bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Dumbbell Exercise on Arteriovenous Fistula in Patients Undergoing Maintenance Haemodialysis: A Prospective Randomized Controlled Trial
Authors: Mo Yawen , Song Li , Sun Chunyan , Huang Jingya , Zhou Lifang , Zheng Shuqian , Zhuang Tingting , Chen Yuanhan , Liu Shuangxin , Liang Xinling , Fu Xia
Published: September 2019

Background: Arteriovenous fistulas (AVF) have been the main vascular accesses for haemodialysis patients, but the maintenance after maturation poses serious challenges. Arm exercises promote the maturation of AVFs. However, few studies have evaluated the effect of arm exercise on matured AVF and addressed the intervention for late fistula failure. Objectives: The study was conducted to explore the effect of dumbbell exercise on mature AVF. Methods: 86 participants undergoing haemodialysis with AVFs were randomized into the control group and experimental group. The experimental group held 6-pound dumbbells on non-dialysis days for 3 months, while the control group squeezed rubber balls. Results: For blood flow of draining vein (DV; primary outcome), the between-group effects, interaction effect and time effect showed significant differences. A significant increase in blood flow of DV was observed in the dumbbell group at the 3rd month (mean difference, 359.50 [111.90–829.05] mL/min; p = 0.001). The difference in blood flow of AVF proximal artery, blood flow of brachial artery, the diameter of DV and the incidence of adverse events at 3 months (secondary outcomes) between the 2 groups was insignificant. Conclusion: Prolonged training with arm exercises is essential for patients with AVFs though the fistula has matured. The designed dumbbell exercise is an economical, effective intervention to maintain the function of AVF, especially for patients with potential reduction of access blood flow and no percutaneous transluminal angioplasty indication.
Mechanical Thrombectomy of Primary Distal Anterior Cerebral Artery Occlusion: A Case Report
Authors: Haruyama Hironori , Uno Junji , Takahara Kenta , Kawano Yosuke , Maehara Naoki , Michiwaki Yuhei , Nagaoka Shintaro , Maeda Kazushi , Ikai Yoshiaki , Gi Hidefuku
Published: September 2019

Objective: Primary anterior cerebral artery (ACA) occlusion is a rare condition and sometimes leads to significant neurological deficits. We herein report on the efficacy of mechanical thrombectomy (MT) in treating the distal ACA occlusion in a clinical setting. Case Presentation: A 76-year-old woman presented with a sudden onset of right hemiparesis. Computed tomographic angiography and perfusion imaging and subsequent analysis with RAPID software revealed acute left ACA occlusion with salvageable penumbra. The patient obtained a score of 11 on the National Institutes of Health Stroke Scale. MT was performed for occlusion of the left ACA (A4), and successful reperfusion (Thrombolysis in Cerebral Infarction score of 3) was achieved on the first attempt using a stent retriever. The patient’s recovery progressed well, and she was discharged 13 days after admission with a modified Rankin Scale score of 1. Conclusion: This case report demonstrates the clinical efficacy, safety, and favorable clinical outcome of treating a primary distal ACA occlusion with MT.
Laryngeal Microsurgery for the Treatment of Vocal Nodules and Cysts in Dysphonic Children
Authors: Martins Regina Helena Garcia , Siqueira Dândara Bernardo , Dias Norimar Hernanes , Gramuglia Andrea Cristina Joia
Published: September 2019

Introduction: Vocal nodules and cysts are frequent causes of infantile dysphonia. Vocal therapy is the first treatment. Microsurgery has restricted indications, especially for nodules. Objective: To describe our experience with microsurgery for nodules and cysts in children. Methods: Dysphonic children (aged 4–18 years) with the diagnosis of nodules and vocal cysts were initially selected. Of these children, only those were included who had undergone microsurgery. For nodules and cysts, the microsurgery was indicated in cases of failure of vocal therapy and in cases of voice worsening or doubts about the diagnosis. All children were submitted to auditory perceptual vocal analysis and videolaryngostroboscopy (before and after surgery, after 6 months). Surgical outcomes were: total improvement (disappearance of vocal symptoms and of the laryngeal lesions); partial improvement (partial improvement of symptoms and/or maintenance of lesions); no improvement (maintenance or worsening of the symptoms and/or persistence of the lesions). ­Results: There were 78 children with vocal nodules and 27 children with vocal cysts. Surgery was indicated for 12 children with vocal nodules (15.4%) and 12 children with cysts (44.4%). Total improvement registered for nodules and cysts was 75 and 83.4%, respectively. Partial improvement for both lesions was 25 and 16.6%, respectively. Conclusion: The best outcome for laryngeal microsurgery in dysphonic children was for vocal cysts. So, we encourage laryngologists for this conduct in vocal cysts. The success of microsurgery for vocal nodules was lower, and in these cases voice therapy seems to be the best treatment.
Acute Kidney Injury and Long-Term Risk for Cardiovascular Events in Patients after Kidney Transplantation
Authors: Rahamimov Ruth , van Dijk Tuvia Y. , Molcho Maya , Lahav Itay , Mor Eytan , Ben Dor Naomy , Goldman Shira , Rozen-Zvi Benaya
Published: September 2019

Background: Acute kidney injury (AKI) was found to be associated with an increased risk of major adverse cardiovascular events (MACE) in the general population. Patients after kidney transplantation are prone to AKI events and are also at an increased risk of cardiovascular (CV) disease. The association between AKI and MACE in kidney transplant patients is yet to be studied. Methods: This retrospective single-center cohort study reviewed 416 adult renal allograft recipients transplanted between 2005 and 2010. AKI events were recorded starting 2 weeks after transplantation, or following discharge with a functioning graft. AKI was defined, according to the KDIGO criteria. The primary outcome was the composite of MACE starting 6 months after transplantation and all-cause mortality. For survival analysis, we used univariate and multivariate time varying Cox proportional hazard model. Results: One hundred and twenty-four patients (29.8%) had at least one episode of AKI. During the median follow-up time of 7.2 years (interquartile range 4.3–9.1), 144 outcome events occurred. By time varying Cox regression analysis, AKI was associated with an increased rate of CV outcomes or death (hazard ratio [HR] 1.96, 95% CI 1.36–2.81, p < 0.001), and the association remained significant by multivariate adjusted model (HR 1.76, 95% CI 1.18–2.63, p = 0.005). As for the different components of MACE, all-cause mortality and CV mortality were the only outcomes that were significantly associated with AKI. No interaction between AKI timing and MACE was found. Conclusion: AKI in kidney transplant recipient is associated with an increased risk of CV disease.
BAP1 Immunoreactivity Correlates with Gene Expression Class in Uveal Melanoma
Authors: See Thonnie Rose , Stålhammar Gustav , Phillips Stephen , Grossniklaus Hans E.
Published: September 2019

Background: Uveal melanoma (UM) is the most common intraocular tumour in adults. Currently there are different tests available to determine the risk of UM for metastasis, among which include BRCA1-associated protein-1 (BAP1) immunohistochemistry (IHC) and gene expression profiling (GEP). BAP1 is a deubiquitylating enzyme (DUB) that has tumour suppressor activity, the loss of which therefore is associated with higher risk for tumour growth and metastasis. Objectives: To compare and correlate the prognostic significance of BAP1-IHC staining patterns and GEP in the prediction of UM’s risk for metastasis. Methods: This is a retrospective chart review with prospective follow-up of patients with primary UM who underwent enucleation from the year 2008 to 2018. Clinical history, histopathologic findings, GEP classification, BAP1-IHC of the formalin-fixed paraffin-embedded tissues, and follow-up data for metastasis were collected and statistically analysed. Results: A total of 30 enucleated eyes with UM were included in the study. All class 1a tumours had high nuclear BAP1 expression and all class 2 had low nuclear BAP1 expression. Fifty percent of the class 1b tumours had low nuclear BAP1 expression. Among the tumours with low nuclear BAP1 expression, 68% developed metastasis, while 9% developed metastasis among high nuclear expression. Fifty-five percent developed metastasis in tumours with high cytoplasmic expression and 42% for low cytoplasmic expression. Predictive values for metastasis (positive predictive value, negative predictive value) are as follows: (1) nuclear BAP1-IHC (68%, 91%), (2) cytoplasmic BAP1-IHC (55%, 58%), and (3) GEP (73%, 80%). Nuclear BAP1-IHC and GEP had the same accuracy rate of 77% and cytoplasmic BAP1-IHC had an accuracy of 57%. Conclusion: Low nuclear BAP1-IHC strongly correlates with GEP class 2 and was equally accurate in the prediction of metastasis.
Diffuse Ischemic Strokes and Sickle Cell Crisis Induced by Disseminated Anaplasmosis: A Case Report
Authors: Herbst John , Crissinger Tyler , Baldwin Kelly
Published: September 2019

We present a 26-year-old female with HbSC disease who presented to the emergency department multiple times with pain and shortness of breath, eventually developing unresponsiveness and a brief episode of pulseless electrical activity. She was admitted to the intensive care unit with multisystem organ failure and found to have diffuse ischemic strokes. Infectious workup revealed disseminated anaplasmosis and babesiosis, which had likely caused sickle cell crisis, atypical hemolytic-uremic syndrome, and ischemic brain injury. She was started on eculizumab therapy as well as antimicrobial therapy with doxycycline, clindamycin, and atovaquone. The patient was given tracheostomy and a percutaneous feeding tube. Unfortunately, she did not have significant neurologic recovery after prolonged hospital stay and was discharged to a skilled nursing facility with significant neurologic burden.
Guillain-Barré Syndrome and Posterior Reversible Encephalopathy Syndrome following Spinal Surgery
Authors: Sanpei Yui , Hanazono Akira , Kamada Sachiko , Sugawara Masashiro
Published: September 2019

Guillain-Barré syndrome (GBS) typically occurs after gastroenteritis and respiratory tract infection, but surgery has also been considered one of the triggers. Posterior reversible encephalopathy syndrome (PRES) is a rare complication of GBS. A normotensive female in her 70s presented ascending paralysis and frontal-parieto-occipital subcortical lesions with intermittent hypertension after spinal surgery. Nerve conduction studies revealed demyelinating polyneuropathy. The patient’s brain lesions disappeared with amelioration of hypertension. She was diagnosed with the demyelinating form of GBS and PRES caused by intermittent hypertension. Intravenous immunoglobulin G (IVIG) improved her symptoms without exacerbation of the PRES. Surgery can be a trigger of GBS, and GBS can cause PRES by hypertension and present as central nervous lesions. It is important to treat hypertension before using IVIG when PRES is suspected as a complication of GBS, since the encephalopathy can be exacerbated by IVIG. There may be more undiagnosed cases of the coexistence of GBS and PRES after surgery because surgery itself can also cause PRES. Proper control of blood pressure and confirmation of negative central nervous lesions are required to treat GBS patients with IVIG safely.
Education and Training in Breast Cancer Surgery in Europe
Authors: Wyld Lynda , Rubio Isabel T. , Kovacs Tibor
Published: September 2019

Background: The substantial increase in the complexity of breast cancer care in the last few decades has resulted in significant improvements in survival rates and also in the quality of life of breast cancer survivors. However, across Europe there are variations in outcomes and access to the latest techniques. Whilst much of this variance is due to differences in health economies between European member states, training variation may also play a part. Training in breast cancer surgery varies greatly across Europe, not only in its basal discipline (general surgery, gynaecology or plastic surgery) but also in the length of training and whether there is any requirement for specialist training. Several countries have been leading the way in training breast specialist surgeons (the USA, the UK, Australia and New Zealand) with dedicated 1- or 2-year fellowships either within or in addition to standard training. Access to such training is limited and consequently many women in Europe are still treated by generalists, potentially denying them access to the best care. This paper reviews the issues surrounding training provision in breast surgery and some of the challenges which need to be addressed to improve the current situation. Summary: Breast surgery training in Europe is of variable quality and duration, which may result in variations in the quality of care received by patients with breast cancer. Specialist training standards are urgently required which should be adopted by all European member states. Excellent models are available in the USA, the UK and Australia and New Zealand on which to base this training. Key Messages: The quality of training in breast surgery needs to be upgraded and harmonised across Europe.
Postnatal Expression Patterns of Estrogen Receptor Subtypes and Choline Acetyltransferase in Different Regions of the Papez Circuit
Authors: Wang Yu-xiang , Zhu Lin , Li Li-xia , Xu Hui-nan , Wang Hong-gang , An Di , Heng Bin , Zhao Qiang , Liu Yan-qiang
Published: September 2019

The Papez circuit is crucial for several brain functions, including long-term memory and emotion. Estradiol modulates cognitive functions based on the expression pattern of its receptor subtypes including estrogen receptor (ER) α, β, and G protein-coupled receptor 30 (GPR30). Similarly, the activity in the cholinergic system correlates with several brain functions, such as learning and memory. In this study, we used immunofluorescence to examine the expression patterns of ERβ and Western blotting to analyze GPR30 and choline acetyltransferase (ChAT) expression, in different regions of the Papez circuit, including the prefrontal cortex, hippocampus, hypothalamus, anterior nucleus of the thalamus, and cingulum in female rats at postnatal days (PND) 1, 10, and 56. Our main finding was that the highest expression of ERβ and GPR30 was noted in each brain area of the Papez circuit in the PND1 rats, whereas the expression of ChAT was the highest in PND10 rats. These results provide vital information on the postnatal expression patterns of ER subtypes and ChAT in different regions of the Papez circuit.
Phantom Restless Legs Syndrome
Authors: Raggi Alberto , Ferri Raffaele
Published: September 2019

Background: Amputees often experience a phantom limb consisting in the vivid impression that the limb is not only still present, but in many cases, painful. These patients may also become restless legs syndrome (RLS) sufferers; conversely, a preexisting RLS may persist after limb amputation. Summary: In this brief essay, papers on phantom RLS (pRLS) are reviewed in order to provide clinical elements for the diagnosis and treatment of this peculiar condition. It is relevant that dopamine receptor agonists yielded a marked reduction of the RLS symptoms in all cases reported. Key Messages: pRLS indirectly confirms the innate capacity of the central nervous system to retain a primordial internal body image responsible of phantom sensations. Moreover, it has been hypothesized that pRLS may provide clues for a better comprehension of some mechanisms underlying phantom pain and for the development of new treatment strategies.
Secondary Management for Recurrent Ureteropelvic Junction Obstruction after Pyeloplasty: A Comparison of Re-Do Robot-Assisted Laparoscopic Pyeloplasty and Conventional Laparoscopic Pyeloplasty
Authors: Zhang Yucong , Ouyang Wei , Xu Hao , Luan Yang , Yang Jun , Lu Yuchao , Hu Jia , Liu Zheng , Yu Xiao , Guan Wei , Hu Zhiquan , Ye Zhangqun , Wang Shaogang , Li Heng
Published: September 2019

Objective: To describe and analyze our experience with secondary robot-assisted laparoscopic pyeloplasty (RALP) and conventional laparoscopic pyeloplasty (LP) in treating recurrent ureteropelvic junction obstruction (UPJO) after primary pyeloplasty. Methods: Patients who underwent secondary RALP or LP for recurrent UPJO were retrospectively analyzed. Baseline characteristics, detailed history of previous pyeloplasty, operative profile and follow-up data were collected and analyzed. Results: Among 29 patients presented with recurrent UPJO, 15 patients underwent secondary RALP. Both groups (RALP or LP) were comparable in baseline characteristics and detailed history of previous pyeloplasty. The mean operative time, suturing time, and hospitalization time of patients in RALP group were significantly less than those in LP group. The mean operative time of RALP group was 2.1 h, while the mean operative time of LP group was 3.23 h. The average suturing time of LP (62.43 min) is about 3 times that of RALP (21.47 min). The overall mean follow-up data was 23 months. The success rate of the RALP group and LP group was 87.7 and 85.7% respectively. Conclusion: Compared to LP, RALP may be a better choice for the treatment of recurrent UPJO. Further high-quality clinical studies are needed to confirm the superior nature of RALP.
Targeted Ablation of Ventricular Tachycardia Guided by Wavefront Discontinuities During Sinus Rhythm
Authors: Aziz Zaid , Shatz Dalise , Raiman Michael , Upadhyay Gaurav A , Beaser Andrew D. , Besser Stephanie A. , Shatz Nathaniel A. , Fu Zihuan , Jiang Ruhong , Nishimura Takuro , Liao Hongtao , Nayak Hemal M. , Tung Roderick
Published: September 2019

Background:

Accurate and expedited identification of scar regions most prone to reentry is needed to guide ventricular tachycardia (VT) ablation. We aimed to prospectively assess outcomes of VT ablation guided primarily by the targeting of deceleration zones (DZ) identified by propagational analysis of ventricular activation during sinus rhythm.

Methods:

Patients with scar-related VT were prospectively enrolled in the University of Chicago VT Ablation Registry between 2016 and 2018. Isochronal late activation maps annotated to the latest local electrogram deflection were created with high-density multielectrode mapping catheters. Targeted ablation of DZ (>3 isochrones within 1cm radius) was performed, prioritizing later activated regions with maximal isochronal crowding. When possible, activation mapping of VT was performed, and successful ablation sites were compared with DZ locations for mechanistic correlation. Patients were prospectively followed for VT recurrence and mortality.

Results:

One hundred twenty patients (median age 65 years [59-71], 15% female, 50% nonischemic, median ejection fraction 31%) underwent 144 ablation procedures for scar-related VT. 57% of patients had previous ablation and epicardial access was employed in 59% of cases. High-density mapping during baseline rhythm was performed (2518 points [1615-3752] endocardial, 5049±2580 points epicardial) and identified an average of 2±1 DZ, which colocalized to successful termination sites in 95% of cases. The median total radiofrequency application duration was 29 min (21-38 min) to target DZ, representing ablation of 18% of the low-voltage area. At 12±10 months, 70% freedom from VT recurrence (80% in ischemic cardiomyopathy and 63% in nonischemic cardiomyopathy) was achieved. The overall survival rate was 87%.

Conclusions:

A novel voltage-independent high-density mapping display can identify the functional substrate for VT during sinus rhythm and guide targeted ablation, obviating the need for extensive radiofrequency delivery. Regions with isochronal crowding during the baseline rhythm were predictive of VT termination sites, providing mechanistic evidence that deceleration zones are highly arrhythmogenic, functioning as niduses for reentry.
Dimethylguanidino Valerate: A Lifestyle‐Related Metabolite Associated With Future Coronary Artery Disease and Cardiovascular Mortality
Authors: Ottosson Filip , Ericson Ulrika , Almgren Peter , Smith Einar , Brunkwall Louise , Hellstrand Sophie , Nilsson Peter M. , Orho‐Melander Marju , Fernandez Céline , Melander Olle
Published: September 2019

Background

Identification of lifestyle modifiable metabolic pathways related to cardiometabolic disease risk is essential for improvement of primary prevention in susceptible individuals. It was recently shown that plasma dimethylguanidino valerate (
DMGV
) levels are associated with incident type 2 diabetes mellitus. Our aims were to investigate whether plasma
DMGV
is related to risk of future coronary artery disease and with cardiovascular mortality and to replicate the association with type 2 diabetes mellitus and pinpoint candidate lifestyle interventions susceptible to modulate
DMGV
levels.

Methods and Results

Plasma
DMGV
levels were measured using liquid chromatography‐mass spectrometry in a total of 5768 participants from the MDC (Malmö Diet and Cancer Study—Cardiovascular Cohort), MPP (Malmö Preventive Project), and MOS (Malmö Offspring Study). Dietary intake assessment was performed in the
MOS
. Baseline levels of
DMGV
associated with incident coronary artery disease in both the
MDC
(hazard ratio=1.29; CI=1.16–1.43;
P
<0.001) and
MPP
(odds ratio=1.25; CI=1.08–1.44;
P
=2.4e‐3). In the
MDC
,
DMGV
was associated with cardiovascular mortality and incident coronary artery disease, independently of traditional risk factors. Furthermore, the association between
DMGV
and incident type 2 diabetes mellitus was replicated in both the
MDC
(hazard ratio=1.83; CI=1.63–2.05;
P
<0.001) and
MPP
(odds ratio=1.65; CI=1.38–1.98;
P
<0.001). Intake of sugar‐sweetened beverages was associated with increased levels of
DMGV
, whereas intake of vegetables and level of physical activity was associated with lower
DMGV
.

Conclusions

We discovered novel independent associations between plasma
DMGV
and incident coronary artery disease and cardiovascular mortality, while replicating the previously reported association with incident type 2 diabetes mellitus. Additionally, strong associations with sugar‐sweetened beverages, vegetable intake, and physical activity suggest the potential to modify
DMGV
levels using lifestyle interventions.
Direct Anticoagulants and Risk of Myocardial Infarction, a Multiple Treatment Network Meta-Analysis
Authors: Kupó Péter , Szakács Zsolt , Solymár Margit , Habon Tamás , Czopf László , Hategan Lidia , Csányi Beáta , Borbás János , Tringer Annamária , Varga Gábor , Balaskó Márta , Sepp Róbert , Hegyi Péter , Bálint Alexandra , Komócsi András
Published: September 2019

We assessed the cardiovascular safety of long-term direct-acting oral anticoagulant (DOAC) treatment. A search of the medical literature was performed from inception until May 31, 2019. Inclusion criteria were (1) randomized trial that assessed the clinical efficacy and/or safety of 1 or more DOAC, (2) control group including oral anticoagulation and/or antiplatelet and/or placebo treatment, and (3) the incidence of acute coronary syndrome during follow-up was reported. Fixed-effect and random-effects models were applied. The analyzed outcomes were myocardial infarction (MI), major bleeding, and mortality. Twenty-eight randomized clinical trials (196 761 patients) were included. Rivaroxaban was associated with a 21% reduction in the relative risk of MI when compared to placebo (relative risk [RR]: 0.79 [95% credible interval, CrI: 0.65-0.94]) and a 31% reduction (RR: 0.70 [95% CrI: 0.53-0.89]) when compared to dabigatran. Apixaban resulted in 24% (RR: 0.76 [95% CrI: 0.58-0.99]) and vitamin K antagonists anticoagulation resulted in 19% (RR: 0.81 [95% CrI: 0.65-0.98]) risk reduction compared to dabigatran. The computed probability of being the first best choice of treatment was 61.8% for rivaroxaban. Cardiovascular safety shows considerable heterogeneity among oral anticoagulants. Treatment with rivaroxaban is associated with reduced rate of MI.
Exploring the Moderating Role of Gender in Juvenile Hacking Behaviors
Authors: Holt Thomas J. , Navarro Jordana N. , Clevenger Shelly
Published: September 2019

Criminological research has demonstrated the significant relationship between deviant peer associations, a lack of self-control, and individual delinquency. These relationships also account for involvement in cybercrime, though these results are based largely on adult samples. There is less research considering juvenile offending online, particularly examining involvement in property-based offenses such as computer hacking. This study utilized an international sample of 48,327 juvenile respondents in the Second International Self-Report of Delinquency (ISRD-2) study to examine the role of gender as a moderating factor in the relationship between deviant peer associations, self-control, opportunity, and self-reported computer hacking behavior. The findings demonstrated different correlates associated with hacking for males and females, as well as differences on the basis of urban and rural residency.
Politics as an Explanation to the Health Divide in Different Settings: A Comparative Study of England and Ghana
Authors: Alhassan Jacob Albin Korem , Castelli Michele
Published: September 2019

Informed by the theoretical perspective of the political economy of health and in the context of the recommendations of World Health Organization’s Commission on Social Determinants of Health, this article examines the political explanations of geographical health inequities in 2 extremely different settings: Ghana and England. Based on the “north-south health divide” in the 2 countries, the article finds that, while the drivers of health inequities in both countries are policy driven, historically situated contextual factors (colonialism in the case of Ghana and deindustrialization in the case of England) offer explanations for health inequities in both countries. We conclude by discussing the importance of paying attention to structural factors such as colonialism for understanding contemporary health inequities in formerly colonized countries such as Ghana.
Swiss Cooperation in the Travel and Tourism Sector: Long-term Relationships and Superior Performance
Authors: Thao Vu Thi , von Arx Widar , Frölicher Jonas
Published: September 2019

Despite a growing body of research on the interface and relationship between transport and tourism, this research area remains undeveloped. Using Switzerland as a case study, the present study aims to investigate the level of integration between public transport and tourism companies, the enablers of their long-term cooperative relationship and outstanding performance, seen from the perspective of the public transport companies. A mixed methods approach is used to provide greater insights into how these companies cooperate with each other. Our findings suggest that public transport companies adopt different cooperative strategies with different types of partners. They are able to maintain long-term cooperative relationships due to strong cooperation in sales, a long tradition of cooperation, a high degree of involvement in national public organizations, and their central focus on the customer. Type of partner, sales, product design and pricing, and service provision have statistically significant effects on cooperative performance.
Evaluating Tourism Market Regulation from Tourists’ Perspective: Scale Development and Validation
Authors: Liu Yixue , Yao Yanbo , Fan Daisy X.F.
Published: September 2019

Despite the increasing attention given to tourism regulation in recent years, great ambiguity surrounds this concept and no valid and reliable instrument exists to measure tourism market regulation (TMR). This study uses multi-step mixed methods to develop a measurement scale of TMR from the perspective of tourists. In the first step, interviews and focus groups are undertaken to formulate a clear definition of TMR and its attributes. In the second step, a scale development procedure is adopted to analyze two rounds of data for dimension exploration via exploratory factor analysis and confirmation via confirmatory factor analysis. Through these analyses, five dimensions are generated: regulatory oversight, truth in advertising, tourism contract compliance, fulfilling tourism contracts, and travel feedback processing. The reliable and valid results contribute to refining TMR in the context of China. They also provide a useful tool for tourists and destination marketing organizations to measure and govern TMR in other regions/countries.
The Media’s Conditional Agenda-Setting Power: How Baselines and Spikes of Issue Salience Affect Likelihood and Strength of Agenda-Setting
Authors: Geiß Stefan
Published: September 2019

Whether agenda-setting effects occur and how strong they are appear to be strongly context-dependent. The baseline public and media salience of an issue and the extent of abrupt changes in salience have been mentioned as potential contingent conditions, but without any empirical follow-ups. First, this study demonstrates how agenda-setting effects unfold on a day-to-day basis, finding that only one fourth of the results ( p < .05) are in line with the original agenda-setting hypothesis. Second, it tests how (a) the baseline intensity of public and media salience and (b) strong temporary increases (“spikes”) in public and media salience impact the likelihood and strength of agenda-setting effects. Higher baseline public salience and stronger spikes in media salience systematically influence the likelihood and strength of agenda-setting effects. Agenda-setting scholars should systematically check, report, and possibly control for baseline intensity and spike momentum of media and public salience, which is also easy to implement.
Punish or Protect? How Close Relationships Shape Responses to Moral Violations
Authors: Weidman Aaron C. , Sowden Walter J. , Berg Martha K. , Kross Ethan
Published: September 2019

People have fundamental tendencies to punish immoral actors and treat close others altruistically. What happens when these tendencies collide—do people punish or protect close others who behave immorally? Across 10 studies ( N = 2,847), we show that people consistently anticipate protecting close others who commit moral infractions, particularly highly severe acts of theft and sexual harassment. This tendency emerged regardless of gender, political orientation, moral foundations, and disgust sensitivity and was driven by concerns about self-interest, loyalty, and harm. We further find that people justify this tendency by planning to discipline close others on their own. We also identify a psychological mechanism that mitigates the tendency to protect close others who have committed severe (but not mild) moral infractions: self-distancing. These findings highlight the role that relational closeness plays in shaping people’s responses to moral violations, underscoring the need to consider relational closeness in future moral psychology work.
Urinary 11-nor-9-carboxy-tetrahydrocannabinol elimination in adolescent and young adult cannabis users during one month of sustained and biochemically-verified abstinence
Authors: Schuster Randi Melissa , Potter Kevin , Vandrey Ryan , Hareli Maya , Gilman Jodi , Schoenfeld David , Evins A Eden
Published: September 2019

Background:

Despite adolescents and young adults being the most frequent users of cannabis, all information on cannabis drug testing interpretation is based on data from adults.

Aims:

This study aimed to define the time course of urinary 11-nor-9-carboxy-tetrahydrocannabinol (THCCOOH) excretion among 70 adolescent and young adult cannabis users during 1 month of biochemically-verified cannabis abstinence.

Methods:

Urine specimens were collected at non-abstinent baseline and after 2, 3, 8, 15, 21 and 28 days of abstinence. Specimens were tested for THCCOOH with a ‘rapid’ immunoassay drug test and a confirmatory assay using liquid chromatography-tandem mass spectrometry, with a 5 ng/mL limit of quantitation. Elimination rate was tested using a population pharmacokinetics model.

Results/outcomes:

Participants had an average of 26 days of abstinence (SD = 6). Initial creatinine-adjusted THCCOOH concentration (CN-THCCOOH) was 148 ng/mg (SD = 157). Half-life was 2 days (SD = 5), with a 10-day window of detection (estimated range: 4–80 days). At the final timepoint and among those with > 25 days of abstinence ( n = 62), 40% ( n = 25) had THCCOOH concentrations > 5 ng/mL (i.e. detectable on confirmatory assay) and 19% ( n = 12) were ‘positive’ per federal drug testing guidelines (i.e. values greater than 50 ng/mL on the screening immunoassay and 15 ng/mL on the confirmatory assay). More frequent past month cannabis use was associated with higher baseline CN-THCCOOH concentrations, but not with rate of elimination. Nested five-fold cross-validation suggested high model reliability and predictive validity.

Conclusions/interpretation:

Findings underscore that, as with adults, detectable cannabinoid metabolites do not necessarily indicate recent use in adolescents and young adults. Algorithms that account for THCCOOH levels, assessed longitudinally and time between specimen collections are best equipped to confirm abstinence.

Clinical Trial Registration:

NCT03276221; https://clinicaltrials.gov/ct2/show/NCT03276221?term=Randi+Schuster&rank=1
Putting Precarity Back to Production: A Case Study of Didi Kuaiche Drivers in the City of Nanjing, China
Authors: Qi Hao , Li Zhongjin
Published: September 2019

This article addresses the questions of why and how precarity should be conceptualized in a Marxian framework on labor. We argue that precarity should be put back to production, which has a twofold meaning: first, we emphasize that the labor process is of crucial importance for conceptualizing precarity, and precarity in the labor process is interrelated with precarity in the labor market and labor reproduction. Second, precarity should be understood through the relationships of production, particularly through capital-labor conflict. Using one case study on Didi Kuaiche drivers in the city of Nanjing, China, we examine the nature of precarity in the flexible labor of the digital economy and present a more nuanced micronarrative of precarious work in the ride-hailing service.
Literacy and civilization
Authors: Murphy Peter
Published: September 2019

The article reviews the social theory of Harry Redner with particular reference to his view of the relationship between high literacy (book culture) and civilization. The question is posed whether, alongside book culture, an axial-type metaphysical culture is also key to the definition of civilization.
The Intrametropolitan Geography of Knowledge-Intensive Business Services (KIBS): A Comparative Analysis of Six European and U.S. City-Regions
Authors: Romero de Ávila Serrano Vicente
Published: September 2019

Analyzing the intrametropolitan locations of knowledge-intensive business services (KIBS) provides insight into the geography of the knowledge economy. This study focuses on the urban spatial structure and implications of KIBS for urban or regional development and planning through a comparison of KIBS’ structures in six city-regions representing different global contexts. This includes varied socioeconomic and political frameworks: three European city-regions (London, Paris, and Madrid) and three U.S. city-regions (New York, Los Angeles, and Chicago). The results show that (a) there is a relationship between urban spatial structure and KIBS location; (b) KIBS locate in a polycentric form in search of urbanization economies; but (c) certain KIBS are highly concentrated in just a few subcenters, looking for localization economies; (d) proximity to the core and agglomeration economies are a factor in the location of KIBS; and (e) the European cases have more KIBS subcenters but closer to their central business districts, while the American cases have fewer and larger KIBS subcenters located farther from their central business districts.
Tribological behaviors of PTFE-based composites filled with bronze microparticles
Authors: Charfi Amine , Neili Sameh , Kharrat Mohamed , Dammak Maher
Published: September 2019

This research article deals with commercial polytetrafluoroethylene (PTFE)-based composites filled with 30% of bronze microparticles. This shade is used as guide rings in hydraulic cylinders. After a certain number of slip cycles, seal wear is one of the main causes of leaks in the hydraulic systems. To solve this problem, it is essential to act on the seal materials to increase its lifetime and consequently the lifetime of hydraulic systems. Excessive pressure on the seal causes a significant wear while a light contact causes lubricant leak. For both situations, we have a failure of the system. For this reason, it is necessary to have a perfect contact between the seal and the metal surface and simultaneously with minimal wear. This problem is the subject of our research works. We analyze, in this article, the tribological behavior of a PTFE/bronze composite under dry and lubricated sliding conditions for different frequencies and loads. An alternating linear motion ball/plane tribometer has been used to characterize friction and wear behavior of the material. Micrographic observation of wear track was taken with the optical microscope. The results showed the good friction behavior of material for low values of loads and frequencies and essentially for 33 N of load with 1 Hz frequency or for 81 N as normal load with 0.75 Hz frequency as well as lubrication improve the wear rate of the PTFE/bronze composite. Under lubrication, load and frequency become inversely proportional to friction coefficients.
Morphological, mechanical, and thermal properties of PP/SEBS/talc composites
Authors: de Oliveira Carlos Ivan Ribeiro , Rocha Marisa Cristina Guimarães , de Assis Joaquim Teixeira , da Silva Ana Lúcia Nazareth
Published: September 2019

The aim of this study is to evaluate the effect of some experimental variables such as the content of styrene–ethylene–butylene–styrene (SEBS) and talc, processing conditions and mixing protocol on the properties of polypropylene (PP). To achieve this objective, PP/SEBS blends and PP/SEBS/talc composites were processed in a corotating twin-screw extruder. A masterbatch of PP/talc was prepared before the extrusion of PP/SEBS/talc composites. The morphology of blends and composites was evaluated by scanning electron microscopy, which revealed the dispersion of small rubber droplets in the PP matrix. Moreover, the micrographs also showed that SEBS and talc particles were uniformly dispersed and distributed in the polymer matrix. Results of thermal properties showed that talc had a nucleating effect, which promoted the increase of both PP crystallization temperature and crystallinity degree. The incorporation of talc in PP/SEBS blends led to an expressive increase in the impact resistance by 70% as compared with the reference blend: PP/SEBS 80/20% (w/w). This result reveals that although the PP/SEBS/talc composites showed a separated morphology, the good dispersion and distribution of this mineral filler in the polymers contributed to avoid crack propagation and increase the impact properties. The tensile properties in the elastic region were not significantly affected.
Relational and Spiritual Coping Among Emerging and Young Adult Cancer Survivors
Authors: Sira Natalia , Lamson Angela , Foster Cameron L.
Published: September 2019

Cancer presents uncertainties for individuals of any age; however, emerging and young adults (EYA) are challenged to cope with developmental tasks in addition to cancer-related stressors. Guided by the double ABC-X model and biopsychosocial–spiritual framework, the current study investigates coping strategies used by this population and the role of psychological resources (perception of parental care/control and spirituality) on their coping ability. Recruited from online social media, 210 EYA cancer survivors self-reported demographic, medical information, and completed the Brief Cope scale. In addition, spirituality reliance, perceived parental care, and parental control were measured and examined in relation to coping ability. While nearly half of participants experienced positive adaptation in relation to multiple stressors, hierarchical multiple regression revealed the developmental nature of coping and indicated that higher spirituality reliance and higher degree of parental care were predictive of adaptive coping among EYA cancer survivors. Content analyses of the open-ended questions confirmed these results. In order to facilitate adaptive coping, attention must be paid to the unique biopsychosocial-spiritual and developmental needs of young cancer survivors while encouraging family support and spirituality reliance as significant tools in coping. Practical recommendations for nursing support and healthcare teams are discussed.
Diagnosis and Treatment of an Odontogenic Epithelial Tumor in a Dog With Features of Squamous Odontogenic Tumor
Authors: Hodesson Deborah L. , Soukup Jason , Bell Cynthia M.
Published: September 2019

A 9-year-old standard poodle presented for a comprehensive oral health assessment and treatment, at which time a left rostral mandibular swelling was recognized. The mass was biopsied and eventually excised by a left rostral mandibulectomy en bloc resection. Histopathology supported the diagnosis of a benign, intraosseous, epithelial tumor that was otherwise unclassified. The clinical, radiological, and histological features of this case are similar to those reported for squamous odontogenic tumor (SOT) in humans. This case study relays the diagnosis, treatment, and follow-up of the first SOT-like tumor in a dog.
Strategic Ambiguity with Probabilistic Voting
Authors: Asako Yasushi
Published: September 2019

Political parties and candidates usually prefer making ambiguous promises. This study identifies the conditions under which candidates choose ambiguous promises in equilibrium, given convex utility functions of voters. The results show that in a deterministic model, no equilibrium exists when voters have convex utility functions. However, in a probabilistic voting model, candidates make ambiguous promises in equilibrium when (i) voters have convex utility functions, and (ii) the distribution of voters’ most preferred policies is polarized.

JEL Classification: D71, D72
Placing the AD 2014–2016 ‘protracted’ El Niño episode into a long-term context
Authors: Allan Robert J , Gergis Joëlle , D’Arrigo Rosanne D
Published: September 2019

Although extended or ‘protracted’ El Niño and La Niña episodes were first suggested nearly 20 years ago, they have not received the attention of other ‘flavours’ of the El Niño–Southern Oscillation (ENSO) or low-frequency ‘ENSO-like’ phenomena. In this study, instrumental variables and palaeoclimatic reconstructions are used to investigate the most recent ‘protracted’ El Niño episode in 2014–2016, and place it into a longer historical context. Although just reaching the threshold for such an episode, the 2014–2016 ‘protracted’ El Niño had very severe societal, agricultural, environmental and ecological impacts, particularly in western Pacific regions like eastern Australia. We show that although ‘protracted’ ENSO episodes of either phase cause similar, near-global modulations of weather and climate as during more ‘classical’ events, impacts associated with ‘protracted’ episodes last longer, with strong influences in eastern Australia. The latter is a response to the dominance of Niño 4 sea surface temperature (SST) and associated atmospheric teleconnection anomalies during ‘protracted’ ENSO episodes. Importantly, while Niño 4 SST anomalies recorded during the austral summer of 2016 were the highest values on record, an analysis of long-term palaeoclimate records indicates that there may have been episodes of greater magnitude and duration than seen in instrumental observations. This suggests that shorter instrumental observations may underestimate the risks of possible future ENSO extremes compared with those observed from multi-century palaeoclimate records. Improved knowledge of ENSO and the potential to forecast ‘protracted’ episodes would be of immense practical benefit to communities affected by the severe impacts of ENSO extremes.
The late Holocene history of cypress (Cupressus sempervirens L.) in the Italian peninsula: New perspectives from archaeobotanical data
Authors: D’Auria Alessia , Teobaldelli Maurizio , Di Pasquale Gaetano
Published: September 2019

The objective of this research is to reconstruct the recent Holocene history of Cupressus sempervirens from the Bronze to the Roman Age in Italy. Our work consisted both in a review of published data and in the identification of novel archaeobotanical remains stored in the deposits of the National Archaeological Museum of Naples and of the Archaeological Park of Pompeii. The literature permitted to collect information linked to different plant remain typologies of the Italian cypress; 362 botanical remains were counted, of which 292 were from the Vesuvian area and 70 from other archaeological sites of the central and western Mediterranean. Data chronology spans from the second century BC to the AD fifth century for the archaeological area of ancient Campania and from the 14th century BC to the AD fourth century for the sites located in different regions. It is clear that the ‘cypress culture’ is confirmed by the archaeobotanical data found in the Roman world. Romans especially appreciated its timber but cypress was also used for many other purposes. Furthermore, the employment of timber for wells was documented in pre-Roman sites and the presence of fruits/seeds in central Italy confirms its importance also in the Bronze Age.
Holocene occupation history of pygoscelid penguins at Stranger Point, King George (25 de Mayo) Island, northern Antarctic Peninsula
Authors: Emslie Steven D , Romero Matías , Juáres Mariana A , Argota Martin R
Published: September 2019

We report additional fossil evidence for pygoscelid penguins breeding on King George (25 de Mayo) Island, South Shetland Islands, in the Holocene beginning at ~7000 cal. yr BP. This evidence comes from a raised marine beach deposit formerly studied and described as Pingfo I at Stranger Point, Potter Peninsula. We relocated and exposed deposits at this site and recovered additional samples of penguin bones from five stratigraphic beds that are redescribed here. Most of these bones are from juvenile penguins and exhibit little or no wear indicating minimal transport to the beach deposits. Some of the bones are developed enough to be identifiable to Adélie ( Pygoscelis adeliae), Gentoo ( Pygoscelis papua), and Chinstrap ( Pygoscelis antarctica) penguins, indicating that all three species were breeding at Stranger Point from ~7320 to 4865 cal. yr BP. This breeding occupation corresponds with the first warming and deglaciation that occurred in the northern Antarctic Peninsula by this time and ends with the onset of reglaciation of the Peninsula. At least 31 abandoned penguin mounds and ornithogenic soils also were located and sampled at Stranger Point and indicate that the current occupation of this area by all three pygoscelid penguins dates no older than ~535 cal. yr BP. The absence of ornithogenic soils from earlier Holocene breeding was probably due to glacial activity and soil solifluction during periods of warming in the mid to late Holocene.