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The Covid 19 pandemic has accelerated the transition to teleworking, and this work paradigm is likely to continue. There is intense debate about the positive and negative aspects of telework. The purpose of this study is to examine the positive and negative aspects of telecommuting. 21 in-depth interviews were conducted with engineers. The data were analysed using NVivo and thematic analysis. The results show that the positive and negative aspects of telecommuting are associated with specific elements, such as the types of tasks an engineer can perform more effectively when working remotely or in the office. In general, teleworkers in this study perceive better work-life harmony because they can save time on commuting. The need for home infrastructure to efficiently connect with high-speed VPN services was identified as the most important technological barrier in this study. Although there are some other negative aspects of teleworking, such as home distractions and career development, the study confirms that the positive elements of telecommuting overall outweigh the disadvantages, at least from the telecommuters' perspective, which is consistent with previous research. [ABSTRACT FROM AUTHOR]

A single case-study design approach was implemented in this qualitative study of 13 participants to identify critical success factors that influence project success in bespoke turnkey mechanical engineering projects within a project-based organisation. Using Nvivo and thematic analysis the study revealed important project success factors. The findings confirm the previous research and extend our understanding of turnkey projects by introducing additional factors such as avoidance of multitasking, availability of materials, and cost-effectiveness of work. A competent project manager with strong leadership skills was also found to be essential for setting clear goals, managing resources, avoiding multitasking, and ensuring a motivated team that cooperates and takes responsibility for results. Establishing realistic project plans, working cost-effectively, and implementing procurement and supply chain strategies were identified as critical elements in ensuring material availability to complete the project, resulting in the timely delivery of a quality product within budget. None of this would be possible without effective communication that ensures accurate information is communicated to the right project stakeholders. [ABSTRACT FROM AUTHOR]

To describe the clinical spectrum of cryoglobulinemic vasculitis (CV) in primary Sjögren's syndrome (pSS), investigate its relation to lymphoma and identify the differences with hepatitis C virus (HCV) related CV. From a multicentre study population of consecutive pSS patients, those who had been evaluated for cryoglobulins and fulfilled the 2011 classification criteria for CV were identified retrospectively. pSS-CV patients were matched with pSS patients without cryoglobulins (1:2) and HCV-CV patients (1:1). Clinical, laboratory and outcome features were analyzed. A data driven logistic regression model was applied for pSS-CV patients and their pSS cryoglobulin negative controls to identify independent features associated with lymphoma. 1083 pSS patients were tested for cryoglobulins. 115 (10.6%) had cryoglobulinemia and 71 (6.5%) fulfilled the classification criteria for CV. pSS-CV patients had higher frequency of extraglandular manifestations and lymphoma (OR=9.87, 95% CI: 4.7–20.9) compared to pSS patients without cryoglobulins. Purpura was the commonest vasculitic manifestation (90%), presenting at disease onset in 39% of patients. One third of pSS-CV patients developed B-cell lymphoma within the first 5 years of CV course, with cryoglobulinemia being the strongest independent lymphoma associated feature. Compared to HCV-CV patients, pSS-CV individuals displayed more frequently lymphadenopathy, type II IgMk cryoglobulins and lymphoma (OR = 6.12, 95% CI: 2.7–14.4) and less frequently C4 hypocomplementemia and peripheral neuropathy. pSS-CV has a severe clinical course, overshadowing the typical clinical manifestations of pSS and higher risk for early lymphoma development compared to HCV related CV. Though infrequent, pSS-CV constitutes a distinct severe clinical phenotype of pSS. [ABSTRACT FROM AUTHOR]

The needs for transit station classification are ever-growing as the planning process, be it at a strategic or operational level, becomes increasingly automated, data-oriented, and short-cycled. Whilst most existing models have used binary methods, this study applied a fuzzy clustering approach and examined cluster memberships (i.e., to what degree a station belongs to each cluster) of London rail transit stations by using entry and exit data with intra-day and intra-week variations. A method of hyperparameter selection in fuzzy clustering considering the context of transportation and a framework of ridership variation analysis was proposed. The results suggest that fuzzy clustering can maximise the information from high-resolution temporal passenger flow data of urban rail transit. The membership breakdowns allow users to have a better understanding of station characteristics and help to avoid inadequate plans by treating the stations belonging to multiple clusters in a different manner from the binary clustering, where each station only belongs to one cluster. Furthermore, fuzzy clustering can capture the ridership variation patterns and reveal special clusters. The results can be potentially applied in operation planning, such as service timetabling, station staff working-hour designs and fare strategy designs, etc. [ABSTRACT FROM AUTHOR]

The construction industry has been perceived as dominant in stirring to move societies for sustainable development in an international framework. As a result of a theoretical perspective, this research extends leadership competencies as hierarchical, reflective constructs, integrating eight involved components. The analysis was done making use of a sample of 70 project managers in eco-friendly building projects. The results exhibits that the leadership competencies of project managers as second-order reflective constructs end up with considerable direct influences on success criteria for sustainable buildings. Furthermore, the outcomes suggest that the intellectual competence of project managers represents the most considerable factor on sustainable building accomplishments. On the whole, this research ends by going over the findings, methodological inferences, limitations, and prospective recommendations for further research. [ABSTRACT FROM AUTHOR]

A project delivery challenge arises in temporary (multi) organizations (TMOs) when the team is multi-cultural in character. One particular element that can influence team effectiveness in such environment is the way conflicts are handled. Recent research implies that different styles of conflict management have different impacts on team effectiveness, some being positive and some negative, and that the impact is often mediated by other factors. Nevertheless the impact of conflict handling style on team performance in TMO multi-cultural environments in East Asia has not widely been considered. As a result, this study investigates how conflict management can contribute to effectiveness in such environments, through the mediation of the level of team coordination, by gathering data from 126 team leaders and supervisors and 378 members nested in different multi-cultural projects in the Malaysian construction industry. The findings suggest that managing conflict cooperatively help to build the ideal positive share to team performance in multi-cultural environments in Malaysian construction industry, while a high degree of team coordination is also existing. The findings also advocate that the avoiding conflict management style may incorporate a positive result when it comes to team overall performance and that the effect of adopting avoidance conflict handling is also mediated by the level of team coordination. [ABSTRACT FROM AUTHOR]

In the search for potential new anti-cancer agents, the possible anti-proliferative effect of various plant extracts from an in-house extract library was investigated in vitro . The cytotoxic, cytostatic and the pro-apoptotic capacity of the extracts was estimated on the HL-60 human promyelocytic leukemia cell line by the trypan-blue exclusion method, the MTT assay and flow-cytometric analysis. Interestingly, out of all extracts screened, three methanol extracts, namely Hypericum perforatum , Hypericum triquetrifolium and Hypericum rumeliacum , exhibited the most significant activity by promoting necrotic cell-death, accompanied by alterations in the mRNA expression levels of the BCL2 and BAX genes. All the three bioactive extracts were subjected to HPLC-DAD and UHPLC-ESI(−)-HRMS & MS/MS dereplication procedures for correlation purposes. Interesting comparative results related to known constituents such as naphodianthrones, phloroglucinol derivatives and flavonoids were elucidated. To our knowledge, this is the first time that H. triquetrifolium and H. rumeliacum are investigated for both their anti-proliferative properties and their detailed composition. [ABSTRACT FROM AUTHOR]

A 63-year-old man was admitted to our hospital for further investigation and management of brain metastases. The patient was initially presented with a 4-day history of confusion. On the day of admission, the patient was confused, agitated, disorientated in place and time, and had visual disturbances. His blood pressure was repeatedly recorded high, with levels of systolic blood pressure between 170–210 mm Hg. A brain magnetic resonance imaging showed areas of high signal on T2 and fluid-attenuated inversion recovery images, located bilaterally in the white matter of the occipital regions and unilateral in the left frontal lobe, suggestive of posterior reversible encephalopathy syndrome. Aggressive treatment of hypertension resulted in complete resolution of the clinical and radiologic features of the syndrome. [ABSTRACT FROM AUTHOR]

Cogan’s syndrome is a rare disorder characterized by ocular and audiovestibular manifestations in its typical form and caries a wide variety of atypical manifestations. It is considered as an autoimmune disease. We present the first case in the literature of a 67 year old woman with the development of low grade non-Hodgkin lymphoma (NHL) in the mastoid bone in a pre-existing history of atypical Cogan’s syndrome. The anatomical development of NHL was to a “target” organ of Cogan’s syndrome, which is the inner ear. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of coronal- and sagittal-plane anterior cruciate ligament (ACL) graft obliquity on tibial rotation (TR) range of motion (ROM) during dynamic pivoting activities after ACL reconstruction with bone–patellar tendon–bone (BPTB) autograft. Methods: We evaluated 19 ACL-reconstructed patients (mean age, 29 years; age range, 18 to 38 years; mean time interval postoperatively, 19.9 months) and 19 matched control subjects (mean age, 30.6 years; age range, 24 to 37 years) using motion analysis during (1) descending a stairway and pivoting and (2) landing from a jump and pivoting. Magnetic resonance imaging was used to measure the coronal and sagittal ACL graft angle. The dependent variables were TR ROM during pivoting and the side-to-side difference (SSD) in TR ROM between the reconstructed knee and the contralateral intact knee. Results: TR ROM of the ACL-reconstructed knee was significantly increased compared with both the contralateral intact knee and the healthy control knee (P < .05). A significant positive correlation was observed between TR ROM and coronal ACL graft angle (r = 0.727, P = .0006 for descending and pivoting; r = 0.795, P = .0001 for landing and pivoting) as well as between SSD of TR ROM and coronal ACL graft angle (r = 0.789, P < .0001 for descending and pivoting; r = 0.799, P < .0001 for landing and pivoting). No correlation was found with the sagittal ACL graft angle. Conclusions: After ACL reconstruction with a BPTB graft, patients'' knees showed higher TR values than their uninjured knees and the knees of uninjured control volunteers during dynamic pivoting activities. The findings of this study show that TR was better restored in ACL-reconstructed patients with a more oblique graft in the coronal plane. A similar relation was not observed for graft orientation in the sagittal plane. Although these data do not imply a cause-and-effect relation between the 2 variables, they may indicate that a more oblique placement of a single BPTB ACL graft in the coronal plane is correlated with better control of TR. Level of Evidence: Level IV, case series. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the diagnostic accuracy of 2 threshold values (105 breaths per minute [bpm]/L and 130 bpm/L) of the rapid shallow breathing index (RSBI) to predict a successful weaning trial outcome in a homogenous group of patients with chronic obstructive pulmonary disease (COPD). Methods: A consecutive population of patients with COPD who were intubated for hypercapnic respiratory failure during a 2-year period were studied prospectively. RSBI was measured by 2 investigators at minute 5 of the T-piece trial, whereas 2 other physicians evaluated the 30 minute T-piece trial as successful or unsuccessful, according to clinical criteria. Results: Of 64 patients with COPD (53 male, 11 female) who constituted the study population, 42 patients (35 male, 7 female; aged 70 ± 9.2 years) completed the spontaneous breathing trial (SBT) and remained clinically stable (group 1). The remaining 22 patients (18 male, 4 female; aged 71.9 ± 4.7 years) had to return to ventilatory support by the end of the SBT because of clinical deterioration (group 2). The 2 threshold values that were evaluated had low specificity (38.1% for < 105 bpm/L and 66.7% for < 130 bpm/L), low sensitivity (63.6% for < 105 bpm/L and 54.5% for < 130 bpm/L), and low diagnostic accuracy (46.8% for < 105 bpm/L and 65.6% for < 130 bpm/L) in predicting a successful T-piece trial outcome. Conclusion: RSBI measured early during an SBT cannot accurately predict the successful outcome of a T-piece trial in a homogenous population of patients with COPD. [Copyright &y& Elsevier]

Abstract: The assessment of glioma proliferation rate is important to predict tumor behavior, response to therapy and prognosis. Various methods, largely involving immunohistological markers in tissue samples, have been proposed to this aim; however, they all require tissue removal through a biopsy or during a surgical procedure. Consequently, non-invasive imaging modalities that could reliably assess the proliferative potential of intracranial space-occupying lesions in vivo would be of obvious significance. In the present study we review the contribution of MRI, positron emission tomography and single-photon emission CT for the assessment of the proliferative potential of gliomas. [ABSTRACT FROM AUTHOR]

Objective: To investigate subclinical atherosclerosis and the effect of treatment in patients with early rheumatoid arthritis (RA). Patients and methods: Forty patients with early RA who met the revised American College of Rheumatology (ACR) criteria and disease duration of <1 year were included in the study. Smokers and patients with classical risk factors for atherosclerosis were excluded. The serum levels of total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol were determined in all patients before and after 1 year of therapy. Carotid artery intima-media thickness (IMT) and carotid plaque were measured before and after treatment. RA disease activity was measured using the 28 joint indices score (DAS-28) and clinical improvement was determined by the ACR response criteria. Forty-five age- and sex-matched nonsmoking volunteers were used as controls. All patients were treated with methotrexate and prednisone. Results: RA patients had a baseline mild dyslipidemia characterized by a decrease in serum HDL-C levels and a high TC/HDL-C atherogenic ratio compared with controls. Both lipid parameters were significantly improved after treatment (P < 0.01). Common carotid artery IMTs at baseline were higher in RA patients compared with controls (P < 0.05). After 1 year of therapy there was a significant decrease in the IMTs (P < 0.001). Thirty-five patients (88%) achieved the ACR 20%, while 30 (75%) reached the ACR 50% response criteria. A significant decrease of DAS-28 was observed after treatment (P < 0.03). Conclusions: The atherogenic lipid profile and subclinical atherosclerosis are features of early RA, which improved after therapy. Early intervention and control of the disease activity may reduce the risk of atherosclerosis and cardiovascular events in patients with RA. [Copyright &y& Elsevier]

Carotid body tumor (CBT), an extra-adrenal paraganglioma, represents an uncommon entity arising in chemoreceptor tissue located at the carotid bifurcation. Only a few cases have been reported in the literature in the pediatric age group less than 14 years of age, primarily as case reports. Surgical excision is advisable in almost all ages, however, in childhood, it is known to carry risks and difficulties due to the smaller size of the involved anatomical structures. We report an unusual case of a large (50 × 43 × 30 mm) carotid paraganglioma of Shamblin type III in a 13-year-old female, living at high altitude until the age of 9 years. This cervical mass was present, but smaller in size, several years before admission. However, an intense hypoxic stimulus at high altitude for 2 months at the age of 13 years probably induced a fast growing period of the lesion. The tumor was removed en bloc with the involved carotid segments and vascular continuity was restored by means of a common carotid to internal carotid saphenous vein interposition graft. No malignant behavior or regional metastatic spread of the resected mass was demonstrated. Furthermore, no inheritance pattern between family members was confirmed. A clinical update on CBTs in childhood a propos of this case report is undertaken. [Copyright &y& Elsevier]

Background: Prolonged maintenance of proteome stability and functionality (proteostasis) is of emerging significance in aging retardation and healthspan.Purpose: An enriched polyphenolic extract obtained from the hydrodistillation of rose petals was tested for its capacity to activate the proteostasis network modules, and thus modulate health- and/or lifespan at the cellular and whole organism level.Methods: The aqueous extract that remained after the hydrodistillation of Rosa damascena petals, was processed with a polystyrene-FPX66 adsorption resin and sequentially fractionated by FCPC. NMR and UHPLC-HRMS analyses revealed the presence of 28 metabolites, mainly glycosides of kaempferol and quercetin.Results: The extract showed high in vitro antioxidant activity and was not toxic in normal human skin fibroblasts, while it promoted the upregulation of NRF2-induced antioxidant genes and main proteostatic modules. Consistently, supplementation of this extract in Drosophila flies' culture medium induced a cncC/NRF2-mediated upregulation of antioxidant and proteostatic modules. Prolonged administration of the extract in flies' culture medium was not toxic and did not affect food intake rate or fecundity; also, it delayed the age-related decline of stress tolerance and locomotion performance (neuromuscular functionality) and dose-dependently extended flies' lifespan.Conclusion: Our findings indicate that the enriched polyphenolic extract obtained from the residue of R. damascena hydrodistillation activates cytoprotective cellular modules that, likely, contribute to its potential anti-aging properties. [ABSTRACT FROM AUTHOR]

We describe the case of a fatal septic illness in a previously healthy young man caused by community-acquired methicillin-susceptible Staphylococcus aureus of Staphylococcus protein A (spa) type t044. The patient developed a devastating Lemierre-like syndrome with extensive thrombosis of inferior vena cava and iliac veins with multiple metastatic septic emboli of the lungs. He presented to the emergency department with rapidly progressing sepsis followed by multiple organ dysfunction syndrome. Recognition of such virulent community-acquired strains is of great importance because they could prove to be emerging pathogens for life-threatening diseases. [ABSTRACT FROM AUTHOR]

We report a clinical case of a 39-year old male, without any known previous medical condition but with occupational exposure to paints and dust cement, who presented an autoimmune pulmonary alveolar proteinosis (PAP) triggered by exposure to toxic inhalation at his workplace. PAP is a rare lung disease characterized by intra-alveolar abnormal accumulation of surfactant. The presence of a crazy-paving pattern in high-resolution computed tomography scan brings the suspicion of PAP although histopathology results of bronchoalveolar lavage are always required for its final diagnosis. The autoimmune form of PAP due to toxic inhalation, such as the one here described, is rare and it is usually difficult to establish a causal relationship. [ABSTRACT FROM AUTHOR]

Abstract: Isolated granulomatous orchitis is a rare chronic testicular inflammation, which should be differentiated from testicular malignancies on scrotal imaging. We present a case of a 33-year-old man, with a diffuse pattern of granulomatous orchitis, confirmed by means of testicular biopsy. MR imaging of the scrotum revealed the presence of two small-sized intratesticular lesions, hypointense on T2-weighted images, not enhancing after gadolinium administration suggesting the diagnosis of benignity. [Copyright &y& Elsevier]