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The present research presented a novel model for incorporating service design to create guest experiential value. Taking a star hotel in Taiwan as an example, this study used the KJ method to classify online reviews about hotel services and then created a customer journey map (CJM) through participant observation of the entire service process. By deconstructing the service process and identifying key service touchpoints, service design ideas were incorporated into the CJM. A Kano questionnaire was then adopted to accommodate 38 service scape attributes in 4 segments: 1 attribute in the maintenance area, 10 of the high-priority area, 11 of the low-priority area, and 16 of differentiation. The overall research results propose experience design strategies for the hotel industry in terms of the service content and operation processes of star-rated hotels, which can then be adjusted according to their operating conditions to construct their unique service experience content. This is expected to be the basis for subsequent research and serve as a basis and reference for improving hotel service design strategies and competitiveness in the future. [ABSTRACT FROM AUTHOR]

Background: Upper urinary tract urothelial carcinoma (UTUC) is the most common malignancy occurring after kidney transplantation (KT) in Taiwan. The aim of this study was to investigate the association between native kidney hydronephrosis and UTUC in post-KT patients. Methods: From 2003 to 2018, we conducted a retrospective cohort study that enrolled 1005 post-KT patients, 67 of whom were subsequently diagnosed with UTUC. We divided patients into two groups based on whether or not they had UTUC. Multivariate analysis and Kaplan-Meier plot were used to evaluate if native kidney hydronephrosis was associated with post-KT UTUC. Results: The total cohort consisted of 612 men (60.9%) and 393 women (39.1%) with a mean age of 48.2 ± 12.0 at KT. The mean follow-up time was 118.6 ± 70.2 months, and mean time from KT to UTUC was 7.53 years. There was a significant gender difference with a female predominance among the UTUC patients (73.1% versus 26.9%, p < 0.001). Native kidney hydronephrosis occurred more frequently in the UTUC group (68.7% versus 4.8%, p < 0.001). Multivariate analysis showed that native kidney hydronephrosis and female gender were significantly associated with UTUC with odds ratios of 35.32 (95% CI, 17.99–69.36; p < 0.001) and 3.37 (95% CI, 1.55–7.29; p = 0.002), respectively. UTUC in the post-KT patients also showed aggressive pathological characteristics and a tendency toward bilateral lesions (41.8%). Conclusions: Native kidney hydronephrosis is significantly associated with post-KT UTUC patients in Taiwan. Native kidney hydronephrosis may be a deciding factor for standard nephroureterectomy and bladder cuff excision in selected patients. Nevertheless, almost half of the patients with kidney hydronephrosis do not present with UTUC at the end of our study. [ABSTRACT FROM AUTHOR]