness for prescribers. It also emphasizes evidence gaps and suggests approaches that may minimize negative consequences and promote health equality.
Pyruvate dehydrogenase kinase 4‐mediated metabolic reprogramming is involved in rituximab resistance in diffuse large B‐cell lymphoma by affecting the expression of MS4A1/CD20
Authors: Jiang Duanfeng , Mo Qiuyu , Sun Xiaoying , Wang Xiaotao , Dong Min , Zhang Guozhen , Chen Fangping , Zhao Qiangqiang
Published: July 2021

Diffuse large B cell lymphoma (DLBCL) heterogeneity promotes recurrence and anti‐CD20‐based therapeutic resistance. Previous studies have shown that downregulation of MS4A1/CD20 expression after chemoimmunotherapy with rituximab leads to rituximab resistance. However, the mechanisms of CD20 loss remain unknown. We identified that pyruvate dehydrogenase kinase 4 (PDK4) is markedly elevated in DLBCL cells derived from both patients and cell lines with R‐CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) resistance. We found that overexpression of PDK4 in DLBCL cells resulted in cell proliferation and resistance to rituximab in vitro and in vivo. Furthermore, loss of PDK4 expression or treatment with the PDK4 inhibitor dichloroacetate was able to significantly increase rituximab‐induced cell apoptosis in DLBCL cells. Further studies suggested PDK4 mediates a metabolic shift, in that the main energy source was changed from oxidative phosphorylation to glycolysis, and the metabolic changes could play an important role in rituximab resistance. Importantly, by knocking down or overexpressing PDK4 in DLBCL cells, we showed that PDK4 has a negative regulation effect on MS4A1/CD20 expression. Collectively, this is the first study showing that targeting PDK4 has the potential to overcome rituximab resistance in DLBCL.
‘Life‐changing surgery’: English‐language news media representation of selective dorsal rhizotomy
Authors: Paget Simon Paul , Campbell Lani , Blaxland Anneliese , Lewis Jennifer , Morrow Angela Mary , Wimalasundera Neil
Published: July 2021

Background

Selective dorsal rhizotomy (SDR) is a neurosurgical intervention to reduce spasticity in children with cerebral palsy. Parents researching SDR for their child may be influenced by framing of SDR in news media articles they read. This study examined framing of SDR in English‐language news media.

Methods

Content analysis of English‐language news media articles including the search term ‘rhizotomy’ in the Factiva database published July 2015 to July 2018 in online or print form in Canada, New Zealand, Australia, United States of America and the United Kingdom.

Results

One hundred and eighty‐six articles were identified describing 91 different children (45 male), almost all with cerebral palsy, median age 4 years old. One hundred and twenty‐six articles were written prior to surgery; in many articles, SDR surgery involved travel overseas and/or fundraising. SDR was described universally in positive terms with little discussion of risks. Content of articles variably included the specialized nature of SDR, parental frustration with their local health system and their hope for positive outcomes. There was geographical variation in both numbers of articles and content.

Conclusions

SDR is a common focus in cerebral palsy news media articles in some countries. Framing in these articles supports SDR as a beneficial and specialized procedure and may lead families to believe they need to work outside their local health systems. As news media are likely an important influence on families' attitudes to SDR, clinicians should be aware of this influence.
Acculturation and dental sealant use among US children
Authors: Wiener R. Constance , Findley Patricia A. , Shen Chan , Dwibedi Nilanjana , Sambamoorthi Usha
Published: July 2021

Objectives

Healthcare (including dental care) service use is influenced by predisposing, enabling and need factors. One area with limited research is the association of acculturation (defined as behavioural changes in the adaptation to another culture) as a predisposing factor for dental care preventive service use. Preventive service use is a primary objective of Healthy People, 2030. The purpose of this study was to determine the association of acculturation with the preventive dental service use of dental pit‐and‐fissure sealant placement, among children in the United States, ages 6‐18 years.

Methods

A cross‐sectional, secondary data analysis study was completed using National Health and Nutrition Examination Survey (NHANES), 2013‐2016 data. NHANES is a nationally representative survey of noninstitutionalized individuals across the United States. In the data set, children, ages 6‐18 years, had been evaluated for pit‐and‐fissure dental sealant use. Information that served as proxies for acculturation was length of stay in the United States (a citizen at the time of the survey; not a citizen and in the country <5 years; or not a citizen and in the country ≥5 years) and whether English was spoken at home (yes; no). Data were analysed for descriptive statistics. Multivariable logistic regressions were used to examine strength of the associations. Odds ratios for pit‐and‐fissure sealants among groups were determined.

Results

There were 2220 children participants whose data were used for this study. Less than half (45.5%) had received dental pit‐and‐fissure sealants. A majority (53.3%) were white and were ages 12‐18 years (51.6%). The mean number of dental pit‐and‐fissure sealants among all children was 5.5. There was a lower percentage of children living in the United States <5 years who had received pit‐and‐fissure sealants than children who were citizens of the United States (22.2% vs 48.9%, respectively). The adjusted odds ratio was lower for dental pit‐and‐fissure sealants among children who were in the United States <5 years than children who were citizens of the United States (adjusted odds ratio, 0.38; 95% Confidence Interval: 0.24, 0.58).

Conclusions

In this study, children who had lived in the United States <5 years were less likely to have pit‐and‐fissure sealants than children who were citizens of the United States. There is a need to reach all children with preventive services to improve dental quality of life, reduce the need for dental restorations and decrease overall financial burden regardless of time in the United States.
Recurrence and colon cancer‐specific death in patients with large bowel obstruction requiring urgent operation: a competing risks analysis
Authors: Adams Katie , Chapuis Pierre H. , Keshava Anil , Rickard Matthew J. F. X. , Stewart Peter , Suen Michael , Chan Charles , Dent Owen F.
Published: July 2021

Aim

Clinical presentation with large bowel obstruction has been proposed as a predictor of poor long‐term oncological outcomes after resection for colorectal cancer. This study examines the association between obstruction and recurrence and cancer‐specific death after resection for colon cancer.

Method

Consecutive patients who underwent resection for colon cancer between 1995 and 2014 were drawn from a prospectively recorded hospital database with all surviving patients followed for at least 5 years. The outcomes of tumour recurrence and colon cancer‐specific death were assessed by competing risks multivariable techniques with adjustment for potential clinical and pathological confounding variables.

Results

Recurrence occurred in 271 of 1485 patients who had a potentially curative resection. In bivariate analysis, obstruction was significantly associated with recurrence [hazard ratio (HR) 2.23, CI 1.52–3.26, p < 0.001] but this association became nonsignificant after adjustment for confounders (HR 1.53, CI 0.95–2.46, p = 0.080). Colon cancer‐specific death occurred in 238 of 295 patients who had a noncurative resection. Obstruction was not significantly associated with cancer‐specific death (HR 1.02, CI 0.72–1.45, p = 0.903). In patients who had a noncurative resection, the competing risks incidence of colon cancer‐specific death was not significantly greater in obstructed than in unobstructed patients (HR 1.02, CI 0.72–1.45, p = 0.903).

Conclusion

Whilst the immediate clinical challenge of an individual patient presenting with large bowel obstruction must be addressed by the surgeon, the patient's long‐term oncological outcomes are unrelated to obstruction per se.
LigaSure™ haemorrhoidectomy and the risk of postoperative bleeding
Authors: Wlodarczyk Jordan R. , Yoon Dong , Lai Rachel , Ault Glenn , Ortega Adrian , Lee Sang W. , Cologne Kyle G. , Koller Sarah
Published: July 2021

Aim

LigaSure™ is an electro‐surgical device that has increasingly been utilized in haemorrhoid surgery. However, recent literature has highlighted a possible increased risk of delayed postoperative bleeding following LigaSure haemorrhoidectomy (LH). We aim to evaluate the rates of postoperative bleeding following LigaSure compared to Ferguson (closed) haemorrhoidectomy (FH).

Methods

A retrospective cohort study was undertaken at our single academic safety‐net county hospital from August 2016 through July 2019 evaluating patients who received FH or LH. Patient demographics, surgical data, postoperative emergency department visit for pain or bleeding within 30 days and resulting transfusion requirement, and rates of readmission and interventions within 30 days were collected.

Results

Sixty‐one FH and 66 LH patients were identified. The groups had no difference in demographics. The LH group and FH group had similar rates of postoperative emergency department visits (29% vs. 23%, P = 0.454), as well as visits for bleeding (20% vs. 11%, P = 0.204). The average operating time was also significantly shorter with LH (14.5 min vs. 24.9 min, P ≤ 0.001). On multivariate analysis, male sex (OR 7.28, 95% CI 1.88–28.25) and haemorrhoid grade ≤2 (OR 4.64, 95% CI 1.31–16.49) were significantly associated with postoperative bleeding on multivariate analysis. Use of LH was not independently associated with postoperative bleeding risk (OR 1.89, 95% CI 0.70–5.11).

Conclusions

LH and FH have similar risks for postoperative bleeding and other complications. Male sex and haemorrhoid Grades 1 or 2 may be associated with increased postoperative bleeding risk. Excisional haemorrhoidectomy should be undertaken with caution for male patients with lower internal haemorrhoid grades.
The role of small and medium enterprise and family business distinctions in decision‐making: Insights from the farm echelon
Authors: Darby Jessica L. , Fugate Brian S. , Murray Jeff B.
Published: July 2021

Small and medium enterprises (SMEs) and family businesses are ubiquitous in global supply chains but differ from large corporations along several dimensions touted as likely to influence their approach to supply chain management. Yet, little research exists that empirically examines how SME and family business distinctions manifest in operations and supply chain management (OSCM) decision‐making. Our study begins to address this important gap by investigating OSCM decisions in the farm echelon—a challenging but critical echelon overwhelmingly composed of small and midsize family farms. Using the hermeneutic method, we delve into the minds of 18 farmers to explore how SME and family business distinctions influence their production and storage decisions. We further examine how these distinctions interact with elements of the supply chain and the institutional environment in which farmers are embedded. Our contextualized understanding offers important implications for supply chain theory, practice, and public policy. We also provide timely guidance on the farmer's perspective amidst increased demands for a farm‐to‐fork experience.
Socioeconomic status, home mathematics environment and math achievement in kindergarten: A mediation analysis
Authors: Muñez David , Bull Rebecca , Lee Kerry
Published: July 2021

Growing evidence suggests that parents’ practices contribute to their children's cognitive development and that such practices may reflect SES disparities. This study investigated longitudinal interrelations between home mathematics environment (HME), children's math achievement, and two facets of SES (mother's educational attainment and household income—subsidy status) during the first year in kindergarten (n = 500 children; Mage at T1 = 57.3 months, SD = 3.8). Results revealed that these facets of SES operated through different mechanisms in kindergarten—the association between mothers’ education and math growth at the end of K1 is fully mediated by HME and children's baseline math knowledge. Furthermore, only home math activities that explicitly supported the understanding of addition and subtraction contributed to children's math growth independently of SES background. The pattern of longitudinal associations suggests that the provision of home math activities may reflect children's mathematical abilities rather than SES disparities.