bluuebunny/crossref_metadata_2025 huggingface dataset:
Training tom cats for semen collection using an artificial vagina: a retrospective study
Authors: Ackermann Camila L , Lopes Maria D
Published: March 2020

Objectives

Owing to the lack of literature on training cats to use an artificial vagina (AV), we performed a retrospective study on the success of training tom cats for semen collection using an AV.

Methods

Records from training 20 cats (2009 until 2019) for semen collection using AVs were analyzed. Sexual preferences, behavior towards humans, queens and other tom cats, as well as libido, number of training sessions and rate of success were observed. Data are presented as percentages and the results are described subjectively.

Results

In 85% of tom cats, collection using an AV was performed successfully. Training was unsuccessful when libido was low or absent. Behavior towards humans did not interfere with the success rate, while libido did.

Conclusions and relevance

Most tom cats can be successfully trained to have semen collected using an AV; the number of training sessions required depends on the male’s libido and the technician’s experience.
Fluorescein angiography versus optical coherence tomography angiography: FA vs OCTA Italian Study
Authors: Savastano Maria Cristina , Rispoli Marco , Lumbroso Bruno , Di Antonio Luca , Mastropasqua Leonardo , Virgili Gianni , Savastano Alfonso , Bacherini Daniela , Rizzo Stanislao
Published: March 2020

Purpose:

To assess the current role of fluorescein angiography after the introduction of optical coherence tomography angiography in real-life clinical practice.

Methods:

This was a multicentric retrospective observational study to evaluate the number of fluorescein angiography and optical coherence tomography angiography procedures performed by different devices from January 2013 to December 2018. The centers involved were Centro Italiano Macula (Rome), and ophthalmology departments of University “G. D’Annunzio” Chieti–Pescara (Chieti) and “Azienda Ospedaliero Universitaria Careggi” (Florence).

Results:

Out of 19,898 total fluorescein angiography procedures performed in the observation period, 3444 (17.3%) were in 2013, 3972 (19.9%) were in 2014, 3601 (18.1%) were in 2015, 3407 (17.2%) were in 2016, 3285 (16.5%) were in 2017, and 2189 (11%) were in 2018. Out of 7949 optical coherence tomography angiography procedures performed in the observation period, none were performed in 2013, 550 (6.9%) were in 2014, 908 (11.5%) were in 2015, 2098 (26.4%) were in 2016, 2090 (26.3%) were in 2017, and 2303 (28.9%) were in 2018.

Conclusion:

Fluorescein angiography procedures were performed less often after the introduction of optical coherence tomography angiography technology. The ease, speed, and safety of the optical coherence tomography angiography procedure in everyday clinical practice have facilitated more optical coherence tomography angiography application compared to fluorescein angiography in recent years. In the future, we will probably evaluate the different pathologies that still need an evaluation by fluorescein angiography.
Theoretical investigation of surface texture effects on the performance characteristics of hydrodynamic two-lobe journal bearing
Authors: Singh Niranjan , Awasthi RK
Published: March 2020

In the present work, theoretical investigation has been performed to predict the influence of spherical textures on the performance characteristics of two-lobe journal bearing system. The flow of lubricant in the clearance space between the bearing and the journal is governed by the Reynolds equation assuming the flow is Newtonian and isoviscous. The Reynolds equation is solved using a finite element method and the static performance parameters of circular/two-lobe smooth/textured journal bearing system have been computed with variation in eccentricity ratio, dimple depth and its location. The numerically simulated results reveal that the partial surface texturing can provide better performance when the textures are created in the pressure build-up region of 126°–286° and the dimple aspect ratio is nearly 1.0.
The multiple sclerosis prodrome: Emerging evidence, challenges, and opportunities
Authors: Tremlett Helen , Marrie Ruth Ann
Published: March 2020

A prodrome is considered an early set of signs or symptoms indicating the onset of a disease or illness. In multiple sclerosis (MS), the prodromal period is the months or years before our current, classic understanding of “MS symptom onset.” Prodromal periods are well recognized in other neurodegenerative conditions and more recently have been shown in MS. In this Viewpoint, we reflect on the emerging evidence surrounding the MS prodrome, including features that may be common across chronic inflammatory and neurodegenerative diseases. Finally, we discuss the implications for future disease prevention in MS.
Effects of lightweight gear blank on noise, vibration and harshness for electric drive system in electric vehicles
Authors: Hou Liguo , Lei Yulong , Fu Yao , Hu Jianlong
Published: March 2020

In this paper, effects of lightweight gear blank on static and dynamic behavior for electric drive system in electric vehicles are studied. First, a hybrid finite element-analytical method is proposed in this paper to establish gear load contact analysis model considering the structure of lightweight gear blank, which can balance the computing speed and numerical accuracy. Second, this paper establishes a rigid-flexible coupled dynamic model of electric drive system considering shaft elasticity, bearing stiffness, and housing flexibility. Finally, aiming at the noise, vibration, and harshness problem of an electric drive system equipped on electric vehicles, effects of gear web and gear rim thickness on noise, vibration, and harshness excitation source such as static transmission error and dynamic meshing force as well as dynamic response at bearings and housing are analyzed. The results show that changing gear web and gear rim thickness can significantly reduce dynamic meshing force and dynamic response. Compared with solid gear, dynamic meshing force is reduced by 68.50%, and dynamic response is reduced by 66.70% after optimization, thereby significantly improving the noise, vibration, and harshness performance of gear transmission system in electric vehicles.
‘A journalism of fear’
Authors: Anderson Chris W
Published: March 2020

What should journalism do, and for what reasons should it do it? The starting point of this article is that two distinct but converging factors have made this question increasingly hard to answer. On one hand, the seemingly perpetual crisis in newsroom capacity has made it hard to sustain a maximalist normative conception of what journalism should accomplish. On the other hand, the globalization of journalism studies research has problematized the assumed link between journalism and democracy. In response, this article outlines a new normative journalistic ideal, grounded in the political theory of the late Judith Shklar – a ‘journalism of fear’. Under this model, the link between journalism and liberalism is asserted over and above the link between journalism and democracy. Drawing on Shklar, the journalism of fear contends that the worst of all evils is cruelty, and the purpose of journalism is to minimize that cruelty. The article elaborates Shklar’s thinking by comparing her perspective on a number of issues to those of a far more familiar political philosopher, John Dewey. It concludes by looking at what a journalism of fear would look like in practice by briefly discussing newsroom responses to the Windrush scandal in the United Kingdom.
Measurement invariance and nomological validity of theAttributional Complexity Scale: Evidence from Estonia, France, India, United States, and Vietnam
Authors: Lakshman C , Vo Linh Chi , Ramaswami Aarti
Published: March 2020

International Business researchers have recently become interested in attributional complexity (AC) in the context of cross-cultural leadership effectiveness. Despite this recent surge in interest in this construct, we know very little about its measurement properties in cross-cultural situations. Given that attributions vary across cultures, verifying the validity (measurement invariance and nomological validity) of the Attributional Complexity Scale (ACS) is a research imperative. In study I, we examine the measurement invariance of ACS using a reduced version of the original scale (ACS-18) in five countries. The results suggest that the ACS shows metric invariance in that it has a similar factor structure across the five societies examined and in two other independent samples. In study II (France), we provide evidence of AC’s predictive validity based on its relationship to a key construct in its nomological network, namely, isomorphic attribution. In study III (United States), we provide additional evidence of nomological validity by showing the relationship between AC and biculturalism. Our results demonstrate the importance of AC and imply that researchers in cross-cultural contexts can safely use the ACS-18 without risking substantive misinterpretation. We discuss results, future research directions, implications, and limitations of the study.
Prioritizing Competencies for “Research” Promotores and Community Health Workers
Authors: Nebeker Camille , Giacinto Rebeca Espinoza , Pacheco Blanca Azucena , López-Arenas Araceli , Kalichman Michael
Published: March 2020

Background. The community health worker (CHW) model is utilized globally to promote health and reduce health disparities in hard-to-reach and underserved communities. The model is deemed successful due to involvement of these natural helpers who are familiar with the local customs, language, and traditions. “Research” CHWs (also known as promotores) serve as cultural mediators between their community and academic researchers and are increasingly involved in the design and implementation of research; yet few of these individuals have received formal training in research methods or ethics. This study identified requisite skills and knowledge needed by research CHWs. Method. Investigators who utilized the CHW/promotor model were recruited to complete a survey and participate in one of four focus group sessions. Participants identified (1) research roles, (2) training received, (3) research competencies, (4) training barriers and facilitators, and (5) assessment preferences. Results. Participants ( n = 20) completed a survey with 19 also participating in a focus group session. All participants involved CHWs in research implementation, with nearly half involving CHWs in the study design and/or dissemination of findings phases. Critical thinking skills and application of ethical principles (e.g., demonstrating respect) were prioritized over knowledge of research infrastructure (e.g., institutional review board/ethics review process). Research ethics training designed for academic researchers was deemed inappropriate because sophisticated terminology and web-based delivery were perceived as an access barrier. Self-assessment and contextualized scenarios were recommended to assess critical thinking. Conclusions. Researchers using the CHW model should provide relevant and accessible research competency training.
Making Sense of Abstract Board Games: Toward a Cross-Ludic Theory
Authors: Danilovic Sandra , de Voogt Alex
Published: March 2020

The frequent absence of culturally specific, figurative, or decorative markings in abstract board games has challenged theorizations that assume a meaningful representation in the study of games. In accepting this challenge, this article theorizes the historical phenomenon of abstract board games whose nonrepresentational board design and formal rules have transmitted with little change over millennia and across vast expanse. A theoretical framework is outlined for understanding abstract board games—a modular ontology of abstract board games and a typology of player meaning-making in abstract board games. It is argued that the reproducibility and transferability of abstract board games as self-sufficient and reliable formal systems that players share independently from culturally specific meanings and materials may contribute to their dispersal. It is in this interaction between the cross-cultural/reliable and local/variable semantic structures of abstract board games that game studies from a historical or archaeological perspective may meet literary and social science perspectives.
Switching from Thoracoscopic to Robotic Platform for Lobectomy: Report of Learning Curve and Outcome
Authors: Lee Eric C. , Lazzaro Richard S. , Glassman Lawrence R. , Singh Vijay A. , Jurado Julissa E. , Hyman Kevin M. , Patton Byron D. , Zeltsman David , Scheinerman Jacob S. , Hartman Alan R. , Lee Paul C.
Published: March 2020

Objective

The optimal minimally invasive surgical management for patients with non-small-cell lung cancer (NSCLC) is unclear. For experienced video-assisted thoracoscopic surgery (VATS) surgeons, the increased costs and learning curve are strong barriers for adoption of robotics. We examined the learning curve and outcome of an experienced VATS lobectomy surgeon switching to a robotic platform.

Methods

We conducted a retrospective review to identify patients who underwent a robotic or VATS lobectomy for NSCLC from 2016 to 2018. Analysis of patient demographics, perioperative data, pathological upstaging rates, and robotic approach (RA) learning curve was performed.

Results

This study evaluated 167 lobectomies in total, 118 by RA and 49 by VATS. Patient and tumor characteristics were similar. RA had significantly more lymph node harvested (14 versus 10; P = 0.004), more nodal stations sampled (5 versus 4; P < 0.001), and more N1 nodes (8 versus 6; P = 0.010) and N2 nodes (6 versus 4; P = 0.017) resected. With RA, 22 patients were upstaged (18.6%) compared to 5 patients (10.2%) with VATS ( P = 0.26). No differences were found in perioperative outcome. Operative time decreased significantly with a learning curve of 20 cases, along with a steady increase in lymph node yield.

Conclusions

RA can be adopted safely by experienced VATS surgeons. Learning curve is 20 cases, with RA resulting in superior lymph node clearance compared to VATS. The potential improvement in upstaging and oncologic resection for NSCLC may justify the associated investments of robotics even for experienced VATS surgeons.
Understanding the Experiences of Young Children on the Autism Spectrum as They Navigate the Irish Early Years’ Education System: Valuing Voices in Child-Centered Narratives
Authors: O’Leary Sarah , Moloney Mary
Published: March 2020

This article, which focuses upon narrative inquiry as a means of including the voice and experience of children on the autism spectrum, draws upon a doctoral study that explores the experiences of young children as they and their families navigate the Irish Early Years’ Education System (both preschool and primary school). It focuses, in particular, on the need to acknowledge and appreciate the experiences of these children within their homes and educational settings, their immediate microsystem. It also urges an increased awareness of how the development of these children’s voices is heavily impacted by the roles and actions of others. Six parents shared stories of navigating the Irish Early Years’ Education System with their young child on the autism spectrum. Their children’s voices were incorporated into these narratives using visual storytelling methods. This research adopted an ecological or intercontextual interpretive stance, thus providing valuable insight into the coconstructed experiences of those who identify as “different” or “other,” in this instance, young children on the autism spectrum and their families. In terms of the present article, this ecological stance encompasses the central aim of the overarching study; the critical restorying of parents’ lived experiences of navigating the Irish Early Years’ Education System with their child on the autism spectrum which is thus, underpinned by narrative inquiry and voice.
A unique case of Lemierre’s syndrome status post blunt cervical trauma
Authors: Denesopolis John M , Medicherla Singh Ratna C , Shah Amit R , Lyon Ross , Chao Edward , Hochsztein Jay G , Rivera Aksim
Published: March 2020

Background

Lemierre’s syndrome is a rare but potentially fatal condition. The course is characterized by acute tonsillopharyngitis, bacteremia, internal jugular vein thrombosis, and septic embolization. There have been some cases secondary to penetrating trauma to the neck. Literature review has yielded no cases secondary to blunt neck trauma in the absence of oropharyngeal injury. We aim to shed light on this unique cause of Lemierre’s syndrome, so as to raise the index of suspicion for clinicians working up patients with blunt cervical trauma.

Methods

We present a case of a 25-year-old male restrained driver who presented with left neck and shoulder pain with a superficial abrasion to the left neck from the seatbelt who was discharged same day by the Emergency Room physicians. He returned to the Emergency Department two days later with abdominal pain. As a part of his repeat evaluation, a set of blood cultures were sent and was sent home that day. The patient was called back to the hospital one day later as preliminary blood cultures were positive for Gram positive cocci and Gram negative anaerobes. Computerized tomography scan of the neck revealed extensive occlusive left internal jugular vein thrombosis and fluid collections concerning for abscesses, concerning for septic thrombophlebitis. The patient continued to decompensate, developing severe sepsis complicated by disseminated intravascular coagulation.

Results

The patient underwent a left neck exploration with en bloc resection of the left internal jugular vein, drainage of abscesses deep to the sternocleidomastoid, and washout/debridement of necrotic tissue. Direct laryngoscopy at the time of surgery revealed no injury to the aerodigestive tract. Wound cultures were consistent with blood cultures and grew Fusobacterium necrophorum, Staphylococcus epidermidis, and Methicillin-resistant staphylococcus aureus. The patient underwent two subsequent operative wound explorations without any evidence of residual infection. The patient was discharged home on postoperative day 13 on a course of antibiotics and aspirin.

Conclusion

This case illustrates the importance of diagnosis of Lemierre’s syndrome after an unconventional inciting event (blunt cervical trauma) and appropriate treatment.
The association between aortic arterial stiffness, carotid intima-media thickness and carotid plaques in community-dwelling older adults: A population-based study
Authors: Del Brutto Oscar H , Del Brutto Victor J , Mera Robertino M , Costa Aldo F , Peñaherrera Rubén , Peñaherrera Ernesto , Matcha Gautam , Generale Laura M , Torpey Andrew P , Peralta Leslie D , Hill John P , Rundek Tatjana , Romano José G , Sedler Mark J
Published: March 2020

Objective

Information on the associations among arterial stiffness, carotid intima-media thickness (cIMT) and carotid plaques as biomarkers of atherosclerosis is limited in diverse populations. We aimed to assess whether aortic pulse wave velocity (aPWV) – as a surrogate of arterial stiffness – is associated with increased cIMT and the presence of carotid plaques in a cohort of older adults of Amerindian ancestry.

Methods

Atahualpa residents aged ≥60 years ( n = 320) underwent aPWV determinations, and carotid ultrasounds for cIMT and plaque assessment. Multivariate models were fitted to assess the independent association between the aPWV, and cIMT and carotid plaques, after adjusting for relevant confounders. Differences in risk factors across these biomarkers were investigated.

Results

Mean values of aPWV were 10.3 ± 1.8 m/s, and those of cIMT were 0.91 ± 0.21 mm (24% had a cIMT >1 mm). Carotid plaques were observed in 118 (37%) subjects. In univariate analyses, risk factors associated with an increased aPWV included age, female gender, poor physical activity and high blood pressure. An increased cIMT was associated with age, male gender, a poor diet, high blood pressure and severe tooth loss. The presence of carotid plaques was associated with increasing age, poor physical activity and high blood pressure. Multivariate models showed a significant association between aPWV and cIMT (β: 0.028; 95% C.I.: 0.001–0.056; p =  0.047) but not between aPWV and carotid plaques (OR: 1.14; 95% C.I.: 0.83–1.56; p =  0.423).

Conclusions

This study shows an independent association between aPWV and cIMT but not with carotid plaques. These biomarkers may indicate distinct phenotypes for atherosclerosis.
Increase of wall shear stress caused by arteriovenous fistula reduces neointimal hyperplasia after stent implantation in healthy arteries
Authors: Liu Chong Dong , Chen Feng
Published: March 2020

Background and objectives

Wall shear stress plays a critical role in neointimal hyperplasia after stent implantation. It has been found that there is an inverse relation between wall shear stress and neointimal hyperplasia. This study hypothesized that the increase of arterial wall shear stress caused by arteriovenous fistula could reduce neointimal hyperplasia after stents implantation.

Methods and results

Thirty-six male rabbits were randomly divided into three groups: STENT, rabbits received stent implantation into right common carotid artery; STENT/arteriovenous fistula, rabbits received stent implantation into right common carotid artery and carotid-jugular arteriovenous fistula; Control, rabbits received no treatment. After 21 days, stented common carotid artery specimens were harvested for histological staining and protein expression analysis. In STENT group, wall shear stress maintained at a low level from 43.2 to 48.9% of baseline. In STENT/arteriovenous fistula group, wall shear stress gradually increased to 86% over baseline. There was a more significant neointimal hyperplasia in group STENT compared with the STENT/arteriovenous fistula group (neointima area: 0.87 mm2 versus 0.19 mm2; neointima-to-media area ratio: 1.13 versus 0.18). Western blot analysis demonstrated that the protein level of endothelial nitric oxide synthase in STENT group was significantly lower than that in STENT/arteriovenous fistula group, but the protein levels of proliferating cell nuclear antigen, vascular cell adhesion molecule 1, phospho-p38 mitogen-activated protein kinase (Pp38), and phospho-c-Jun N-terminal kinase in STENT group were significantly higher than that in the STENT group.

Conclusion

High wall shear stress caused by arteriovenous fistula as associated with the induction in neointimal hyperplasia after stent implantation. The underlying mechanisms may be related to modulating the expression and activation of endothelial nitric oxide synthase, vascular cell adhesion molecule 1, p38, and c-Jun N-terminal kinase.
Effectiveness of lubratex and vitamin A on ocular surface disorders in ICU patients: A randomized clinical trial
Authors: Badparva Mitra , Veshagh Mohammad , Khosravi Farideh , Mardani Abbas , Ebrahimi Hossein
Published: March 2020

Background

High prevalence of ocular surface disorders includes eye dryness and corneal ulcer among intensive care unit patients remains an issue. This study aimed to compare the effectiveness of Lubratex ointment and vitamin A eye ointment in preventing ocular surface disorders in intensive care unit patients.

Methods

A single-center randomized clinical trial was conducted in critically ill patients of vitamin A eye ointment and Lubratex ointment in preventing ocular surface disorders. Forty-one eligible patients were randomly assigned to administered vitamin A eye ointment in one eye and Lubratex ointment in the other eye. After five days, using fluorescein and Schirmer's tests, an ophthalmologist examined patients and specified those with ocular surface disorders.

Results

The results showed a significant decrease in the incidence of dry eye ( p ≤ 0.001) and corneal ulcer ( p = 0.002) with the use of Lubratex ointment.

Conclusions

Although Lubratex ointment was more effective than vitamin A ointment in preventing ocular surface disorders, further research is needed to confirm the findings of the present study.
Permits, Points, and Permanent Household Registration: Recalibrating Hukou Policy under “Top-Level Design”
Authors: Wang Xiang
Published: March 2020

China’s New-type Urbanisation Plan heralded a new phase of reform of the household registration ( hukou) system and initiated a nation-wide reconfiguration of hukou policy in Chinese cities. This study reveals that the former localisation of hukou policymaking has been brought to greater uniformity under the current central guidelines. The liberalisation of hukou conversion has been expanded to many large cities that previously employed selective migrant integration policies. Mega-cities have recalibrated the selection criteria for new citizens, elevating the importance of settlement duration and moderating the importance of educational and professional qualifications. Case studies in Guangdong further reveal the dynamic interactions among different levels of government in the course of reform. Local policy experimentations set important precedents for central policymaking, and the central guidelines are enforcing new adjustments in local implementation. The provincial government plays a prominent role in coordinating top-down directives and local conditions.
Investigation of Antioxidant and Elastase Inhibitory Activities of Geum urbanum Aerial Parts, Chemical Characterization of Extracts Guided by Chemical and Biological Assays
Authors: Schmitt Marie , Magid Abdulmagid Alabdul , Nuzillard Jean-Marc , Hubert Jane , Etique Nicolas , Duca Laurent , Voutquenne-Nazabadioko Laurence
Published: March 2020

This study presents the bioguided chemical investigation of the 80% aqueous methanol extract of Geum urbanum aerial parts. Liquid–liquid partitioning of this extract in solvents of increasing polarity combined with biological screening showed that the ethyl acetate (EtOAc) soluble fraction was the most active part of the extract. This fraction was chemically profiled by a 13C nuclear magnetic resonance (NMR)-based dereplication method, resulting in the identification of 14 compounds. The dereplication process was followed by the purification of unknown and minor compounds of the EtOAc fraction. A new glycosylated phenol, namely, 3-(3,4-dihydroxyphenyl)propyl-α-l-rhamnopyranoside, together with 6 known compounds were isolated. Their structures were elucidated by spectroscopic methods including NMR and high-resolution electrospray ionization mass spectrometry. The antioxidant activity of fractions and isolated compounds were evaluated by 2,2,1-diphenyl-1-picrylhydrazyl and hydroxyl radical scavenging, and by cupric ion reducing antioxidant capacity assays. In parallel, their enzyme inhibitory property against human neutrophil elastase was assessed. Four subfractions, essentially containing polyphenols and triterpenes, exhibited a significant elastase inhibitory activity and an ellagitannin showed a very high radical scavenging activity.
Treatment of Adolescent Hallux Valgus With Percutaneous Distal Metatarsal Osteotomy
Authors: Kotlarsky Pavel , Gannot Gil , Katsman Alexander , Eidelman Mark
Published: March 2020

Background. Hallux valgus is a complex deformity of the first ray of the foot, and a significant number of adolescents develop this deformity. More than 130 surgical procedures have been described to treat hallux valgus, but there is no compelling evidence to prefer one method over another. Minimal invasive techniques have been proposed and reported to be successful and cost-effective. The objective of this study was to describe the clinical course of adolescent patients treated with percutaneous distal metatarsal osteotomy. Methods. A retrospective study included patients who had a percutaneous hallux valgus correction during the years 2008 to 2015. The following measurements were compared before surgery up to last follow-up: AOFAS Hallux-Metatarsophalangeal-Interphalangeal questionnaire and radiological measurements (HVA, IMA, DMAA). Any postoperative complications were extracted from the medical records. Results. The procedure was performed on 32 feet (27 patients). All patients were <18 years of age. There were 10 male patients (12 feet) and 17 female patients (20 feet). Average age at surgery was 15.8 years (range = 13-18 years). Average follow-up time was 43 months (range= 24-94 months). The average AOFAS score before surgery was 66, and after surgery, at last follow-up was 96. This difference was significant (P value <.0001). Most patients were pain free after the procedure and returned to appropriate age functioning. Significant improvement was noted in all radiological criteria. Conclusions. Percutaneous distal metatarsal osteotomy is safe, reliable, and effective for the correction of mild to moderate symptomatic hallux valgus in adolescents.

Levels of Evidence: Level IV
Low QRS voltages in Olympic athletes: Prevalence and clinical correlates
Authors: Mango Federica , Caselli Stefano , Luchetti Andreas , Pelliccia Antonio
Published: March 2020

Background

Recently, novel interest in low QRS voltages was prompted by the observation that low QRS voltages are present in arrhythmogenic cardiomyopathy patients, even before occurrence of symptoms/events.

Aim

The purpose of this study was to assess prevalence and clinical correlates of low QRS voltages in Olympic athletes, evaluated and followed-up within our cardiovascular screening programme.

Methods

Five hundred and sixteen athletes consecutively examined (2010–2011) were included in this study. A low QRS voltage was defined as amplitude of QRS <0.5 mV in limb and/or <1.0 mV in precordial leads. Cardiovascular evaluation included 12-lead and exercise electrocardiogram, echocardiography and, selectively, additional tests to conﬁrm diagnosis. Athletes were followed-up for 5 ± 2 (1–9) years.

Results

The majority of athletes (493; 96%) showed normal/increased R/S-wave voltages, but 23 (4%) had low QRS voltages. No differences were observed in low QRS voltage athletes compared to normal/increased QRS voltages for QRS duration, QTc and PR intervals, left ventricular cavity size and mass, or gender and sport participated. However, premature ventricular beats, occurred more frequently in low QRS voltages (39% vs 7%; p < 0.001), with patterns suggesting origin from left or right free wall. No diseases or events were registered in low QRS voltage athletes over the follow-up.

Conclusions

In Olympic athletes, the prevalence of low QRS voltages was 4%. Athletes with low QRS voltages did not differ from other athletes according to sport participated in or cardiac dimensions. However, more frequently (39% vs 7%) they showed premature ventricular beats, originating from either the left or right free ventricular wall. Therefore, long-term follow-up with serial clinical evaluations is needed in low QRS voltage athletes, in order to definitely clarify the clinical significance.
How psychosocial well-being and usage amount predict inaccuracies in retrospective estimates of digital technology use
Authors: Sewall Craig J. R. , Bear Todd M. , Merranko John , Rosen Daniel
Published: March 2020

Using Apple’s Screen Time application to obtain reported actual iPhone and social media (SM) use, we examined the accuracy of retrospective estimates of usage, how inaccuracies bias associations between use and psychosocial well-being (depression, loneliness, and life satisfaction), and the degree to which inaccuracies were predicted by levels of well-being. Among a sample of 325 iPhone users, we found that (a) participants misestimated their weekly overall iPhone and SM use by 19.1 and 12.2 hours, respectively; (b) correlations between estimated use and well-being variables were consistently stronger than the correlations between reported actual use and well-being variables; and (c) the degree of inaccuracy in estimated use was associated with levels of participant well-being and amount of use. These findings suggest that retrospective estimates of digital technology use may be systematically biased by factors that are fundamental to the associations under investigation. We propose that retrospective estimates of digital technology use may be capturing the construct of perceived use rather than actual use, and discuss how the antecedents, correlates, and consequences of perceived use may be distinct from those of actual use. Implications of these findings are discussed in view of the ongoing debate surrounding the effects of digital technology use on well-being.
The ACROSS study: Long-term efficacy of fingolimod in patients with relapsing–remitting multiple sclerosis
Authors: Derfuss T , Sastre-Garriga J , Montalban X , Rodegher M , Wuerfel J , Gaetano L , Tomic D , Azmon A , Wolf C , Kappos L
Published: March 2020

Background

In chronic diseases such as multiple sclerosis requiring lifelong treatment, studies on long-term outcomes are important.

Objective

To assess disability and magnetic resonance imaging-related outcomes in relapsing multiple sclerosis patients from a Phase 2 study of fingolimod 10 or more years after randomization and to compare outcomes in patients who had a higher fingolimod exposure versus those with a lower fingolimod exposure.

Methods

ACROSS was a cross-sectional follow-up study of patients originally enrolled in a Phase 2 fingolimod proof-of-concept study (NCT00333138). Disability and magnetic resonance imaging-related outcomes were assessed in patients grouped according to fingolimod treatment duration, based on an arbitrary cut-off: ≥8 years (high exposure) and <8 years (low exposure).

Results

Overall, 175/281 (62%) patients participated in ACROSS; 104 (59%) of these were classified “high exposure.” At 10 years, patients in the high-exposure group had smaller increases in Expanded Disability Status Scale (+0.55 vs. +1.21), and lower frequencies of disability progression (34.7% vs. 56.1%), wheelchair use (4.8% vs. 16.9%), or transition to secondary progressive multiple sclerosis (9.6% vs. 22.5%) than those in the low-exposure group. The high-exposure patients also had less progression in most magnetic resonance imaging-related outcomes.

Conclusion

After 10 years of fingolimod treatment, disability progression was lower in the high-exposure group than in the low-exposure group.
Humor and the Creative Use of English Expressions in the Speech of University Students: A Case From Jordan
Authors: Salem Essa , Jarrah Marwan , Alrashdan Imran
Published: March 2020

The present study examines the use of English lexical insertions to create humor by Jordanian university students. The data of the study are collected from spontaneous tape-recorded conversations from 62 participants of both males and females, representing different age groups (from 18–23 years old) and belonging to different specializations (e.g., engineering, pharmacy, mathematics, business, and English). The recorded conversations are qualitatively analyzed applying Auer’s sequential approach to code-switching to attain a local interpretation of lexical insertions for humor effect from English into Jordanian Arabic (JA). The findings of the study reveal that Jordanian university students exploit their bilingual repertoire to create humor by playfully and innovatively switching to English. This is shown to take place by unexpected switching points, a switching that flouts Arabic syntactic constraints, a violation of code-switching constraints, incongruity and incompatibility of translating Arabic culture-bound expressions to English, and imposing Arabic word formation templates to English insertions. Specifically, five patterns of code-switching of humor are found, namely, switching around the interrogative, playful affixation, phonological playfulness, haphazard calquing, and the imposition of Arabic morphological rules on English lexical insertions. The study argues that humorous insertions are in fact a marker of solidarity and an in-group membership. Humorous insertions are also shown not to contribute to the content of the message or the pragmatic meaning. Bilingual university students (of Arabic and English) purposefully make use of an additional linguistic resource to mock certain propositions.
The Effects of Serious Leisure Involvement on Subjective Well-Being and Successful Aging: A Case Study of Young-Old Participants in Chinese Seniors’ Universities
Authors: Wu Jin , Li Xi , Gao Bo , Su Xinwei
Published: March 2020

China is the only country with more than 200 million people aged 60 years and above. The Chinese government considers seniors’ universities to be an important form of leisure in which older people spend their free time. To explore the benefits of this education-oriented form of serious leisure, this study investigates the concept of successful aging and tests the effect of serious leisure involvement in seniors’ universities on the subjective well-being and successful aging of “young-old” participants in the context of China. In addition, this study examines the influence of family structure on the relationship between the above variables based on third-place theory. Although limitations to the approach are identified and discussed, the survey results show that the involvement of the aging population in education-oriented serious leisure activities is significantly associated with successful aging and that subjective well-being partially mediates the relationship between serious leisure involvement and successful aging. Furthermore, the relationship between serious leisure involvement and successful aging differs significantly among groups with different family structures.
Health Status and Illness Experiences of Refugee Scavengers in Pakistan
Authors: Malik Beenish , Lyndon Novel , Chin Yew Wong
Published: March 2020

Scavengers are continuously exposed to several health hazards which affect their quality of life. The phenomenon of scavenging in Pakistan is on the rise but literature on scavengers’ health and illness is limited. Hence, this study intends to add to the knowledge by exploring the health status and illness experiences of refugee scavengers using phenomenology approach. Thirty-one adult male Afghan refugee scavengers (with at least 5 years of work experience) were recruited in this qualitative study through purposive sampling. To collect the lived experiences, this study predominantly relied on open-ended, face-to-face, semistructured, and in-depth interviews by using an interview protocol. The qualitative data analyzed with Max van Manen’s hermeneutic phenomenological reflection revealed that all the scavengers were experiencing multiple health problems ranging from minor to chronic illnesses. These health issues were frequent in nature and had affected their overall life mostly daily activities, job, and earnings. The study concludes with the need to increase literacy among scavengers, raise their health awareness and usage of personal protective equipment at work.
Impact of Skilled and Unskilled Labor on Project Performance Using Structural Equation Modeling Approach
Authors: Hussain Shahid , Xuetong Wang , Hussain Talib
Published: March 2020

Construction labors play critical roles in executing the project. Therefore, the purpose of this study is to provide and review using partial least square structural equation modeling (PLS-SEM) approach that the skilled and unskilled labor force impact on project performance which has been overlooked in the previous literature in the context of the public construction industry in developing countries, like Pakistan. To achieve the objective of this study, a hypothetical model was developed and empirically examined by using Structural Equation Modeling. Data were gathered through a questionnaire survey method. In total, 400 construction practitioners responded to the questionnaire on behalf of their organization. The results revealed that unskilled labor has a significant negative impact on project performance during the construction phase, whereas the results confirmed that skilled labors have a significant positive impact on project performance in enhancing the success rate of the project in the public construction industry. These results could be used by construction experts to elaborate a broader and rooted view of the labor skills affecting the project performance. The results provide adequate information to policy and decision makers concerning labor skills being a compulsory part of the operational strategy in accelerating the better execution and success of construction projects. The current study adds to the construction project management literature by examining the effect of labor skills on project performance positively or negatively, and the hypothesized model was developed that should be adopted by practitioners to ascertain labor skills for the successful execution of the project.
Analysis of Leader Effectiveness in Organization and Knowledge Sharing Behavior on Employees and Organization
Authors: Sonmez Cakir Fatma , Adiguzel Zafer
Published: March 2020

The aim of this study is to analyze the relationships between leadership effectiveness, knowledge sharing behavior, business performance, firm strategy, and firm performance. In this study, to reveal the relationships, statistical analyses were applied to the data collected using one-to-one questionnaire techniques while the relationships between the variables were tried to be revealed. In this study, the importance of knowledge sharing behavior and the positive effects of both independent variable and mediator variable on the organization are emphasized. In addition, the positive effect of leadership effectiveness and knowledge sharing behavior on work performance, firm strategy, and firm performance variables was detected. Analysis was made using LISREL, IBM SPSS 23 software program, and SPSS PROCESS V.3 add-in, and confirmatory and explanatory factor analysis and reliability analysis were performed on questions using Likert-type scale. In the analysis of the relationships between variables in the correlation menu of the main menus of SPSS Program, the regression menu was used to test the hypotheses and to reveal the mediation variable effect of the PROCESS V.3 add-in. Confirmatory factor analysis was performed by LISREL program.
Operative Versus Nonoperative Treatment of Acute Achilles Tendon Ruptures: A Pilot Economic Decision Analysis
Authors: Su Alvin W. , Bogunovic Ljiljana , Johnson Jeffrey , Klein Sandra , Matava Matthew J. , McCormick Jeremy , Smith Matthew V. , Wright Rick W. , Brophy Robert H.
Published: March 2020

Background:

The operative treatment of Achilles tendon ruptures has been associated with lower rerupture rates and better function but also a risk of surgery-related complications compared with nonoperative treatment, which may provide improved outcomes with accelerated rehabilitation protocols. However, economic decision analyses integrating the updated costs of both treatment options are limited in the literature.

Purpose:

To compare the cost-effectiveness of operative and nonoperative treatment of acute Achilles tendon tears.

Study Design:

Economic and decision analysis; Level of evidence, 2.

Methods:

An economic decision model was built to assess the cost-utility ratio (CUR) of open primary repair versus nonoperative treatment for acute Achilles tendon ruptures, based on direct costs from the practices of sports medicine and foot and ankle surgeons at a single tertiary academic center, with published outcome probabilities and patient utility data. Multiway sensitivity analyses were performed to reflect the range of data.

Results:

Nonoperative treatment was more cost-effective in the average scenario (nonoperative CUR, US$520; operative CUR, US$1995), but crossover occurred during the sensitivity analysis (nonoperative CUR range, US$224-US$2079; operative CUR range, US$789-US$8380). Operative treatment cost an extra average marginal CUR of US$1475 compared with nonoperative treatment, assuming uneventful healing in both treatment arms. The sensitivity analysis demonstrated a decreased marginal CUR of operative treatment when the outcome utility was maximized, and rerupture rates were minimized compared with nonoperative treatment.

Conclusion:

Nonoperative treatment was more cost-effective in average scenarios. Crossover indicated that open primary repair would be favorable for maximized outcome utility, such as that for young athletes or heavy laborers. The treatment decision for acute Achilles tendon ruptures should be individualized. These pilot results provide inferences for further longitudinal analyses incorporating future clinical evidence.
Examining the Effects of Internal Communication and Emotional Culture on Employees’ Organizational Identification
Authors: Yue Cen April , Men Linjuan Rita , Ferguson Mary Ann
Published: March 2020

As one of the first empirical attempts investigating the emerging role of positive emotional culture within organizations, the study examined how a symmetrical internal communication system and leaders’ use of motivating language contribute to fostering a positive emotional culture featured by joy, companionate love, pride, and gratitude. Furthermore, the study examined the linkage between a positive emotional culture and employees’ organizational identification. A quantitative online survey was conducted with 482 full-time employees in the United States. Results showed that both symmetrical internal communication and leaders’ use of motivating language, including meaning making, empathetic, and direction-giving languages, induced employees’ perception of a positive emotional culture of joy, companionate love, pride, and gratitude, which in turn enhanced employees’ organizational identification. Positive emotional culture fully mediated the impact of corporate and leadership communications on employee identification with the organization. Theoretical and practical implications of the findings are discussed.
Large anterior temporal Virchow–Robin spaces: Evaluating MRI features over the years—Our experience and literature review
Authors: Capasso Raffaella , Negro Alberto , Cirillo Sossio , Iovine Silvia , Puoti Gianfranco , Cirillo Mario , Conforti Renata
Published: March 2020

Dilated Virchow–Robin spaces (VRSs) are expansions of the normal perivascular spaces with a short axis greater than 2 mm or, according to some authors, greater than 3 mm. They are usually documented at the basal ganglia, at the convexity white matter (WM) and centrum semiovale, and at the mesencephalon. The anterior temporal WM is a recently described preferential location for large (≥5 mm) VRSs. The aim of our study was to evaluate the magnetic resonance imaging (MRI) features and their modifications during a long-term follow-up period (≥24 months) of the anterior temporal VRSs with a retrospective analysis among all brain MRI studies performed at our institution between January 2010 and January 2017. In our study, the presence and the stability of characteristic MRI features certainly increased our diagnostic confidence allowing us to continue conservative approach while the surrounding signal change, as reported in the literature, should not in itself prompt alternative diagnoses to be entertained.