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Synchronous hybrid delivery (simultaneously teaching on-campus and online students using web conferencing) is becoming more common; however, little is known about how students experience emotions in this learning environment. Based on Pekrun's (2006) control-value theory of emotions, the dual purpose of this study was first to compare synchronous hybrid students who attend online versus on-campus in terms of control, value, emotions and perceived success and second to compare students’ degree of emotional activation in the domains of programme achievement and technology use. Survey data from 101 graduate business students revealed that online students reported significantly higher levels of technology-related anger, anxiety and helplessness. Furthermore, in comparison to their on-campus counterparts, online students more clearly separated their emotions in terms of programme achievement and technology use. Emotions related significantly to students’ perceived success for both programme achievement and technology use, and mediated the effects of control and value appraisals on perceived success.

Synchronous hybrid delivery (simultaneously teaching on-campus and online students using web conferencing) is becoming more common; however, little is known about how students experience emotions in this learning environment. Based on Pekrun's (2006) control-value theory of emotions, the dual purpose of this study was first to compare synchronous hybrid students who attend online versus on-campus in terms of control, value, emotions and perceived success and second to compare students' degree of emotional activation in the domains of programme achievement and technology use. Survey data from 101 graduate business students revealed that online students reported significantly higher levels of technology-related anger, anxiety and helplessness. Furthermore, in comparison to their on-campus counterparts, online students more clearly separated their emotions in terms of programme achievement and technology use. Emotions related significantly to students' perceived success for both programme achievement and technology use, and mediated the effects of control and value appraisals on perceived success.

Leadership is a management tool to direct effective achievement of goals. Historical investigation can provide a valuable lens for the study of leadership styles. To that end, this study examines the disparate approaches of Roald Amundsen and Robert Scott as they raced to be the first explorer to reach the South Pole. The objective of this study is to analyze the leadership techniques used in these expeditions, and to determine how they shaped the outcome of each. The process of tacit knowledge and experience coalesces and fosters both leadership and action that are not only communication-oriented and value-driven, but also rooted in growth mindset and reflexivity. Both concepts proved to be imperative to the success of both Amundsen and Scott's expeditions. Ultimately, the experiences, choices, and eventual fate of polar explorers Roald Amundsen and Robert Scott provide a unique view of the human endeavor that holds valuable lessons for leaders in a variety of professional settings. [ABSTRACT FROM AUTHOR]

After failed conservative therapy or in the absence of any intervention, a rupture of the digital subcutaneous extensor tendon at the distal interphalangeal (DIP) joint, known as mallet finger, may lead to a chronic extension deficit due to excessive scarring and tendon elongation. Various surgical techniques to restore the extension of the distal phalanx have been proposed, but an optimal approach has not yet been established. To tighten the extensor tendon, a purse-string suture can be applied. Although it has shown efficacy, it can result in significant bulging and scar formation. Using the “abbreviato” technique, the elongated part of the extensor tendon is excised, and the tendon is re-sutured. Also, tenodesis has been described, particularly in pediatric cases. In this retrospective follow-up study, we aimed to investigate if the step-plasty procedure previously described by Baumeister provides comparable, if not superior, functional and aesthetic outcomes compared to existing techniques for patients with chronic mallet finger. In this retrospective study, a consecutive series of 68 patients with chronic mallet fingers was enrolled. Patients were treated surgically using step-plasty of the respective extensor tendon. After skin incision and tenolysis, the elongated extensor tendon was incised in a Z-like fashion and stepwise resected in the transverse portion of the Z. The functional and aesthetic effects of this step-plasty technique were compared with results of 44 patients previously treated using purse-string sutures of the extensor tendon and evaluated using Crawford’s and Levante’s criteria. In all patients undergoing the step-plasty procedure, the extension deficit was significantly reduced from an average of 42 degrees preoperatively to 11 degrees postoperatively. In contrast, the control group treated by purse-string sutures showed a slightly higher postoperative extension deficit of 15 degrees. According to Levante’s criteria, the results of our step-plasty procedure were significantly better than those achieved with purse-string sutures. Our study demonstrated that the treatment of older or chronic subcutaneous extensor tendon ruptures using the step-plasty technique led to a significant reduction in extension deficits. According to Levante’s criteria, the postoperative outcome was significantly better in comparison to the purse-string suture technique. Additionally, no skin resection was required to improve the extension capability of the distal finger joint, compared to established surgical procedures.

Objective: To investigate factors that together with hand or hip/knee osteoarthritis (OA) could contribute to functional decline over a year's time in elderly individuals. Methods: The data of 1,886 individuals between ages 65 and 85 years in a prospective, observational population‐based study with 12–18 months of follow‐up in the context of the European Project on Osteoarthritis were analyzed. The outcome measures were self‐reported hand and hip/knee functional decline, evaluated using a minimum clinically important difference of 4 on the Australian/Canadian Hand OA Index and of 2 on the Western Ontario and McMaster Universities Osteoarthritis Index hip/knee physical function subscales, both normalized to 0–100. Using regression models adjusted for sex, age, country, and education level, the baseline factors considered were clinical hand or hip/knee OA, pain, analgesic/antiinflammatory medications, comorbidities, social isolation, income, walking time, grip strength, physical activity time, and medical/social care. Results: After a year, 453 participants were identified as having worse hand functionality and 1,389 as not worse. Hand OA, anxiety, walking time, and grip strength were risk factors for hand functional decline; pain was a confounder of the effect of hand OA. Analgesic/antiinflammatory medications mediated the combined effect of hip/knee OA plus pain on functional decline in the 554 individuals classified as having worse hip/knee functionality and the 1,291 persons who were not worse. Peripheral artery disease, obesity, and cognitive impairment were other baseline risk factors. Conclusion: Study findings showed that together with emotional status and chronic physical and cognitive conditions, OA affects hand and hip/knee functional decline. [ABSTRACT FROM AUTHOR]

BackgroundPreoperative anxiety in cardiac surgery can lead to prolonged hospital stays and negative postoperative outcomes. An improved patient education using 3D models may reduce preoperative anxiety and risks associated with it.MethodsPatient education was performed with standardized paper-based methods (n = 34), 3D-printed models (n = 34) or virtual reality models (n = 31). Anxiety and procedural understanding were evaluated using questionnaires prior to and after the patient education. Additionally, time spent for the education and overall quality were evaluated among further basic characteristics (age, gender, medical expertise, previous non-cardiac surgery and previously informed patients). Included surgeries were coronary artery bypass graft, surgical aortic valve replacement and thoracic aortic aneurysm surgery.ResultsA significant reduction in anxiety measured by Visual Analog Scale was achieved after patient education with virtual reality models (5.00 to 4.32, Δ-0.68, p

Abstract Background 3D printed models of pediatric hearts with congenital heart disease have been proven helpful in simulation training of diagnostic and interventional catheterization. However, anatomically accurate 3D printed models are traditionally based on real scans of clinical patients requiring specific imaging techniques, i.e., CT or MRI. In small children both imaging technologies are rare as minimization of radiation and sedation is key. 3D sonography does not (yet) allow adequate imaging of the entire heart for 3D printing. Therefore, an alternative solution to create variant 3D printed heart models for teaching and hands-on training has been established. Methods In this study different methods utilizing image processing and computer aided design software have been established to overcome this shortage and to allow unlimited variations of 3D heart models based on single patient scans. Patient-specific models based on a CT or MRI image stack were digitally modified to alter the original shape and structure of the heart. Thereby, 3D hearts showing various pathologies were created. Training models were adapted to training level and aims of hands-on workshops, particularly for interventional cardiology. Results By changing the shape and structure of the original anatomy, various training models were created of which four examples are presented in this paper: 1. Design of perimembranous and muscular ventricular septal defect on a heart model with patent ductus arteriosus, 2. Series of heart models with atrial septal defect showing the long-term hemodynamic effect of the congenital heart defect on the right atrial and ventricular wall, 3. Implementation of simplified heart valves and addition of the myocardium to a right heart model with pulmonary valve stenosis, 4. Integration of a constructed 3D model of the aortic valve into a pulsatile left heart model with coarctation of the aorta. All presented models have been successfully utilized and evaluated in teaching or hands-on training courses. Conclusions It has been demonstrated that non-patient-specific anatomical variants can be created by modifying existing patient-specific 3D heart models. This way, a range of pathologies can be modeled based on a single CT or MRI dataset. Benefits of designed 3D models for education and training purposes have been successfully applied in pediatric cardiology but can potentially be transferred to simulation training in other medical fields as well.

Abstract The determination of the neutrino mass is one of the major challenges in astroparticle physics today. Direct neutrino mass experiments, based solely on the kinematics of $$\upbeta $$ β -decay, provide a largely model-independent probe to the neutrino mass scale. The Karlsruhe Tritium Neutrino (KATRIN) experiment is designed to directly measure the effective electron antineutrino mass with a sensitivity of $$0.2\hbox { eV}$$ 0.2eV ($$90\%$$ 90% CL). In this work we report on the first operation of KATRIN with tritium which took place in 2018. During this commissioning phase of the tritium circulation system, excellent agreement of the theoretical prediction with the recorded spectra was found and stable conditions over a time period of 13 days could be established. These results are an essential prerequisite for the subsequent neutrino mass measurements with KATRIN in 2019.

Abstract Background Protein kinase C θ has been established as an important signaling intermediate in T-effector-cell activation and survival pathways by controlling activity of the key transcription factors NF-κB and NFAT. Previous studies identified an activation-induced auto-phosphorylation site at Thr-219, located between the tandem C1 domains of the regulatory fragment in PKCθ, as a structural requirement for its correct membrane translocation and the subsequent transactivation of downstream signals leading to IL-2 production in a human T cell line. Methods The present work aimed to define the role of this phosphorylation switch on PKCθ in a physiological context through a homozygous T219A knockin mouse strain. T cell activation was analyzed by H3-thymidine uptake (proliferative response), qRT-PCR and luminex measurements (cytokine production). NFAT and NF-κB transactivation responses were estimated by Gel mobility shift and Alpha Screen assays. Frequencies of T cell subsets were analyzed by flow cytometry. Results Despite a normal T cell development, in vitro activated effector T cells clearly revealed a requirement of Thr-219 phosphorylation site on PKCθ for a transactivation of NF-κB and NFAT transcription factors and, subsequently, robust IL-2 and IFN-γ expression. Conclusion This phenotype is reminiscent of the PKCθ knockout T cells, physiologically validating that this (p) Thr-219 auto-phosphorylation site indeed critically regulates PKCθ function in primary mouse T cells.

Abstract Background The protein kinase C theta (PKCθ) has an important and non-redundant function downstream of the antigen receptor and co-receptor complex in T lymphocytes. PKCθ is not only essential for activation of NF-κB, AP-1 and NFAT and subsequent interleukin-2 expression, but also critical for positive selection and development of regulatory T lymphocytes in the thymus. Several domains regulate its activity, such as a pseudosubstrate sequence mediating an auto-inhibitory intramolecular interaction, the tandem C1 domains binding diacylglycerol, and phosphorylation at conserved tyrosine, threonine as well as serine residues throughout the whole length of the protein. To address the importance of the variable domain V1 at the very N-terminus, which is encoded by exon 2, a mutated version of PKCθ was analyzed for its ability to stimulate T lymphocyte activation. Methods T cell responses were analyzed with promoter luciferase reporter assays in Jurkat T cells transfected with PKCθ expression constructs. A mouse line expressing mutated instead of wild type PKCθ was analyzed in comparison to PKCθ-deficient and wild type mice for thymic development and T cell subsets by flow cytometry and T cell activation by quantitative RT-PCR, luminex analysis and flow cytometry. Results In cell lines, the exon 2-replacing mutation impaired the transactivation of interleukin-2 expression by constitutively active mutant form of PKCθ. Moreover, analysis of a newly generated exon 2-mutant mouse line (PKCθ-E2mut) revealed that the N-terminal replacement mutation results in an hypomorph mutant of PKCθ combined with reduced PKCθ protein levels in CD4+ T lymphocytes. Thus, PKCθ-dependent functions in T lymphocytes were affected resulting in impaired thymic development of single positive T lymphocytes in vivo. In particular, there was diminished generation of regulatory T lymphocytes. Furthermore, early activation responses such as interleukin-2 expression of CD4+ T lymphocytes were significantly reduced even though cell viability was not affected. Thus, PKCθ-E2mut mice show a phenotype similar to conventional PKCθ-deficient mice. Conclusion Taken together, PKCθ-E2mut mice show a phenotype similar to conventional PKCθ-deficient mice. Both our in vitro T cell culture experiments and ex vivo analyses of a PKCθ-E2-mutant mouse line independently validate the importance of PKCθ downstream of the antigen-receptor complex for activation of CD4+ T lymphocytes.

Depending on the context, robust and durable T lymphocyte activation is either desirable, as in the case of anti-tumor responses, or unwanted, in cases of autoimmunity when chronic stimulation leads to self-tissue damage. Therefore, reliable in vivo models are of great importance to identify and validate regulatory pathways of T lymphocyte activation. Here, we describe an in vivo mixed-lymphocyte-reaction (MLR) approach, which is based on the so-called parent-into-F1 (P → F1) mouse model in combination with the congenic marker CD45.1/2 and cell proliferation dye-labeling. This setup allows us to track adoptively transferred allogenic CD4+ and CD8+ T lymphocytes and analyze their phenotype as well as the proliferation by flow cytometry in the blood and spleen. We could show hypo-reactive responses of T lymphocytes isolated from knockout mice with a known defect in T lymphocyte activation. Thus, this MLR-based in vivo model provides the opportunity to analyze positive regulators of T cell responses under physiological conditions of polyclonal T lymphocyte activation in vivo.

Synchronous hybrid delivery, defined as a course option where mutually exclusive groups of online and on-campus students are taught simultaneously using real-time audio and video technology, is becoming more common in higher education. This paper reports on a study whose objective was to investigate how online versus on-campus attendance in synchronous hybrid graduate business programs affects the relationships among students' need satisfaction, motivation, and perceived success. Ryan and Deci's self-determination theory was used to guide the analyses and interpret the results. Survey data involving 112 hybrid graduate business students revealed that need satisfaction significantly predicted several categories of motivation, which in turn predicted perceived success. For online students, perceived favorability of online and on-campus delivery was significantly correlated with key dimensions of need satisfaction and perceived success. The results also indicated that there are few significant differences on types of motivation and psychological needs between online and on-campus hybrid students; an exception was that online students reported significantly lower levels of relatedness than their on-campus counterparts. Differences based on attendance mode, may not be as substantial as was once thought. [ABSTRACT FROM AUTHOR]