bluuebunny/crossref_metadata_2025 huggingface dataset:
Health(y) education: A critical analysis of the role of public health regulation in and on tertiary education in Aotearoa New Zealand
Authors: Shaw Susan , Tudor Keith
Published: February 2021

This article offers a critical analysis of the role of public health regulation on tertiary education in Aotearoa New Zealand and, specifically, the requirements and processes of Responsible Authorities under the Health Practitioners Competence Assurance Act for the accreditation and monitoring of educational institutions and their curricula (degrees, courses of studies, or programmes). It identifies and discusses a number of issues concerned with the requirements of such accreditation and monitoring, including, administrative requirements and costs, structural requirements, and the implications for educational design. Concerns with the processes of these procedures, namely the lack of educational expertise on the part of the Responsible Authorities, and certain manifested power dynamics are also highlighted. Finally, the article draws conclusions for changing policy and practice.
The Performance and Interrater Agreement of Vibration Perception for the Diagnosis of Loss of Protective Sensation in People With Diabetes Mellitus
Authors: Tentolouris Anastasios , Tentolouris Nikolaos , Eleftheriadou Ioanna , Jude Edward B.
Published: February 2021

This study examined the performance of VibraTip for the diagnosis of loss of protective sensation (LOPS) and the interrater agreement of different neurological modalities performed by 3 health care professionals, a consultant diabetologist, a diabetes specialist nurse, and a podiatrist. Diagnosis of LOPS was based on 10-g Semmes Weinstein monofilament testing performed by a consultant diabetologist (reference method), while examination with a 128-Hz tuning form was also performed. The performance of VibraTip for the diagnosis of LOPS was examined using the receiver operating characteristic curves analysis. Interrater agreement was determined by weighted kappa (κ) statistics. Diagnosis of LOPS (%) was 37.5%. Receiver operating characteristic curve analysis showed that VibraTip examination versus 10-g monofilament, both performed by a consultant, could diagnose LOPS ( P < .001). Sensitivity, specificity, positive predictive value, and negative predictive value of VibraTip versus 10-g monofilament, both performed by a consultant (value, 95% confidence interval), was 0.705 (0.591-0.803), 0.836 (0.758-0.897), 0.733 (0.642-0.808), and 0.816 (0.757-0.863), respectively. The interrater agreement among the health care professionals for 10-g monofilament, VibraTip, and 128-Hz tuning fork in neurological assessment was good with κ > 0.61. VibraTip can be used as a screening tool for the detection of LOPS. There was good overall agreement in the results of neurological examination using 10-g monofilament, 128-Hz tuning fork, and VibraTip among health care professionals.
Exercise Stress Testing Is a Useful Adjunct in the Evaluation of Patients With Claudication and Normal Ankle-Brachial Index
Authors: Weaver Kim
Published: February 2021

A 45-year-old man presented with bilateral lower extremity claudication and was evaluated for lower extremity peripheral arterial disease. Ankle-brachial indices (ABIs) were performed with exercise stress testing. Resting ABI was normal, with postexercise arterial testing revealing a significant drop in ankle pressures, suggesting moderate proximal atherosclerotic vascular occlusive disease. It is important that sonographers are sufficiently trained to determine true claudication symptoms, and lab protocols should be established to effectively appropriate exercise stress testing when necessary.
Lightweight load-balanced and authentication scheme for a cluster-based wireless sensor network
Authors: Zhou Jiliang , Lin Ziqiang
Published: February 2021

Clustering technology is one of the crucial technologies to prolong the lifetime in wireless sensor networks. However, most cluster schemes choose cluster head randomly to send data without considering load balancing and security. In addition, some cluster heads in the highly active area may be overloaded, while others in the low active area may be overloaded, which may easily lead to extreme imbalance in task allocation. Our research on relevant literature shows that the existing authentication schemes do not fully consider the load balancing of cluster heads, while the load balancing schemes ignore the security authentication of cluster heads. Therefore, this article effectively combines load balancing and security verification, and proposes a lightweight load balancing and verification scheme (secure load and energy balancing) based on clustered wireless sensor networks. Secure load and energy balancing implements cluster head’s authentication and confidentiality and integrity of all messages in load balancing. This scheme not only effectively maintains the energy balance of the whole network but also successfully improves the security overhead, thus prolonging the network lifetime. The simulation results show that compared with other similar schemes, this scheme has higher packet forwarding rate, longer network life, and lower overhead. This further proves that the scheme is energy-saving, safe, dynamic, stable, and sustainable.
“Coronavation: Keep Calm, and Carry On”
Authors: Seales William Brent
Published: February 2021

In this essay, I summarize a few ideas inspired by my involvement in the “Coronavation” working group, which spanned 2020’s COVID-19 crisis. Health-care practitioners, computer scientists, and engineers alike, we strive to meet the challenges associated with practice under threat of pandemic with the same ideals driving the rapid, positive developments in health care today: innovation, collaboration and technology convergence, and acquisition of valuable data that leads to better approaches and new ideas. The ideas sketched here, forged by the need for practical pandemic responses, are rooted in those ideals.
China: The New Powerhouse of Hormesis Research?
Authors: Agathokleous Evgenios
Published: February 2021

More than one third of the worldwide hormesis research has been produced at institutions in the United States (US). Although the US ranked first in terms of hormesis publication records from the mid. 1980s to the mid-late 2010s, China became the largest producer of hormesis publications in the years 2019-2020. As China is transforming into a powerhouse of hormesis research, new opportunities might arise for the research field.
Conducting Web-Based Focus Groups With Adolescents and Young Adults
Authors: Brown Courtney A. , Revette Anna C. , de Ferranti Sarah D. , Fontenot Holly B. , Gooding Holly C.
Published: February 2021

This methodologic paper aims to update researchers working with adolescents and young adults on the potentials and pitfalls associated with web-based qualitative research. We present a case study of synchronous web-based focus groups with 35 adolescents and young women ages 15–24 years old recruited from a clinical sample for a mixed methods study of heart disease awareness. We contrast this with two other studies, one using asynchronous web-based focus groups with 30 transgender youth ages 13 to 24 years old and another using synchronous web-based focus groups with 48 young men who have sex with men ages 18 to 26 years old, both recruited via social media. We describe general and logistical considerations, technical platform considerations, and ethical, regulatory, and research considerations associated with web-based qualitative research. In an era of technology ubiquity and dependence, researchers should consider web-based focus groups a potential qualitative research tool, especially when working with youth.
Evolution of contact performance of industry electrical connector based on reliability accelerated testing
Authors: Ni Jing , Han Lidong , Pan Jianfeng , Zheng Junqiang , Shi Yu , Cui Zhi , Cai Jun
Published: February 2021

The evolution of contact performance of electrical connectors, as an expression of service performance, played a significant role in various electronic equipment or system. However, very few methods had been used to detect the evolution of contact performance effectively and accurately. Hence, in this research, reliability accelerated testing was conducted to investigate the evolution of contact performance of electrical connectors. To detect the evolution of contact performance, contact resistance and friction and wear of the connector were measured using a DC resistance tester and an electron microscope respectively. Also, the effect of external conditions such as ambient temperature, mating speed, mating cycles was statistically investigated, and evolution curves were developed for contact resistance and abrasion loss. The obtained results revealed the temperature and mating speed affected the contact performance of electrical connectors. The increment of temperature reduced the shear strength of material and increased the thickness of oxide film. Increased mating speed greatly increased the probability of fracture of micro-protrusion due to collision, the wear form of connector had realized transition from low-speed adhesive wear to high-speed peeling wear. In addition, when the connector was mated about 3000 cycles, the contact performance of the connector would be greatly decreased.
Sub-band selection approach to artifact suppression from electroencephalography signal using hybrid wavelet transform
Authors: Ferdous Jannatul , Ali Sujan , Hamid Ekramul , Molla Khademul Islam
Published: February 2021

This article presents a hybrid wavelet-based algorithm to suppress the ocular artifacts from electroencephalography (EEG) signals. The hybrid wavelet transform (HWT) method is designed by the combination of discrete wavelet decomposition and wavelet packet transform. The artifact suppression is performed by the selection of sub-bands obtained by HWT. Fractional Gaussian noise (fGn) is used as the reference signal to select the sub-bands containing the artifacts. The multichannel EEG signal is decomposed HWT into a finite set of sub-bands. The energies of the sub-bands are compared to that of the fGn to the desired sub-band signals. The EEG signal is reconstructed by the selected sub-bands consisting of EEG. The experiments are conducted for both simulated and real EEG signals to study the performance of the proposed algorithm. The results are compared with recently developed algorithms of artifact suppression. It is found that the proposed method performs better than the methods compared in terms of performance metrics and computational cost.
The construction of leadership practice: Making sense of leader competencies
Authors: Jansson Dag , Døving Erik , Elstad Beate
Published: February 2021

The notion of leadership competencies is a much-debated issue. In this article, we propose that how the leader makes sense of his or her competencies is key to leadership practice. Specifically, we look at how leaders reconcile discrepancies between the self-perceived proficiency of various competencies and their corresponding importance. Empirically, we study leaders within the music domain – how choral conductors make sense of their competencies in the shaping of their professional practice. We investigated how choral leaders in Scandinavia ( N = 638) made sense of their competencies in the face of demands in their working situations. A mixed methodology was used, comprising a quantitative survey with qualitative comments and in-depth interviews with a selection of the respondents. The results show that when choral leaders shape their practice, they frequently face competency gaps that compel them to act or adjust their identity. The key to this sensemaking process is how they move competency elements they master to the foreground and wanting elements to the background. The concept of ‘sensemaking affordance’ is introduced to account for how various leader competency categories are negotiated to safeguard overall efficacy.
A case for complexity-informed participatory action research with young people
Authors: Crook Deborah J , Cox Pat
Published: February 2021

This article addresses the fundamental issue of using qualitative research methods that encourage young people’s participation in settings that more commonly promote neoliberalism at the expense of social justice. Through a case study in an English primary school, it demonstrates how complexity-informed participatory action research could be advanced to enable young people’s participation rights, by building intergenerational relationships that reposition young people and adults within systems and by revealing local and global complexities involved in conceptualising transformational resistance. The developing method is discussed providing an original contribution to knowledge and practice in research with young people, with potential to reconcile schooling and socially just strategy.
Invisible threads linking phantasmal landscapes in Java: Haunted places and memory in post-authoritarian Indonesia
Authors: Leong Kar-Yen
Published: February 2021

The nation is often ‘imagined’ through various elements such as the media, education, ideologies, each providing the necessary ‘boundaries’ for its existence. It is also a space where the landscape is constructed and utilised to shape its citizens’ perception. However, the idea of a nation is not just circumscribed by what is celebrated or visible but also by what is ‘silenced’. During the transitional period between the Sukarno and Suharto administrations in the mid 60’s, approximately 500,000–1 million suspected leftists, communists and dissidents were incarcerated and disappeared. Thus even 20 years after the downfall of Suharto’s authoritarian regime, the incident continues to be an unspeakable ‘open secret’. This paper posits that beneath Indonesia’s modern veneer lies ‘pockets’ of spaces that physically mark this hidden history. I ask how Indonesians conceive and tell of this ‘unmentionable’ history through narratives that surround places of death and violence. I will be looking specifically at sites where dissidents have either been interrogated, imprisoned as well as executed. This research looks at how Indonesians utilise tales of the ghostly and the spectral as a way to bypass the taboo which surrounds the event and at the same time ‘narrativise’ it. I state that these tales of ghosts, hauntings and the supernatural are attempts by Indonesians to comprehend better what was otherwise an ‘incomprehensible’ event. Also, despite the state’s best efforts in creating a vacuum on the event, I state that these sites of violence, the landscapes which they inhabit and the tales they carry, are part of an invisible landscape where a counter ‘imagined community’ exists linking these sites as well as the past and present. With each of the sites, a hidden history is thus revealed despite efforts in suppressing this knowledge.
Long-term outcomes after corrective cartilaginous joint resection based on arthrographic findings of duplicated thumbs
Authors: Iba Kousuke , Saito Akira , Hanaka Megumi , Yamashita Toshihiko
Published: February 2021

We report greater than 10-year outcomes in duplicated thumbs following corrective cartilaginous resection during the growth period. We have undertaken corrective resection of cartilaginous joint connections based on intraoperative arthrographic findings to reconstruct favourable alignment in six Wassel Type II and IV thumb duplication in six patients. The age at surgery was 13 months (range 10–15), and the average post-surgical follow-up was 134 months (range 120–160). We observed five excellent and one good outcome using the Japanese Society for Surgery of the Hand scoring method. Favourable joint congruency and alignment were preserved, and no growth plate arrest or joint space narrowing was present more than 10 years after surgery. We conclude that corrective resection of the cartilaginous joint based on intraoperative arthrographic findings has long-term reliability for duplicated thumbs, especially those of Wassel Type II and IV, which have a cartilaginous joint connection.

Levels of evidence: IV
How Social Media Shapes One’s Public Mood: The Three-Way Interaction Effect of Sphere, Information Valence, and Justice Sensitivity
Authors: Zhou Yixin , Zhang Zheng , Wang Kexin , Chen Shuang , Zhou Mingjie
Published: February 2021

Public mood is a key concept in explaining collective activity, but the way social media shapes an audience’s public mood is still not fully understood. This study aims to explore how social media posts with various characteristics change public mood. The authors asked 351 participants to read 30 microblog newsletters with a 2 × 2 between-subject design (public × private sphere; positive × negative value). The results showed that (a) positive private information decreased negative public mood, (b) positive public information decreased positive public mood rather than increasing it, and (c) negative private information reduced the positive public mood of individuals who were high in justice sensitivity. The discussion focuses on the adverse effect of overexposure to positive public information and how individuals’ means of information processing vary.
Antibacterial Mechanism of Dihydrotanshinone I
Authors: Zhao Lin , Zhao Yingying , Wei Jinfeng , Liu Zhenhua , Li Changqin , Kang Wenyi
Published: February 2021

The antimicrobial activity and the underlying action mechanisms of dihydrotanshinone I against Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamases Staphylococcus aureus were investigated with Kleihauer-Betke (K-B) test. The antibacterial mechanisms of dihydrotanshinone I were investigated by monitoring the changes in electric conductivity, concentration of AKP, protein content, and patterns of protein electrophoretic bands in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The antibacterial rings showed that antimicrobial activity of dihydrotanshinone I at 18 mM was stronger to Staphylococcus aureus than to methicillin-resistant Staphylococcus aureus and extended-spectrum beta-lactamases Staphylococcus aureus. The minimum inhibitory concentration (MIC) and IC50 values showed that dihydrotanshinone I had the strongest inhibitory activity against S. aureus (MIC = 280 µM, IC50 = 874 ± 0.01 µM, respectively). Dihydrotanshinone I could increase the electric conductivity, concentration of alkaline phosphatase (AKP) and protein content. The patterns of protein bands in SDS-PAGE were changed obviously. Dihydrotanshinone I also significantly inhibited S. aureus, methicillin-resistant S. aureus, and extended-spectrum beta-lactamases S. aureus, indicating that dihydrotanshinone I can damage the structures of cell wall and cell membrane to increase permeability of cell membrane and release of cell components. Dihydrotanshinone I could influence the synthesis of bacterial protein, destroy the protein, or reject the anabolism or expression of the protein, and finally lead to the loss of normal physiological function of bacteria.
Effects of Individualized Ischemic Preconditioning on Protection Against Eccentric Exercise–Induced Muscle Damage: A Randomized Controlled Trial
Authors: Santos Cerqueira Mikhail , Kovacs Daniel , Martins de França Ingrid , Pereira Rafael , da Nobrega Neto Sinval Bezerra , Aires Nonato Rúsia Dayanny , De Araújo Moura Lemos Telma Maria , De Brito Vieira Wouber Hérickson
Published: February 2021

Background:

The effects of ischemic preconditioning (IPC) versus a deceptive sham protocol on indirect markers of exercise-induced muscle damage (EIMD) after the application of individualized occlusion pressure were examined. The goal of using a sham protocol is to control for the potential effect of placebo.

Hypothesis:

IPC would surpass the sham protocol in protecting against EIMD.

Study Design:

A randomized, double-blinded, clinical trial.

Level of Evidence:

Level 1.

Methods:

Thirty healthy young men were randomly assigned to an eccentric exercise for the knee extensor muscles preceded by IPC (4 × 5 minutes of individualized total occlusion pressure) or sham protocol (4 × 5 minutes using 20 mm Hg). Maximal voluntary isometric torque (MVIT), rate of torque development, muscle soreness, pressure pain threshold, knee range of motion, thigh girth, and creatine kinase (CK) activity were assessed before IPC or sham protocol and up to 72 hours after the eccentric EIMD. Affective valence and perceived exertion were also evaluated.

Results:

MVIT decreased 17.1% in the IPC and 18.1% in the sham groups, with no differences between groups. Differences from baseline were observed in the sham group for muscle soreness at 48 hours ( P < 0.001) and 72 hours ( P = 0.02), and for CK activity at 72 hours ( P = 0.04). Muscle soreness was reduced in the IPC group at 48 hours compared with the sham group (∆ = 15.8 mm; P = 0.008) but without achieving the minimal clinically important difference. IPC induced a smaller perceived exertion than the sham protocol (∆ = 1.1 a.u.; P = 0.02). The remaining outcomes were not statistically different in both groups.

Conclusion:

IPC does not surpass the sham protocol to protect against mild EIMD of the knee extensors muscles.

Clinical Relevance:

Although IPC is a noninvasive, low-cost, and easy-to-administer intervention, the IPC effects can, in part, be explained by the placebo effect. In addition, individualized IPC promotes attenuation in perceived exertion during eccentric exercise.
Effects of Different Recovery Times on Internal and External Load During Small-Sided Games in Soccer
Authors: Branquinho Luis , Ferraz Ricardo , Travassos Bruno , Marinho Daniel A. , Marques Mário C.
Published: February 2021

Background:

The ability to maintain a high intensity of exercise over several repetitions depends on recovery from previous exercises. This study aimed to identify the effects of different recovery times on internal and external load during small-sided soccer games.

Hypothesis:

An increase in recovery time will increase the external training load and decrease the internal exercise load, which will result in a greater physical impact of the exercise.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 2.

Methods:

Twenty male semiprofessional soccer players participated in the present study. They performed the same exercise (5-a-side game format) continuously (1 × 18 minutes) and repeatedly/fractionated (3 × 6 minutes) with different recovery times (30 seconds, 1 minute, 1.5 minutes, and 2 minutes). Their internal load (ie, average heart rate (HR) and maximum HR) and external load (ie, total distance, maximum speed, and ratio meters) were measured using an HR band and an inertial device equipped with a global positioning system, respectively.

Results:

The manipulation of recovery times induced differences in the internal and external load. For the same total duration, the external and internal load indicators exhibited higher values during the fractionated method, particularly with short recovery periods.

Conclusion:

The application of small-sided soccer games with different recovery times induced varying responses in training load. To maintain high physical performance and high training load, the fractional method with short recovery periods (ie, 30 seconds) should be used. In contrast, to carefully manage players’ efforts and decrease response to training load, continuous or fractional methods with longer recovery periods (ie, 1-2 minutes) should be used.

Clinical Relevance:

The proper prescription of recovery time between exercises facilitates enhanced training efficiency and optimized performance.
Dialectics to the rescue: Critical insights into Africa’s (under)development
Authors: Mensah Joseph , Firang David
Published: February 2021

That dialectics, as a mode of reasoning, is routinely used to explain the worlds of both nature and society per their inherent complexities, contradictions, and states of flux makes it quite amenable to robust theorizations of development. However, since many are those who see Africa(ns) in simplistic and wholly pessimistic terms, it is unsurprising that there is a conspicuous dearth of dialectical analysis of Africa’s development challenges and prospects. This paper examines Africa’s development from the standpoint of dialectics, showing how the key tenets and concepts of dialectics—including negation, sublation, the transformation of quantity to quality, the interpenetration of opposites, and the interchangeability of causes and effects—could help us understand the trajectory and dynamics of Africa’s development. The paper conceptualizes development as a dialectical process and, consequently, sees efforts in development discourse to set Africa (or any other part of the world, for that matter) in strict binary opposition to another region as unsustainable.
Management of Recurrent Acute Rhinosinusitis: A Systematic Review
Authors: Saltagi Mohamad Z. , Comer Brett T. , Hughes Samuel , Ting Jonathan Y. , Higgins Thomas S.
Published: February 2021

Background Objective Study Design

RARS is a challenging clinical problem that impacts many patients. This article seeks to systematically review the literature on RARS management.

Methods

Cochrane, PubMed, EMBASE, and other databases were queried for articles related to RARS dating from 1990 to present, according to PRISMA guidelines. Inclusion criteria included articles specifically addressing RARS management; studies with 3 or more patients; and articles in English.

Results

A total of 1022 titles/abstracts potentially related to RARS were identified. Of these, sixty-nine full texts were selected for review, and 10 met inclusion criteria (five with level 4 evidence, four with level 3 evidence, one with level 2 evidence). The studies included a total of 890 patients (Age range 5.8 to 53.5 years), with follow up ranging from 1 to 19 months. Endpoints were primarily based on symptomatic improvement, although some articles also reported post-treatment endoscopic and radiographic findings. Management options included medical therapy (intranasal steroids, antibiotics, nasal saline irrigations, N-acetylcysteine, allergy treatment, and decongestants), balloon sinus dilation (BSD), and endoscopic sinus surgery (ESS). Surgical patients (BSD and ESS) had a trend towards greater symptom control than medically-treated patients, but meta-analysis was not possible.

Conclusion

Despite increasing interest in the treatment of RARS, there remains a lack of consensus regarding optimal management. The literature thus far, largely based on expert opinion, suggests that surgical management, either through balloon sinus dilation or endoscopic sinus surgery, may be helpful in improving symptoms and quality of life in those who do not respond to initial trials of medical management.
Short-Term Effect of Lumbar Traction on Intervertebral Discs in Patients with Low Back Pain: Correlation between the T2 Value and ODI/VAS Score
Authors: Liu Zhen-zhen , Wen Hui-quan , Zhu Ye-qing , Zhao Bin-liang , Kong Qing-cong , Chen Jian-yu , Guo Ruo-mi
Published: February 2021

Objective

The effect of lumbar traction on low back pain (LBP) patients is controversial. Our study aims to assess changes in the intervertebral disc water content after lumbar traction using T2 mapping and explore the correlation between changes in the T2 value and Oswestry Disability Index (ODI)/visual analogue scale (VAS) score.

Design

Lumbar spine magnetic resonance imaging was performed, and the ODI/VAS scores were recorded in all 48 patients. Midsagittal T2-weighted imaging and T2 mapping were performed to determine the Pfirrmann grade and T2 value. Then, the T2 values were compared between pre- and posttraction, and the correlation between changes in the T2 value and ODI/VAS scores were examined.

Results

In the traction group, the changes in the nucleus pulposus (NP) T2 values for Pfirrmann grades II-IV and the annulus fibrosus (AF) T2 values for Pfirrmann grade II were statistically significant after traction ( P < 0.05). Changes in the mean NP T2 value of 5 discs in each patient and in the ODI/VAS score showed a strong correlation ( r = 0.822, r = 0.793).

Conclusion

T2 mapping can be used to evaluate changes in the intervertebral disc water content. Ten sessions of traction resulted in a significant increase in quantitative T2 measurements of the NP in discs for Pfirrmann grade II-IV degeneration and remission of the patients’ clinical symptoms in the following 6 months. Changes in the mean NP T2 value of 5 discs in each patient were strongly correlated with changes in the ODI/VAS score.
The Experience of Situations Before and During a COVID-19 Shelter-at-Home Period
Authors: Funder David C. , Lee Daniel I. , Baranski Erica , Gardiner Gwendolyn
Published: February 2021

Undergraduate participants described their experience of an ordinary situation before ( N = 544) and during ( N = 123) a COVID-19 shelter-at-home period using the Riverside Situational Q-sort (RSQ). They also rated the experience’s positivity and completed a Big Five Personality Inventory. RSQ items placed higher before the sheltering period included “new relationships could develop,” “femininity can be expressed,” and “talking is expected.” Items placed higher during the sheltering period included “family is important” and “people are disagreeing.” Average positivity ratings did not differ, but relatively positive ratings before sheltering correlated with Extraversion, Agreeableness, Conscientiousness, and Openness; negative ratings correlated with Negative Emotionality. During sheltering, positive ratings again correlated with Agreeableness; negative ratings correlated with Conscientiousness. Sheltering conditions accentuated the importance of family, could lead to conflict, and limited opportunities for social interaction. Agreeableness was associated with positivity at both time periods; other traits varied in relevance as the situation changed.
Urban–Rural Residential Mobility Associated With Political Party Affiliation: The U.S. National Longitudinal Surveys of Youth and Young Adults
Authors: Jokela Markus
Published: February 2021

The current study used longitudinal panel data from the National Longitudinal Survey of Youth 1979 (NLSY79; n = 7,064) and National Longitudinal Survey of Young Adults (NLSY-YA; n = 2,985) to examine whether political party affiliation was related to residential mobility between rural regions, urban regions, and major cities in the United States. Over a follow-up of 4–6 years, stronger Republican affiliation was associated with lower probability of moving from rural regions to major cities (relative risk [RR] = 0.71, confidence interval [CI] = [0.54, 0.93]) and higher probability of moving away from major cities to urban or rural regions (RR = 1.17, CI = [1.03, 1.33]). The empirical correlation between party affiliation and urban–rural residence was r = −0.15 [−0.17, −0.13]. Simulated data based on the regression models produced a correlation of r = −0.06 [−0.10, −0.03], suggesting that selective residential mobility could account almost half of the empirically observed association between party affiliation and urban–rural residence.
The prevalence of epileptic seizures in multiple sclerosis in a large tertiary hospital in Australia
Authors: Ooi Suyi , Kalincik Tomas , Perucca Piero , Monif Mastura
Published: February 2021

Rationale

To determine the prevalence of epileptic seizures in multiple sclerosis (MS) at an Australian tertiary hospital and to define their clinical features.

Methods

We retrospectively analysed adult patients at the Royal Melbourne Hospital electronically identified to have ICD codes for MS and seizures and/or epilepsy between 1996 to 2019, utilising paper and electronic-based records.

Results

Of the 2,125 MS patients identified, 16 (0.75%) experienced epileptic seizures during a mean follow-up period of 12.9 years. Median age of MS diagnosis (SD) was 38 (9.3) years. Four patients had relapsing remitting MS (25%), 10 secondary progressive MS (63.5%), and 2 primary progressive MS (12.5%). More than two-thirds of patients had seizure onset following the diagnosis of MS, and the majority of these had advanced disease (approximate EDSS >6) at the time of seizure onset. Focal onset-seizures occurred in 87.5% of patients with seizures.

Conclusion

The estimated prevalence of seizures in our cohort was lower than in previous studies (0.75 vs 2–4%). In most cases, seizures occurred after the diagnosis of MS in the context of advanced disease. Further studies are required to determine if MS disease modifying treatments reduce the risk of seizures in this cohort.
Spillover democratisation: Reflections from MENA politics
Authors: Ghosh Sujay
Published: February 2021

‘Spillover democratisation’ is an ongoing process. It envisages that democratic values, institutions and practices continue to spread and evolve through various pathways – horizontal, geographical and vertical. Yet, possibilities also remain that anti-democracy forces may thwart the process. In Middle East and North Africa (MENA), social and economic rights were not accompanied by civil and political rights. The Arab Spring was a response to this gap: it raised the optimism of achieving democratisation in the MENA region, through geographical and horizontal pathways. However, the promise remains largely elusive at present; rather, we witness the cementing of existing anti-democratic forces. Yet, citizens’ innate support for democracy, sporadic pro-democracy activism and rising consumerism sustain the democratising potentials of the Arab Spring.
Perioperative Hidden Blood Loss in Elderly Osteoporotic Vertebral Compression Fracture Patients With Percutaneous Vertebroplasty and Influencing Factors
Authors: Cai Tongchuan , Wang Feng , Nan Liping , Chen Dong , Wang Shuguang , Feng Xinmin , Zhang Wenjie , Zhang Liang
Published: February 2021

Introduction:

To analyze perioperative hidden blood loss (HBL) and its influencing factors in elderly patients with osteoporotic vertebral compression fracture (OVCF) treated with percutaneous vertebroplasty (PVP).

Materials and Methods:

From January 2016 to December 2018, 103 elderly patients with OVCF (age > 85 years) treated with PVP were selected. The patient’s height, weight, duration of symptoms, previous medical history and other basic information were recorded. The hemoglobin (Hb) and hematocrit (Hct) immediately after admission and the next day postoperative were recorded. The operation time, surgical bleeding, Kummell’s disease, vertebral height preoperative and postoperative, and bone cement leakage was recorded. The total blood loss (TBL) was calculated according to Gross’s formula, and HBL was calculated based on the TBL and surgical bleeding. The influential factors were analyzed by multivariate linear regression analysis and single factor correlation analysis.

Results:

The mean surgical bleeding was 11.83 ± 5.37 mL, and HBL was 306.19 ± 185.92 mL, with a statistically significant difference (P = 0.000). According to the multiple linear regression analysis, the duration of symptoms (P = 0.030), number of fracture segments (P = 0.016), operation time (P = 0.004), loss of vertebral height (P = 0.026), recovery of vertebral height (P = 0.004), Kummell’s disease (P = 0.040) and cement leakage (P = 0.004) were correlated with an increased amount of HBL. Sex (P = 0.077), body mass index (BMI) (P = 0.486), hypertension (P = 0.734), diabetes (P = 0.769), fracture level (P = 0.518) and surgical bleeding (P = 0.821) had no correlation with the amount of HBL.

Conclusions:

There was obvious HBL during the perioperative period of PVP in elderly patients with OVCF. A fresh fracture, multi-segment vertebral fracture, longer operation time, presence of Kummell’s disease, loss of vertebral height, recovery of vertebral height and cement leakage the increased perioperative HBL during PVP.
Effects of an Innovative Training Program for New Graduate Registered Nurses: A Comparison Study
Authors: Xu Fengqin , Ma Liang , Wang Yinhe , Yu Jiang , Li Dandan , Zhou Guohui , Xu Yuzi , Zhang Hailin , Cao Yang
Published: February 2021

New graduate registered nurses (NGRNs) face a great challenge during the transition from school to clinical practice. We conducted a quasi-randomized controlled study to evaluate the effects of a new training mode for newly recruited NGRNs in a Chinese teaching hospital. A total of 150 NGRNs were recruited from a teaching hospital and assigned into two groups. The conventional training and a new training program were taken for the control group and the research group, respectively. At the end of the training, the two groups were evaluated and compared for theoretical knowledge and operation skills using a mutual-evaluation examination and the Chinese Registered Nurse Core Competency Scale. The scores of theoretical knowledge (88.4 vs. 81.7, p < .001) and operation skills (94.8 vs. 90.3, p < .001), and the total core competencies score (156.2 vs. 148.8, p < .05) in the research group were statistically significantly higher than those in the control group. Compared with the control group, the research group also had statistically significantly higher scores in education and consultation (2.47 vs. 2.40), clinical nursing (2.87 vs. 2.62), interpersonal relationship (2.56 vs. 2.43), and critical thinking and scientific research (2.78 vs. 2.61). The innovative pre-job training program for NGRNs conducted in Chinese clinical nursing skill training bases might significantly improve the training effects and is worthy of broader implementation.
Sustaining Workforce Well-being: A Model for Supporting System Resilience During the COVID-19 Pandemic
Authors: Morrow Ellen , Call Megan , Ransco Mari , Hofmann Kim Mahoney , Locke Amy
Published: February 2021

Professional well-being in health care is critical to the success of academic medical centers inpatient care, educating trainees, serving communities, and pursuing research missions. The COVID-19 pandemic, caused by SARS-COV-2, has stretched health care teams and individuals in unique ways, leading to high levels of persistent stress with concern for longer term mental health implications. The pandemic is a catalyst to grow and strengthen support for those who work in health professions. Using one academic health center as a model, this paper reviews how professional well-being can be approached comprehensively at a system level while considering the needs of diverse employees during a time of increased need. This ramping up of services has the opportunity to build community and support a trajectory of post traumatic growth.
Biologic Augmentation Reduces the Failure Rate of Meniscal Repair: A Systematic Review and Meta-analysis
Authors: Zaffagnini Stefano , Poggi Alberto , Reale Davide , Andriolo Luca , Flanigan David C. , Filardo Giuseppe
Published: February 2021

Background:

Clinical results after isolated meniscal repair are not always satisfactory, with an overall failure rate of around 25%. To improve the success rate of meniscal repair, different biologic augmentation techniques have been introduced in clinical practice, but their real efficacy is still controversial.

Purpose/Hypothesis:

To evaluate the safety, clinical results, and failure rate of biologic augmentation techniques for meniscal repair. The hypothesis was that biologic augmentation would improve the results of meniscal repair.

Study Design:

Systematic review and meta-analysis of comparative studies.

Methods:

A systematic review of the literature was performed in March 2020 of 3 electronic databases (PubMed, Scopus, and the Cochrane Library) regarding meniscal repair combined with biologic augmentation techniques. Articles combining biologic augmentation with other surgical procedures besides meniscal suture were excluded. The quality of the included studies was assessed using a modified Coleman Methodology Score, and the risk of bias was evaluated using the ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) and the RoB 2.0 (Revised Tool for Risk of Bias in Randomized Trials) for nonrandomized and randomized controlled trials, respectively.

Results:

A total of 11 studies were included in the qualitative analysis: platelet-rich plasma (PRP) augmentation in 6 comparatives studies, fibrin clot augmentation in 2 case series, and mesenchymal stem cells augmentation in 2 case series and 1 case report. One severe adverse event of septic arthritis was reported for PRP 1 month after surgery. The quality of evidence evaluated with the modified Coleman Methodology Score was low overall. Five studies reporting on 286 patients (111 PRP augmentation, 175 control) were included in the quantitative synthesis. A significantly lower risk of failure was documented in the PRP augmentation group as compared with the control group: 9.9% (4.5%-19.1%) versus 25.7% (12.7%-38.7%) ( P < .0005).

Conclusion:

The literature on biologic meniscal augmentation is recent and scarce. Only a few comparative trials are available, all focusing on the potential of PRP. The meta-analysis documented that PRP is safe and useful in improving the survival rate, with a 9.9% rate of failure versus 25.7% for the control group. Further high-level studies are needed to confirm these findings and identify the most effective biologic augmentation strategy to improve the outcome of meniscal repair.
Comparable Clinical and Radiologic Outcomes Between an Anatomic Tunnel and a Low Tibial Tunnel in Remnant-Preserving Posterior Cruciate Ligament Reconstruction
Authors: Yoon Kyoung Ho , Kim Jung-Suk , Park Jae-Young , Park Soo Yeon , Kiat Raymond Yeak Dieu , Kim Sang-Gyun
Published: February 2021

Background:

There is currently no consensus on the optimal placement of the tibial tunnel for remnant-preserving posterior cruciate ligament (PCL) reconstruction.

Purpose/Hypothesis:

The purpose of this study was to compare the clinical and radiologic outcomes of remnant-preserving PCL reconstruction using anatomic versus low tibial tunnels. We hypothesized that the outcomes of low tibial tunnel placement would be superior to those of anatomic tibial tunnel placement at the 2-year follow-up after remnant-preserving PCL reconstruction.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We retrospectively reviewed the data for patients who underwent remnant-preserving PCL reconstruction between March 2011 and January 2018 with a minimum follow-up of 2 years (N = 63). On the basis of the tibial tunnel position on postoperative computed tomography, the patients were divided into those with anatomic placement (group A; n = 31) and those with low tunnel placement (group L; n = 32). Clinical scores (International Knee Documentation Committee subjective score, Lysholm score, and Tegner activity level), range of motion, complications, and stability test outcomes at follow-up were compared between the 2 groups. Graft signal on 1-year follow-up magnetic resonance imaging scans was compared between 22 patients in group A and 17 patients in group L.

Results:

There were no significant differences between groups regarding clinical scores or incidence of complications, no between-group differences in posterior drawer test results, and no side-to-side difference on Telos stress radiographs (5.2 ± 2.9 mm in group A vs 5.1 ± 2.8 mm in group L; P = .900). Postoperative 1-year follow-up magnetic resonance imaging scans showed excellent graft healing in both groups, with no significant difference between them.

Conclusion:

The clinical and radiologic outcomes and complication rate were comparable between anatomic tunnel placement and low tibial tunnel placement at 2-year follow-up after remnant-preserving PCL reconstruction. The findings of this study suggest that both tibial tunnel positions are clinically feasible for remnant-preserving PCL reconstruction.
Internal Risk Factors for Low Back Pain in Pole Vaulters and Decathletes: A Prospective Study
Authors: Enoki Shota , Kuramochi Rieko , Murata Yuki , Tokutake Gaku , Sakamoto Tatsuo , Shimizu Takuya
Published: February 2021

Background:

Pole vaulters and decathletes frequently experience several types of injuries to their lower back, often resulting in mechanical low back pain (LBP). However, the risk factors for the occurrence of LBP in these athletes have not been defined.

Purpose:

To determine the physical factors that relate to LBP occurrence for collegiate pole vaulters and decathletes.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

We observed 31 pole vaulters and decathletes for 1 year. At the start of the observation period, isokinetic flexion and extension muscle strength of the knee and hip joints were recorded along with active and passive range of motion (ROM) and muscle tightness. Participants were then divided into 2 groups using the median value of each measurement: those below the median (low group) and those above the median (high group). The log-rank test was used to compare LBP occurrence between the low group and high group for all measurements. Multivariate regression analyses were thereafter applied using the Cox proportional hazards regression.

Results:

Log-rank tests revealed a statistically significant change in the survival curve for the occurrence of LBP in the participants with chronic LBP ( P = .037), the low group for hip flexion peak torque per body weight on the non-takeoff leg ( P = .047), and the low group for passive hip flexion angle on both legs (takeoff leg: P = .034; non-takeoff leg: P = .023). In addition, log-rank tests revealed a statistically significant change in the survival curve for the occurrence of LBP in the low group for passive hip extension angle on the takeoff leg only for the participants without chronic LBP ( P = .014).

Conclusion:

It may be necessary to acquire sufficient ROM and hip flexion to prevent LBP occurrence in pole vaulters and decathletes.
Impact of Body Mass Index on the Accuracy of Physical Examination and MRI of the Shoulder
Authors: Beer Yiftah , Gilat Ron , Ner Eran Beit , Shohat Noam , Atoun Ehud , Lindner Dror , Agar Gabriel
Published: February 2021

Background:

The physical examination of overweight patients can require specific adaptations. Orthopaedic literature on the impact of body mass index (BMI) on the physical examination of the shoulder is virtually nonexistent.

Purpose:

To assess whether BMI affects the sensitivity and specificity of common shoulder tests, using arthroscopy as a gold standard. We also examined the effects of BMI on the sensitivity and specificity of magnetic resonance imaging (MRI) of the shoulder for reference.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

We analyzed the data of 116 consecutive patients who underwent shoulder arthroscopy for the treatment of rotator cuff tears, Bankart lesions, and superior labral anterior-posterior (SLAP) lesions. Preoperative BMI, physical examination of the shoulder findings, and MRI findings were extracted. Contingency tables and receiver operating characteristic curves were used to evaluate the sensitivity and specificity of provocative tests of the shoulder and MRI as well as their relationship to BMI.

Results:

The sensitivity and specificity of the Jobe supraspinatus test were 77.8% and 72.7% in patients with BMI ≤25, 82.6% and 70.6% in those with 25 < BMI ≤ 30, and 81.3% and 55.6% in those with BMI >30, respectively ( P < .001). The apprehension and relocation tests demonstrated higher sensitivity and specificity for the overweight patients (25 < BMI ≤ 30) compared with the other BMI groups, with a sensitivity and specificity of 83.3% and 100% for the apprehension test and a sensitivity and specificity of 75% and 100% for the relocation test, respectively. The O’Brien, Speed, and Ebinger tests for SLAP tears had low accuracy and did not yield statistically significant results. MRI interpretation was found to be influenced by BMI in obese patients, especially when SLAP lesions were assessed.

Conclusion:

Counterintuitively, tests for shoulder instability had greater specificity in overweight patients and should be encouraged, particularly in obese patients, in whom the specificity of shoulder MRI for the detection of a Bankart lesion is lower. The Jobe test was more sensitive but less specific in overweight patients. These findings may assist care providers in improving the interpretation of the shoulder examination of overweight patients and consequently lead to better treatment-related decisions.