bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustainable Development in Tourism: A Stakeholder Analysis of the Langhe Region
Authors: Vrontis Demetris , Christofi Michael , Giacosa Elisa , Serravalle Francesca
Published: January 2021

The tourism literature has increasingly recognized the significance of various stakeholders on how a region should attempt to apply the principles of sustainable development. Based on stakeholder theory, the article aims to investigate how the business model in tourism that is used in Italy’s Langhe region is aligned to the promotion of a “sustained, inclusive and sustainable economic growth, full and productive employment and decent work,” in accordance to the United Nations General Assembly 2030 agenda for sustainable development. The research employed a single case study approach, drawing on 36 semistructured interviews with key stakeholders in the region, and the findings show that a variety of stakeholders play an important role toward the sustainable development of the region. The various stakeholders were categorized as either internal or external, followed by the identification of definitive stakeholders. The article concludes with the managerial and theoretical implications of the findings and reports several future research directions.
“We Are the White Aryan Warriors”: Violence, Homosociality, and the Construction of Masculinity in the National Socialist Movement in Sweden
Authors: Mattsson Christer , Johansson Thomas
Published: January 2021

Violence is a significant element in the constitution, emotional structure, and reproduction of right-wing extremism and neo-Nazism. This article examines the life histories of former neo-Nazis and explores the roles of violence in the Swedish skinhead culture and neo-Nazi organizations. We conducted individual and group interviews with seven former neo-Nazis who held high positions in the movement. Our study focused on violence and violent acts, as well as feelings of redemption and regret. The findings show that violence had always been a part of our subjects’ lives. Violence was a means to solve disagreements and position themselves within the organizational hierarchy. Among our informants, masculinity was displayed and constructed through the performance of being “real men” within the circles of skinheads and neo-Nazis. The portrayal of real men as Aryan warriors attracted violent men to these circles to a greater extent and for longer than in other Nordic countries.
Better Evaluation Can Improve the Effectiveness of Agreements Between Public Health Organizations and Food and Beverage Companies
Authors: Wiecha Jean L. , Muth Mary K.
Published: January 2021

Most Americans consume diets at odds with nutrition recommendations, contributing to our ongoing epidemics of noncommunicable diseases. One strategy for accelerating progress toward healthier diets involves formal agreements between companies and nongovernmental organizations to develop new products, reformulate existing products, and implement new marketing strategies. Although the general intention for industry agreements is to generate public health benefits, their goals and activities may not align with this intention. Based on a literature review and technical assistance we provided to organizations engaged in industry agreements, we believe that increasing scientific scope and rigor in evaluations of voluntary food and beverage industry agreements could improve potential public health benefits and understanding of their actual effects. We provide recommendations for external, unconflicted funding that permits comprehensive, independent, and rigorous evaluation of voluntary industry agreements.
Feline comorbidities: Recognition, diagnosis and management of the cushingoid diabetic
Authors: Cook Audrey K , Evans Jeremy B
Published: January 2021

Practical relevance:

Diabetes mellitus (DM) is a common feline endocrinopathy, and is often driven by underlying insulin resistance with associated pancreatic beta (β)-cell dysfunction. Although spontaneous hyperadrenocorticism (HAC) with hypercortisolemia (hypercortisolism) is relatively uncommon in cats, it is a well-established cause of insulin resistance and is routinely associated with DM in this species.

Clinical challenges:

Many of the clinical signs associated with feline HAC are subtle and may be attributed to concurrent DM or the aging process. Failure to recognize HAC in the diabetic cat can impact patient wellbeing and predispose the patient to progressive compromise. Unfortunately, it can be difficult to establish a diagnosis of HAC, as test results may be influenced by poor diabetic regulation, and protocols are different to those used in canine patients. Treatment options depend on the underlying cause, and often require careful, ongoing assessment and modulation of both adrenal function and insulin requirements. However, various approaches have been shown to either improve glycemic control in cats with sustained insulin dependence, or facilitate diabetic remission.

Evidence base:

This review summarizes the current literature on feline HAC, with a particular focus on cats with concurrent DM. The clinical findings that suggest HAC are discussed, along with an outline of diagnostic options and their limitations. Published outcomes for various medical options, surgical procedures and radiation therapy are provided. The authors also share their thoughts on the safe and effective management of cats with HAC and DM, with an emphasis on the anticipation and recognition of changing insulin requirements.
Congenital central corneal dermoid: A rare entity
Authors: Hameed Syed , Kaur Inderjeet , Singh Vivek , Mishra Dilip C , Reddy Jagadesh C
Published: January 2021

Background:

To understand the pathogenesis of a central corneal dermoid (CD) in a 12-day-old child, a comparison of CD specimen was done with limbal dermoid (LD) and cadaveric corneal (CC) specimens by immuno-histochemical staining.

Methods:

The child underwent penetrating keratoplasty for visual rehabilitation. The corneal tissue was sent for histo-pathological and immunochemistry evaluation. The corneal specimen obtained was compared the origin of central CD with LD and CC based on their antigenic expression profile.

Results:

Clinically over a period of 75 months post operatively the child maintained a clear graft. Hematoxylin and Eosin staining of LD had a typical morphology including stratified keratinized epithelium, hair shaft with pilo sebaceous glands, eccrine sweat glands, lymphocytes, and blood vessels. Immuno-histochemical staining showed positive stain for Cytokeratin 3 epithelial marker in the epithelium of CC, LD, and CD. Smooth muscle maker (SMA) was identified in LD and CD but not in the CC as it is devoid of blood vessels. Limbal stem cell maker (P63) was detected only in LD. Vimentin, a mesenchymal stem cell marker stained positively in all three tissues of CC, LD, and CD.

Conclusions:

Corneal dermoid showed positive staining for mesodermal tissue components compared to both ectodermal and mesodermal components in limbal dermoid suggesting possibly a different origin of corneal dermoid
Social imaginaries of subsea cables: recovering connections between Broome and Banyuwangi
Authors: Kerr Thor , Wahyudi Irfan
Published: January 2021

As most data travel through subsea cables, this article investigates social imaginaries of the cable laid in 1889 from Banyuwangi in south-eastern Java to Broome in north-western Australia. Through collaborative fieldwork in Broome and Banyuwangi, radically different representations are identified at either end of the cable. In Broome, the cable telegraph station is memorialized for introducing colonial sophistication to a town where Java is celebrated for facilitating communication with Britain. In Banyuwangi, there is no mention of Broome and little mention of the undersea cable. Instead, there are mythical and haunted representations of a decrepit British Hostel occasionally associated with telegraph operations. Despite some similarities in Indigenous perspectives and entrepreneurial desire to realize tourism income from cable heritage, an ocean-size gulf was identified between the social imaginaries that enabled the cable to be dug up and normalized as a cultural attraction in Broome while remaining buried, almost forgotten, in Banyuwangi.
Dutch Disease phenomenon and demand for international business travels: Panel ARDL/PMG estimation
Authors: Gholipour Hassan F , Tajaddini Reza , Al-mulali Usama
Published: January 2021

This article explores the long-run and short-run effect of natural resource rents on inbound and outbound business travels in resource-abundant economies. By applying panel ARDL/PMG models for 25 countries with annual data for 2005–2017, our results show that increases in dependency on natural resources lead to lower demand for inbound and outbound business travels in the long run. The short-run analyses indicate that while natural resource rents have a significant and positive impact on outbound business travels, they do not affect inbound business travels.
Social support buffers the impacts of Diabetes distress on health-related quality of life among type 2 diabetic patients
Authors: Onu Desmond Uchechukwu , Ifeagwazi Chuka Mike , Prince Obot Anwanabasi
Published: January 2021

Diabetes patients experience significant distress. Improving health-related quality of life (HRQoL) is cardinal in the management of all chronic health conditions. We investigated the moderating role of social support (SS) in the relationship between diabetes distress (DD) and HRQoL. Three hundred and ninety-six type 2 diabetes mellitus (T2DM) patients (M age = 57.71 years) completed measures of relevant variables. Results showed that SS moderated DD-HRQoL association. Our findings provided a guide on extent of support for T2DM management behaviors that may be helpful in ameliorating impacts of stress on patients’ health.
Discipline and Feed: Food Banks, Pastoral Power, and the Medicalisation of Poverty in the UK
Authors: Möller Christian
Published: January 2021

Food banks across the UK are offering basic food supplies and a range of support services to people who have been affected by years of welfare cuts and the ongoing COVID-19 health crisis. Despite a growing research interest in the drivers and experiences of food bank use, their own role in constructing and managing poverty as a social problem has been neglected. Adopting a Foucauldian approach, this study critically explored how power is exercised and subjects are formed inside three UK food banks. The localised care for the poor is shown to work through a pastoral power, which requires confessions of crises and obedience to an expert regime in the diagnosis and treatment of poverty as an individual condition. By making food aid conditional on active engagement with other support agencies, volunteers negotiate and translate neoliberal discourses of personal responsibility and active citizenship. Findings are linked to a wider critique of neoliberal government, which works through therapeutic discourses and retains disciplinary and paternalistic elements in managing poverty at a distance.
The COVID-19 International Student Well-being Study
Authors: Van de Velde Sarah , Buffel Veerle , Bracke Piet , Van Hal Guido , Somogyi Nikolett M. , Willems Barbara , Wouters Edwin ,   for the C19 ISWS consortium#
Published: January 2021

As a large international consortium of 26 countries and 110 higher-education institutions (HEIs), we successfully developed and executed an online student survey during or directly after the initial peak of the COVID-19 pandemic. The COVID-19 International Student Well-being Study (C19 ISWS) is a cross-sectional multicountry study that collected data on higher-education students during the COVID-19 outbreak in the spring of 2020. The dataset allows description of: (1) living conditions, financial conditions, and academic workload before and during the COVID-19 outbreak; (2) the current level of mental well-being and effects on healthy lifestyles; (3) perceived stressors; (4) resources (e.g., social support and economic capital); (5) knowledge related to COVID-19; and (6) attitudes toward COVID-19 measures implemented by the government and relevant HEI. The dataset additionally includes information about COVID-19 measures taken by the government and HEI that were in place during the period of data collection. The collected data provide a comprehensive and comparative dataset on student well-being. In this article, we present the rationale for this study, the development and content of the survey, the methodology of data collection and sampling, and the limitations of the study. In addition, we highlight the opportunities that the dataset provides for advancing social science research on student well-being during the COVID-19 pandemic in varying policy contexts. Thus far, this is, to our knowledge, the first cross-country student well-being survey during the COVID-19 pandemic, resulting in a unique dataset that enables high-priority socially relevant research.
The reshaping of political representation in post-growth capitalism: A paradigmatic analysis of green and right-wing populist parties
Authors: Reitz Tilman , Jörke Dirk
Published: January 2021

This article aims to provide an analysis of the reconfiguration of political orientations in the face of weakening economic growth. We address a widely observed new polarization in the party systems of Western democracies, with radically universalist and ecological orientations, often represented by green parties, versus industrialist and authoritarian values, mainly represented by right-wing populism. In our effort to explain this constellation, we offer an alternative to accounts that merely focus on an underlying change of class structures or that, conversely, declare socio-economic factors obsolete in their relevance for voting behaviour. While the one side focuses on the ‘losers of modernization’ or deindustrialization, the other side emphasizes a cultural conflict between new cosmopolitan values and a defence of male, white, heterosexual, non-migrant privileges. In contrast to such accounts, we analyse how the general trend towards decelerated economic growth provoked new orientations on the (liberal) left and on the (populist) right. In a first step, we provide an overview of diagnoses of ‘secular stagnation’ and of the rise of radically universalist and right-wing parties in Western Europe, focusing in particular on the last decade and looking to the US by way of comparison. We then focus on the attitudes which the political actors in question entertain towards economic growth and offer an interpretation of their ‘cultural’ motives as struggles over economic distribution. The third and last step presents a Gramscian extension of socio-economic analysis beyond the study of voter groups and their attitudes. Here, we take into account the interests of the ruling classes along with the quest for legitimacy and projected changes in the regime of accumulation—if indeed the term accumulation is still adequate in a post-growth context.
Contact characteristic and vibration mechanism of rolling element bearing in the process of fault evolution
Authors: Tu Wenbing , Yang Jinwen , Yu Wennian , Luo Ya
Published: January 2021

The vibration response of rolling element bearing has a close relation with its fault. An accurate evaluation of the bearing vibration response is essential to the bearing fault diagnosis. At present, most bearing dynamics models are built based on rigid assumptions, which may not faithfully reveal the dynamic characteristics of bearing in the presence of fault. Moreover, previous similar works mainly focus on the fault with a specified size without considering the varying contact characteristics as the fault evolves. This paper developed an explicit dynamics finite element model for the bearing with three types of raceway faults considering the flexibility of each bearing component in order to accurately study the contact characteristic and vibration mechanism of defective bearings in the process of fault evolution. The developed model is validated by comparing its simulation results with both analytical and experimental results. The dynamic contact patterns between the rolling elements and the fault, the additional displacement due to the fault and the faulty characteristics within the bearing vibration signal during the fault evolution process are investigated. The analysis results from this work can provide practitioners an in-depth understanding towards the internal contact characteristics with the existence of raceway fault and theoretical basis for rolling bearing fault diagnosis.
Optimization of gasoline compression ignition combustion with ozone addition and two-stage direct-injection at middle loads
Authors: Kobashi Yoshimitsu , Dan Da Tu Dan , Inagaki Ryuya , Shibata Gen , Ogawa Hideyuki
Published: January 2021

Ozone (O3) was introduced into the intake air to control the ignition in a gasoline compression ignition (GCI) engine. An early fuel injection at −68 °CA ATDC was adopted to mix the fuel with the reactive O-radicals decomposed from the O3, before the reduction of the O-radicals due to their recombination would take place. The second injection was implemented near top dead center to optimize the profile of the heat release rate. The engine experiments were performed around the indicated mean effective pressure (IMEP) of 0.67 MPa with a primary reference fuel, octane number 90 (PRF90), maintaining the 15% intake oxygen concentration with the EGR. The quantity of the first injection, the second injection timing as well as the ozone concentration were changed as experimental parameters. The results showed that the GCI operation with the ozone addition makes it possible to reduce the maximum pressure rise rate while attaining high thermal efficiency, compared to that without the ozone. Appropriate combinations of the ozone concentration and the first injection quantity achieve low smoke and NOx emissions. Further, the ozone-assisted GCI operation was compared with conventional diesel operation. The results showed that the indicated thermal efficiency of the ozone-assisted GCI combustion is slightly lower than that of the conventional diesel combustion, but that GCI assisted with ozone is highly advantageous to the smoke and NOx emissions.
Value co-destruction: Review and conceptualization of interactive value formation
Authors: Echeverri Per , Skålén Per
Published: January 2021

The aim of this conceptual article is to both provide a critical review of research into value co-destruction (VCD) and outline a common conceptual framework in order to better understand and guide future research into VCD and value co-creation (VCC). This review finds that the VCD stream of research has followed two lines of enquiry: one that highlights the role of resources and service systems and another that focuses on practices. It further finds that some prior research has argued that a direct and reciprocal relationship exists between VCD and VCC, captured in the concept of interactive value formation (IVF). A synthesizing IVF framework is outlined which suggests that the alignment and misalignment both within practices and in-between different practices determines IVF, that is, VCD and VCC. The framework further suggests that IVF is both enabled and constrained by resources and service systems.
Acts of pedagogical resistance: Marking out an ethical boundary against human technologies
Authors: McNair Lynn J , Blaisdell Caralyn , Davis John M , Addison Luke J
Published: January 2021

This article highlights an action research project that sparked transformation regarding how early years practitioners documented children’s learning. The dominant discourse of standardisation and narrowing of early childhood education, encapsulated in the Organisation for Economic Co-operation and Development’s International Early Learning Study, has resulted in the ‘shaping’ and ‘testing’ of young children around the globe. The OECD has become very interested in early childhood education and is a very instrumental player today (Moss, 2018). Consequently, the testing of young children has been instigated by governments to ensure children gain the accepted knowledge, skills and dispositions required to be successful learners.

Situated within this context of testing and standardisation, this article will share knowledge gained from a small action research project that took place in one Scottish early years setting. The study was stimulated by the early years practitioners of the setting, who strongly opposed the ‘reductionist’ formal ‘tick-box’ assessments produced by their local authority. These types of didactic formal assessments suggest that pedagogy is underpinned by a desire to tame, predict, prepare, supervise and evaluate learning. This article is of critical importance as it examines the imposition of didactic assessment from the practitioners’ perspective. The practitioners in the study contested that ‘tick-box’ assessments diminished children’s identities down to a list of judgements about their academic abilities, or lack thereof. The introduction of the ‘tick-box’ assessments presented a dilemma for the practitioners, in terms of the different views of the government and practitioners of what knowledge is worth knowing and what individuals and groups are able to learn. Many of the practitioners from the early childcare and learning setting positioned themselves and their work as being consciously different from what was going on in the wider sector. The early childcare and learning setting employed in this article introduced a new method to capture children’s learning, which they named the ‘Lived Story’ approach. In this article, we argue that Lived Stories are a form of narrative assessment which are designed to track children’s progress whilst respecting the complexity of their learning, their position within the learning process, the flow/fluidity of their ways of being and their ability to act in radical, creative and innovative ways. We conclude that by using ‘Lived Stories’ practitioners were able to lessen the surety of the language we use. The article highlights that as practitioners write Lived Stories and assess children’s progress they are freed to use language such as ‘wondering, puzzling, thinking, exploring’. In turn, we demonstrate that this language, and the ideas it enables, are on a continuum; a journey that spans a lifetime.
A Qualitative Exploration of Indicators of Health Equity Embeddedness Among Public Health Policy Advocacy Campaigns
Authors: Calloway Eric E. , Fricke Hollyanne E. , Carpenter Leah R. , Yaroch Amy L.
Published: January 2021

There are socioeconomic and racial/ethnic health disparities that warrant policy change to advance health equity. The purpose of this qualitative study was to elucidate primary activities and/or tangible characteristics that indicate that a policy advocacy campaign has an embedded health equity focus. Researchers interviewed policy advocacy experts ( n = 13) and campaign leaders ( n = 9), transcribed audio recordings of interviews, and conducted a thematic analysis to examine health-equity-related processes within policy campaigns. Based on experiences of policy advocacy experts and campaign leaders, mostly within the Voices for Healthy Kids initiative, several objective aspects and activities were identified that indicate that a policy campaign, and the coalition that conducts the campaign, has an embedded health equity focus. It should be stressed that these activities are not intended to represent the extent of all campaign activities, only the subset of activities and aspects of a campaign that indicate a health equity orientation. Broadly, aspects identified were related to what had the campaign done to engage with the community, who in the community was providing input about direction of the campaign, and how had that community input been used. Authentic Community engagement was seen as the foundation of a campaign’s health equity focus. A model synthesizing these findings is included in the results. A major strength of this study is that factors associated with health equity in campaign functioning are not typically assessed. These findings support identification of associated constructs to inform measurement development, and can help guide organizations, campaigns, and researchers working to advance health equity.
A review: Surface treatments, production techniques, mechanical properties and characteristics of Luffa cylindrica bio composites
Authors: Kamran M Jahanzail , Jayamani Elammaran , Heng Soon K , Wong Yat C
Published: January 2021

The need for alternative eco-friendly and sustainable materials has forced many researchers to focus on composites made using natural fibers and biodegradable polymer matrices. In addition to that, these natural fibers are low in cost, have good mechanical properties, biodegradability, and require less production energy. Therefore, this review paper will focus on one of the natural fibers known as Luffa cylindrica (LC) by understanding all the natural fibers' benefits. A detailed overview is provided for commonly used fiber surface treatments, surface treatment techniques, and processing techniques for various LC composites from numerous other researches. Furthermore, this paper will also discuss the characteristics, mechanical properties, and water absorption properties of LC composites before and after surface treatments, where a comprehensive understanding of LC reinforced polymer composites' behavior has been reviewed.
KRAS/BRAF mutations in brain arteriovenous malformations: A systematic review and meta-analysis
Authors: Bameri Omid , Salarzaei Morteza , Parooie Fateme
Published: January 2021

Introduction

Somatic KRAS mutations have been identified in the majority of brain arteriovenous malformations (AVM) specimens. The aim of our study was to evaluate the prevalence of Kirsten rat sarcoma (KRAS)/murine sarcoma viral oncogene homolog B1 (BRAF) mutations in brain AVM.

Methods

A systematic literature review was performed in November 2019. We reviewed MEDLINE/PubMed, Cochrane Library, and ClinicalTrials.gov for citation or ongoing trials from January 2010 to March 2020.

Results

6 studies were identified as meeting the inclusion criteria of this review. The total frequency of KRAS mutations in 1726 patients with AVM was 55%. The prevalence of BRAF mutation was 7.5%. The prevalence of AVMs with grade 2 was the most (39%). Frontal and parietal lobes were the commonest sites of AVMs (21%). the most prevalent presentation of patients with AVM was hemorrhage (62%).

Conclusion

Our findings support a high prevalence of somatic activating mutations in KRAS and less commonly, BRAF in the overwhelming majority of brain AVMs. Practically and importantly, this pathway homogeneity in CNS arteriovenous malformations also supports the development of targeted therapies with RAS/RAF pathway inhibitors. However, more studies are needed to confirm this hypothesis.
Metaphoric perceptions of pre-service teachers about ‘LEGO Robotic Instructional Practices,’ ‘Augmented Reality’ and ‘Flipped Classroom’ concepts
Authors: Fidan Mustafa , Debbag Murat , Cukurbasi Baris
Published: January 2021

The aim of this study is to reveal perceptions of pre-service teachers about ‘LEGO robotic instructional practices,’ ‘augmented reality’ and ‘flipped classroom’ concepts through metaphors. The study is descriptive research that was conducted as a survey model. The study group consists of 37 pre-service teachers studying the undergraduate programme of Science Teaching, Faculty of Education of a university in the Western Black Sea Region in the spring semester of the academic year 2016–2017. A form consisting of three open-ended questions was used as a data collection tool during the study. The data acquired were analyzed through content analysis method. Following the study, 15 different metaphors created in relation to the LEGO robotic instructional practices concept were categorized as ‘edutainment tool,’ ‘a technological tool’ and a ‘development tool,’ while 24 different metaphors created in relation to the augmented reality concept were categorized as ‘Perception Of Reality’, ‘A Technological Tool’, ‘Change/Transformation Tool’ and ‘Entertainment Tool’. Moreover, 25 different metaphors created in relation to the flipped classroom concept were classified in two categories as a ‘form of education’ and ‘an education shaping tool’. Moreover, almost all of the metaphors created were observed to have positive features.
Reliability and concurrent validity of a functional electromechanical dynamometer device for the assessment of movement velocity
Authors: Rodriguez-Perea Ángela , Jerez-Mayorga Daniel , García-Ramos Amador , Martínez-García Dario , Chirosa Ríos Luis J
Published: January 2021

The aims of the study were (i) to determine the reliability and concurrent validity of a functional electromechanical dynamometer (FEMD) to measure different isokinetic velocities, and (ii) to identify the real range of isokinetic velocity reached by FEMD for different prescribed velocities. Mean velocities were collected simultaneously with FEMD and a linear velocity transducer (LVT) in two sessions that were identical, consisting of 15 trials at five isokinetic velocities (0.40, 0.60, 0.80, 1.00, and 1.20 m·s−1) over a range of movement of 40 cm. The results obtained using each method were compared using Paired samples t-tests, Bland-Altman plots and the Pearson’s product–moment correlation coefficient, while the reliability was determined using the standard error of measurement and coefficient of variation (CV). The results indicate that the mean velocity values collected with FEMD and LVT were practically perfect correlations ( r > 0.99) with low random errors (<0.06 m·s−1), while mean velocity values were systematically higher for FEMD ( p < 0.05). FEMD provided a high or acceptable reliability for mean velocity (CV ≤ 0.24%), time to reach the isokinetic velocity (CV range = 1.68%–9.70%) and time spent at the isokinetic velocity (CV range = 0.53%–8.94%). These results suggest that FEMD offers valid and reliable measurements of mean velocity during a fixed linear movement, as well as a consistent duration of the isokinetic phase. FEMD could be an appropriate device to evaluate movement velocity during linear movements. More studies are needed to confirm the reliability and validity of FEMD to measure different velocity metrics during more complex functional exercises.
Inducing moral elevation in veterans with PTSD: An experimental investigation using a mixed methods approach
Authors: McGuire Adam P. , Mignogna Joseph
Published: January 2021

Moral elevation is a positive emotion described as feeling inspired by others’ virtuous actions. Elevation has several psychosocial benefits, some of which may be relevant to trauma-related distress; however, past studies have primarily examined elevation in nonclinical, civilian populations or in naturalistic studies. This experimental study used mixed methods to assess if veterans with post-traumatic stress disorder (PTSD) experience elevation when exposed to elevation stimuli in a controlled setting. Participants included 47 veterans with significant PTSD symptoms. Following baseline measures and a written trauma narrative, veterans were randomized to an elevation or amusement condition where they viewed two videos intended to elicit the condition emotion. Veterans also provided a written journal response describing their reaction to the videos. Self-report measures were administered after each study task to assess state-level elevation and amusement. Veterans randomized to the elevation condition reported significantly higher levels of elevation after videos compared to veterans in the amusement condition. Qualitative results offered further support for differences between groups and identified unique themes related to the experience of elevation. Overall, findings indicate it is possible to induce elevation in veterans with significant PTSD symptoms. Additionally, qualitative results highlight specific benefits of elevation and potential targets for treatment integration and future exploration.
Major post-prostate biopsy complications under antibiotic augmentation prophylaxis protocol
Authors: Rodrigues Antônio Antunes , Muglia Valdair , de Albuquerque Emanuel Veras , Mori Rafael Ribeiro , Feres Rafael Neuppmann , Nogueira André Beluso , e Almeida Vanessa Soares de Oliveira , Freire Guilherme Carvalho , Santos Henrique Amorim , dos Santos Sandra Conceição , Cologna Adauto José , Tucci Jr Silvio , dos Reis Rodolfo Borges
Published: January 2021

Objective:

To identify risk factors for major post-biopsy complications under augmented prophylaxis protocol. The risk factors already described mainly comprise outdated antibiotic prophylaxis protocols.

Material and methods:

This retrospective cohort study included patients that underwent transrectal ultrasound-guided biopsies, from 2011 to 2016. All patients had received antibiotic prophylaxis with ciprofloxacin and gentamicin. Patients were grouped according to the presence or absence of post-biopsy complications. Demographic variables and possible risk factors based on routine clinical assessment were registered. Correlation tests, univariate and multivariate analyses were used to identify risk factors for post-biopsy complications.

Results:

Of the 404 patients that were included, 25 (6.2%) presented 27 post-biopsy complications, distributed as follows: acute urinary retention ( n = 14, 3.5%), infections ( n = 11, 2.7%) and hemorrhage ( n = 2, 0.5%). On univariate analysis, patients who presented complications showed higher body mass index and post-voiding residual volumes. Multivariate analysis identified ethnicity and prostate-specific antigen (PSA) density as possible risk factors for biopsy complications. The presence of bacterial resistance identified by rectal swabs did not correlate with the incidence of complications and infections.

Conclusions:

Non-infectious post-biopsy complications were more frequent than infectious ones in this cohort. Higher post-voiding residual volumes and PSA density, that indicates prostate enlargement, were identified as risk factors and interpreted as secondary to bladder outlet obstruction. The higher body mass index and ethnicity were also identified as risk factors and attributed to the heterogeneity of the patients included.

Level of evidence:

Not applicable for this multicentre audit.
Bentall and redo-Konno Operation for an Adult With Aortic Paraprosthetic Leak and Root Aneurysm
Authors: Shinkawa Takeshi , Nakayama Yuki , Nishinaka Tomohiro , Niinami Hiroshi
Published: January 2021

We report a case of Bentall and redo-Konno operation. A 39-year-old male with surgical history of Konno operation presented with hemolytic anemia and heart failure. Further evaluations revealed aortic paraprosthetic leak with moderate regurgitation, moderate biventricular outflow tract obstruction, and aortic root aneurysm. During the operation, the old Konno septoplasty patch with organized thrombus and the severely calcified right ventricular patch were replaced, and the aortic root was replaced with a larger mechanical valve in a Valsalva graft. Postoperative images showed appropriately reconstructed biventricular outflow tracts. The Bentall operation with redo-Konno was an excellent option in this situation.
A Review of the Surgical Management of Aorto-ventricular Tunnels
Authors: Chowdhury Ujjwal Kumar , Anderson Robert H. , George Niwin , Singh Sukhjeet , Sankhyan Lakshmi Kumari , Pradeep Doniparthi , Chauhan Abhinavsingh , Sengupta Sanjoy , Vaswani Prateek
Published: January 2021

We present a synthesis of 95 published investigations of the exceedingly rare tunnels that can exist between the aortic root and the left or right ventricles. From the 220 suitable cases included in these investigations, we reviewed the clinical presentations, modalities used for diagnosis, surgical approaches, and outcomes. Diagnostic information was provided by clinical presentation, radiographic findings, saline contrast echocardiography, computed tomographic angiocardiography, magnetic resonance imaging, cardiac catheterization, and angiocardiography. These techniques elucidated the coronary arterial origins and associated defects and defined the disease before surgery. Patients occasionally present with an asymptomatic cardiac murmur and cardiomegaly, but most suffer cardiac failure in the first year of life when the tunnel enters the left ventricle. Antenatal diagnosis by fetal echocardiography is reliable after 18 weeks of gestation. Associated defects, involving the proximal coronary arteries or the aortic or pulmonary valves, are present in nearly half the cases. Prompt diagnosis and surgical repair are important for a favorable outcome. Overall, operative mortality has been cited to be between 3% and 8.3%. Associated congenital coronary arterial anomalies, residual severe aortic stenosis, poor left ventricular function, and rupture of an infected suture line have been the reported causes of death. Despite early surgical intervention, an incidence of 16% to 60% postoperative residual aortic regurgitation of varying severity has been reported. The requirement of further repair or replacement of the aortic valve ranges from 0% to 50%. We submit that an increased appreciation of these details relative to the tunnels will contribute to improved surgical management.
Children at the Heart of Global Cardiac Surgery: An Advocacy Stakeholder Analysis
Authors: Vervoort Dominique , Zheleva Bistra , Jenkins Kathy J. , Dearani Joseph A.
Published: January 2021

One in a hundred babies, or 1.3 million per year around the world, are born with congenital heart defects (CHD), of which over 70% will require medical or surgical treatment within their first year of life. In low- and middle-income countries, the majority does not receive the treatment they need or receive suboptimal care. Despite a higher pediatric cardiac surgical disease burden, low-income countries only have 0.07 pediatric cardiac surgeons per million pediatric population, compared to 9.51 per million in high-income countries. Here, we perform a stakeholder analysis of existing advocacy bodies within the field of pediatric global cardiac surgery and identify gaps and opportunities in advocating for cardiac care for children with CHD. We propose a framework to optimize civil society messaging in order to more effectively advocate domestically and internationally to hold national and international policy makers accountable for existing gaps and disparities in CHD care around the world.
The Effect of Confirmation of Nation Brand Image in International Tourism Advertisement on Travel Intention of Foreign Tourists: The Case of Korean ITA for Chinese Tourists
Authors: Lee Un-Kon
Published: January 2021

With the rapid growth of the international tourism industry, governments and tourism promotion agencies in various countries challenge to make more attractive international tourism advertisement (ITA) for foreign tourists to visit their countries. However, there may be difference in the degree to which each travel advertisement reflects the nation brand image. In some ITA cases, foreign tourists could not vividly highlight the unique images of the destination countries. Few studies have empirically validated the impact of confirmation of nation brand image in ITA on the tourist’s responses. This study challenged to empirically examine how the fit between the ITA contents and nation brand image affects the travel intentions of foreign tourists. I developed my research model based on the literature of country image, brand advertisement fit model, and expectation confirmation theory. I conducted the quasi-experiment by using 4 examples of ITA which reflect 4 unique images of Korea (i.e. K-Food, Korean wave, shopping, hot place) compared with other countries. Totally 276 valid data were collected and analyzed using the partial least squares (PLS) algorithm. The results indicate that confirmation of nation brand image in ITA significantly increase perceived usefulness, perceived enjoyment. These changes could increase tourist’s satisfaction, ITA adoption intention, destination visit intention, and E-word of mouth intention. The findings of this study could contribute to identify the impacts on the nation brand image in ITA and could provide practical lessons on how to make more persuasive ITA.
Anatomic reconstruction of the anterior cruciate ligament of the knee with or without reconstruction of the anterolateral ligament: A meta-analysis
Authors: Yin Jianjian , Yang Kaiyuan , Zheng Dong , Xu Nanwei
Published: January 2021

Purpose:

To systematically analyze the effectiveness between combined anterior cruciate ligament and anterolateral ligament reconstruction (ACL+ALLR) and isolated anterior cruciate ligament reconstruction (ACLR) for treatment of patients with injured ACL.

Methods:

We performed a systematic search in MEDLINE, EMBASE, PubMed, Web of Science, Cochrane databases, Chinese Biomedical Literature Database, CNKI, and Wanfang Data for all relevant studies. All statistical analysis was performed using Review Manager version 5.3.

Results:

A total of six articles with 460 study subjects were included, with 193 patients in ACL+ALL reconstruction group and 267 patients in ACL reconstruction group. The results of the meta-analysis showed that the ACL+ALL reconstruction group had significantly lower KT measured value (P < 0.00001), Lachman test positive-rate (P = 0.02), Pivot-shift test positive-rate (P < 0.00001) and graft rupture rate (P = 0.02) compared with the ACL reconstruction group. Higher IKDC score ( P < 0.00001) and Lysholm score ( P < 0.00001) were measured in ACL+ALL reconstruction group, while infection rate ( P = 0.86) and other complications rate ( P = 0.29) showed no significant differences between the two groups.

Conclusions:

Anatomic reconstruction of the ACL of the knee with reconstruction of the ALL indicates better postoperative knee function and clinical outcomes compared with isolated ACL reconstruction. The infection rate and other complications rate showed no significant difference between two groups.
Interleukin-6, C-reactive protein, fibrinogen, and risk of recurrence after ischaemic stroke: Systematic review and meta-analysis
Authors: McCabe JJ , O’Reilly E , Coveney S , Collins R , Healy L , McManus J , Mulcahy R , Moynihan B , Cassidy T , Hsu F , Worrall B , Murphy S , O’Donnell M , Kelly PJ
Published: January 2021

Background

Recent randomised trials showed benefit for anti-inflammatory therapies in coronary disease but excluded stroke. The prognostic value of blood inflammatory markers after stroke is uncertain and guidelines do not recommend their routine measurement for risk stratification.

Methods

We performed a systematic review and meta-analysis of studies investigating the association of C-reactive protein (CRP), interleukin-6 (IL-6) and fibrinogen and risk of recurrent stroke or major vascular events (MVEs). We searched EMBASE and Ovid Medline until 10/1/19. Random-effects meta-analysis was performed for studies reporting comparable effect measures.

Results

Of 2,515 reports identified, 39 met eligibility criteria (IL-6, n = 10; CRP, n = 33; fibrinogen, n = 16). An association with recurrent stroke was reported in 12/26 studies (CRP), 2/11 (fibrinogen) and 3/6 (IL-6). On random-effects meta-analysis of comparable studies, CRP was associated with an increased risk of recurrent stroke [pooled hazard ratio (HR) per 1 standard-deviation (SD) increase in loge-CRP (1.14, 95% CI 1.06–1.22, p < 0.01)] and MVEs (pooled HR 1.21, CI 1.10–1.34, p < 0.01). Fibrinogen was also associated with recurrent stroke (HR 1.26, CI 1.07–1.47, p < 0.01) and MVEs (HR 1.31, 95% CI 1.15–1.49, p < 0.01). Trends were identified for IL-6 for recurrent stroke (HR per 1-SD increase 1.17, CI 0.97–1.41, p = 0.10) and MVEs (HR 1.22, CI 0.96–1.55, p = 0.10).

Conclusion

Despite evidence suggesting an association between inflammatory markers and post-stroke vascular recurrence, substantial methodological heterogeneity was apparent between studies. Individual-patient pooled analysis and standardisation of methods are needed to determine the prognostic role of blood inflammatory markers and to improve patient selection for randomised trials of inflammatory therapies.
Joint displays for qualitative-quantitative synthesis in mixed methods reviews
Authors: Younas Ahtisham , Inayat Shahzad , Sundus Amara
Published: January 2021

Mixed methods reviews offer an excellent approach to synthesizing qualitative and quantitative evidence to generate more robust implications for practice, research, and policymaking. There are limited guidance and practical examples concerning the methods for adequately synthesizing qualitative and quantitative research findings in mixed reviews. This paper aims to illustrate the application and use of joint displays for qualitative and quantitative synthesis in mixed methods reviews. We used joint displays to synthesize and integrate qualitative and quantitative research findings in a segregated mixed methods review about male nursing students' challenges and experiences. In total, 36 qualitative, six quantitative, and one mixed-methods study was appraised and synthesized in the review. First, the qualitative and quantitative findings were analyzed and synthesized separately. The synthesized findings were integrated through tabular and visual joint displays at two levels of integration. At the first level, a statistics theme display was developed to compare the synthesized qualitative and quantitative findings and the number of studies from which the findings were generated. At the second level, the synthesized qualitative and quantitative findings supported by each other were integrated to identify confirmed, discordant, and expanded inferences using generalizing theme display. The use of two displays allowed in a robust and comprehensive synthesis of studies. Joint displays could serve as an excellent method for rigorous and transparent synthesis of qualitative and quantitative findings and the generation of adequate and relevant inferences in mixed methods reviews.
A frequency-dependent ground-motion spatial correlation model of within-event residuals for Fourier amplitude spectra
Authors: Wang Nan , Olsen Kim B , Day Steven M
Published: January 2021

Ground motion time series recorded at stations separated by up to about 50 km show a frequency-dependent spatial coherency structure, and the corresponding ground motion intensity measures are found to be correlated. As omitting this correlation can result in underestimation of seismic losses in risk analysis, it is critical to quantify the spatial correlation structure for ground motion Fourier spectra estimated at different sites during a single event within a region. Toward this goal, we have developed an empirical frequency-dependent spatial correlation model for the within-event residuals of effective Fourier amplitude spectra from the Pacific Earthquake Engineering Research Center (PEER) Next Generation Attenuation (NGA) West2 database. The correlation model shows slower decrease of the spatial correlation with distance at lower frequencies compared with higher frequencies, in agreement with the underlying ground motion data, and no significant dependence on the magnitude of the earthquakes is observed. We use this empirical model to incorporate frequency-dependent spatial correlation into a hybrid deterministic-stochastic broadband ground motion generation module, which successfully generates synthetic time series for seven western US earthquakes with frequency-dependent spatial correlation that closely mimics that of the empirical model. Furthermore, the method also significantly improves the correlation for spectral accelerations, cumulative absolute velocities, and Arias intensities, compared with that derived from the original broadband module.