bluuebunny/crossref_metadata_2025 huggingface dataset:
Empathy and Language in the Clinician Patient Relationship: Improving the Translation of Evidence to Practice
Authors: Geyer Cynthia
Published: May 2021

For clinicians, effective communication goes beyond the delivery of scientific information to include an understanding of who the patient is and what they value; treating them with respect; and acknowledging their emotional and social realities. Recognizing our own implicit biases and cultivating a more mindful approach to the impact of language, especially around weight and food, and using verbal and nonverbal approaches to convey empathic concern can improve our relationships with our patients. Patients who feel seen and respected are more likely to follow through with recommendations including dietary change, leading to improved health and quality of life.
Micro Nudges: A Systems Approach to Health
Authors: Buettner Dan
Published: May 2021

The secret to longevity and healthier communities lies in a systems-level lifestyle-based approach. There are currently 5 regions across the world where people live relatively longer, healthier, and happier lives. Taking lessons from these areas, dubbed “blue zones,” we can help improve health and wellness at the population level. There are already cases of these Blue Zones Projects implemented in communities across the United States, which have had demonstrable, positive impacts on public health. Collaboration between the public and private sectors at the local level can make these changes to improve lifestyles and reduce the burden of chronic diseases on the healthcare system.
Polyurethane-urea-amide-based triblock copolymer contains functionalized polystyrene: Synthesis, characterization and solvent resistivity study
Authors: Balaji K , Suresh J , Karthik S , Karthikeyan A , Arun A
Published: May 2021

Synthesized polystyrene (PSt) with a molecular weight of 2100 g/mol, hexamethylene diisocyanate (HMDI), 6-hexylamino benzamide (6B), and N1-(6-aminohexyl)-N4-(6-benzoylaminohexyl)terephthalamide (6T6B) are used to make a copolymer of thermoplastic elastomers. The prepared polymers’ inherent viscosity results (0.4–1.1 dL/g) support the polymer’s high mass. The presence of a monodentate urea group in the polymer chain is confirmed by FT-IR tests. The temperature dependence of FT-IR confirms that the synthesized copolymer has a space length dependent reversible crystallinity. Data from differential scanning calorimetry (DSC) also shows that the hard segment crystallization is strong and reversible in nature. The XRD results show that the polymer is semi-crystalline. The TGA analysis confirmed that the synthesized copolymers are thermally stable up to 290°C. The presence of hydrogen bonds in polymer chains is thermally reversible. The polymer’s solvent resistivity is excellent due to its high crystallinity.
Growing home dialysis: The Ontario Renal Network Home Dialysis Initiative 2012–2019
Authors: Blake Peter G , McCormick Brendan B , Taji Leena , Jung James KH , Ip Jane , Gingras Joanie , Boll Phil , McFarlane Phil , Pierratos Andreas , Aziz Anas , Yeung Angie , Patel Monisha , Cooper Rebecca
Published: May 2021

The Ontario Renal Network (ORN), a provincial government agency in Ontario, Canada, launched an initiative in 2012 to increase home dialysis use province-wide. The initiative included a new modality-based funding formula, a standard mandatory informatics system, targets for prevalent home dialysis rates, the development of a ‘network’ of renal programmes with commitment to home dialysis and a culture of accountability with frequent meetings between ORN and each renal programme leadership to review their results. It also included funding of home dialysis coordinators, encouragement and funding of assisted peritoneal dialysis (PD), and support for catheter insertion and urgent start PD. Between 2012 and 2017, home dialysis use rose from 21.9% to 26.5% and then between 2017 and 2019 stabilised at 26% to 26.5%. Over 7 years, the absolute number of people on home dialysis increased 40% from 2222 to 3105, while the number on facility haemodialysis grew 11% from 7935 to 8767. PD prevalence rose from 16.6% to 20.9%, a relative increase of 25%. The initiative showed that a sustained multifaceted approach can increase home dialysis utilisation.
‘Somewhere between science and superstition’: Religious outrage, horrific science, and The Exorcist (1973)
Authors: Chambers Amy C.
Published: May 2021

Science and religion pervade the 1973 horror The Exorcist (1973), and the film exists, as the movie’s tagline suggests, ‘somewhere between science and superstition’. Archival materials show the depth of research conducted by writer/director William Friedkin in his commitment to presenting and exploring emerging scientific procedures and accurate Catholic ritual. Where clinical and barbaric science fails, faith and ritual save the possessed child Reagan MacNeil (Linda Blair) from her demons. The Exorcist created media frenzy in 1973, with increased reports in the popular press of demon possessions, audience members convulsing and vomiting at screenings, and apparent religious and specifically Catholic moral outrage. However, the official Catholic response to The Exorcist was not as reactionary as the press claimed. The United States Conference of Catholic Bishops’ Office of Film and Broadcasting (USCCB-OFB) officially and publicly condemned the film as being unsuitable for a wide audience, but reviews produced for the office by priests and lay Catholics and correspondence between the Vatican and the USCCB-OFB show that the church at least notionally interpreted it as a positive response to the power of faith. Warner Bros. Studios, however, were keen to promote stories of religious outrage to boost sales and news coverage – a marketing strategy that actively contradicted Friedkin’s respectful and collaborative approach to working with both religious communities and medical professionals. Reports of Catholic outrage were a means of promoting The Exorcist rather than an accurate reflection of the Catholic Church’s nuanced response to the film and its scientific and religious content.
Exploring vegan ideology through graffiti slogans
Authors: Hughes Neil
Published: May 2021

This article is a study of a sample of eighteen animal rights graffiti slogans that were chalked on the walls of a tunnel known as Potterow Port near the main University of Edinburgh campus, in Scotland, in February 2020. The purpose of the article is to interrogate the implicit ideological commitments underpinning the graffiti slogans, the rhetorical aims of their authors and the linguistic devices and structures they used to achieve their goals. These three dimensions of the slogans are analysed using an inter-disciplinary framework inspired by work on discourse and ideology, recent studies of graffiti slogans in protest contexts and important contributions to the animal rights canon.

Regarding the ideological underpinnings of the slogans, the study reveals four core concepts that it argues are central to contemporary vegan thought: the speciesist relationship between human and non-human animals; species egalitarianism; the vegan imperative; and a commitment to non-violent direct action. In addition to these core beliefs, it detects the presence in the slogans of adherence to adjacent values and ideals such as love, compassion and respect for life, attempts to thicken vegan ideology by reaching out to environmentalism and the peace movement and tension around the moral basis for adopting vegan practices. The interconnected conceptual map that lies at the heart of contemporary veganism has emerged, it argues, in response to ‘dislocations’ in human/animal relations and within the animal advocacy movement, between advocates of a welfarist response to animal exploitation and those such as the authors of the graffiti slogans committed to a more radical, vegan inspired solution to animal oppression.
Fast Refugee Protection: Temporality and Migration Control
Authors: Masoumi Azar
Published: May 2021

This article explores the temporality of migration control through an analysis of refugee claim processing in Canada. I draw on organizational reports, commissioned studies, media reports, interviews and archival data to argue that time is a key technology of state-controlled migration regulation. I show that temporal technologies have long been used to both control the access of migrants and the labour of civil servants. Furthermore, I show that procedural temporalities have been consistently manipulated to reflect and facilitate growing restrictionism in Canadian migration regulation. In short, I suggest that migration regulation regimes devise and use temporal technologies to block, deter or delay access to rights to unwanted and unauthorized migrants, and to reduce the cost of doing so where possible.
Theological Reinterpretation of “Christology of Water” from Feng Shui
Authors: Kang Hyun Mi
Published: May 2021

This article presents the “Christology of Water” from Feng Shui cosmology, which promotes liberating women and nature from the oppression perpetrated against them by contemporary Korean churches, which have sexism and eco-antipathy at their heart. The presentation of the “Christology of Water” from Feng Shui envisions a new eco-feminist theological solution to the critique of patriarchies and anthropocentricism alienating and suppressing women and nature. This “Christology of Water” developed from the metaphorical languages of Feng Shui suggests a contextual hermeneutic through reinterpretation from the eco-feminist perspective.
A Case of Negative Externality: Use of Pesticide and Its Impact on Health Among Farmers in Salumbhu Village, Nepal
Authors: Rahman Mohammad Mashiur , Chowdhury Soumi Roy , K. Bohara Alok , Karmacharya Biraj
Published: May 2021

The widespread and uncontrolled use of harmful pesticide to facilitate mass-level agricultural production creates negative externalities ranging from environmental degradation to having adverse health implications to the users. This article explores a primary village-level data of farmers in the Salumbhu village of Nepal to investigate the health effects associated with pesticide use. A total of six health symptoms grouped into two categories such as serious health-related issues and irritants are analysed separately using ordered logit model. For the robustness of the results, Poisson and negative binomial models are also used. We found that farmers as compared to the non-farmers are significantly more prone to facing serious health issues. Furthermore, as farmers are the applicators of pesticide, the odds of them facing all the health symptoms increases significantly. The results are uniform across different measures of health and over multiple models, which advocates the need of appropiate regulations in the usage of pesticide in Nepal.
Impact of Employer Branding on Employee Commitment: Employee Engagement as a Mediator
Authors: Yousf Aasia , Khurshid Shabana
Published: May 2021

Employer branding has fascinated human resources (HR) managers and establishments over the last two decades. This is attributed to its practical business implications and being a strong predictor of many favourable organizational outcomes. Due to the fierce business rivalry and market saturation in recent times, businesses are increasingly looking to engage their workforce in order to induce employer commitment among them. Employer brand is one factor that can help organizations keep their employees involved in the job. Employee engagement is critical for service brands, such as the banking industry, for delivering better customer service and maintaining a motivated workforce. An engaged workforce is also more committed towards the organization, which also leads to many desirable business outcomes. This study targeted 485 employees from two banks (one a public sector bank and the other a private bank), which resulted in 409 functional responses. The work objective was to examine the influence of employer brand on employee engagement, which may lead to organizational commitment. This article also examined the mediating role of employee engagement with respect to the five dimensions of employer brand and organizational commitment. The regression analysis using structural equation modelling (SEM) revealed that all five dimensions of employer brand influence employee engagement. Employee engagement also shares a positive and significant association with organizational commitment. Moreover, the mediation analysis also revealed that employee engagement partially mediates the relationship between employee engagement and organizational commitment. These study findings have important implications for business managers, HR managers and academicians.
The Relationship of Critical Success Factors of the Mineral Industry: A Study on India
Authors: Mohanty Manoj Kumar , Mishra Padma Charan , Samantaray Alaka
Published: May 2021

The mineral industry environment is an interlinked chain of activities. Identification of major activities of the mineral industry, termed as critical success factors (CSFs), and their relationship structure will be approachable, productive and efficiency-oriented for the industry to manage. The aim of the article is to develop a relationship structure consisting of CSFs influencing the mineral industry. Sixteen such operational influencing CSFs are identified through a broad literature review and subsequent dialogues held with mineral-field experts. The interpretive structural modelling (ISM) approach is applied for analysing CSFs and finding a relationship structure. The study is carried out in Odisha, Chhattisgarh and Jharkhand, mineral-rich states of India. Identification of CSFs and their relationship is carried out in nine phases sequentially to arrive at the latent structure. This is the only study to develop relationships of CSFs for any mineral industry in India. The findings of the study will provide insights on the relationship structure of CSFs of the mineral industry’s operation and be helpful for improvements in addressing operational difficulties for corporates, as well as academics. Among the 16 CSFs identified, ‘training and skill level’, ‘infrastructure’ and ‘political influence’ have the maximum driving force and are the least dependent. The projected model is helpful in understanding the relationship among CSFs and the business operation as a whole.
Strategic Responses During Crisis: An Empirical Investigation
Authors: Singhal Neeraj
Published: May 2021

The coronavirus spread across the globe has affected the human life and economies critically. On one side, this situation has brought the attention of policymakers to save the mankind, on the other side; this pandemic situation threatened the business across the sphere. The firms are worst hit by the virus outbreak and are struggling to survive in this tough phase. The objective of this study is to measure the challenges faced by manufacturing and service industry, and how it influenced the financial parameters such as market share, profit margin, and logistics cost, and operating cost of the organization. It is also to be observed that in such a crisis, an appropriate strategic plan is required to sustain the businesses. Sales, revenue, production, profit margin, raw material availability, in-house employees decreased in manufacturing industries during COVID-19 but no significant change is observed in the service industry. Raw material cost, manufacturing cost, logistics cost, and operating cost increased significantly in both manufacturing and services industries. Market share, advertising cost, and customer connect decreased in manufacturing industries and increased in services industries. The main strategies in crisis are investigated empirically; retrenchment, persevering, innovation, and exit (Wenzel M, Stanske S, Lieberman MB, 2020, Strategic Management Journal, 41, V7–V18), it shows how organizations have taken steps proactively to fight in the crisis of COVID-19.
The Body of Christ: An Aligning Union Model
Authors: King Rolfe
Published: May 2021

In the context of recent debate about whether “Reformed Catholics” and Protestants, more generally, should accept Augustine’s totus Christus Christological ecclesiology, I illustrate the notion of an asymmetric aligning union. This is a metaphysically real union, but not a substantial union. I suggest that Reformed catholic theology would be better served by deploying the notion of an asymmetric aligning union. It preserves the Reformation solas and is compatible with the notion of the mystical body of Christ, without the disadvantages of the totus Christus notion, if that is taken to involve a substantial union. This form of union should be of wider ecumenical interest.
Hold Fast
Authors: Galman Sally Campbell
Published: May 2021

In the world of maritime lore and practice, tattoos were both commemorative and magical. Sailors frequently tattooed the words H-OL- D F-A-S-T onto the skin above each knuckle in the hopes of strengthening their grasp on the ship’s rigging. It gave sailors an edge at saving their own lives when the winds would howl and the ship tossed wildly on the waves, and they must hold fast or be thrown into the dark cold sea. This illustrated autoethnographic work will draw on the metaphor of the ship in transit, the slippery rigging, storied magic and the dangers of the chasm below, to interrogate the idea of the academy as literal and figurative home for transnational academics. In it, I will combine words and pictures to tell two stories of being. The piece concludes with problematizing the notion of “home” as a desirable construct in the context of the academy.
“We Are the Future”: Critical Inquiry and Social Action in the Classroom
Authors: Spires Hiller , Himes Marie , Lee Crystal Chen , Gambino Andrea
Published: May 2021

This study explored how engaging in critical inquiry through Project-Based Inquiry (PBI) Global fostered social action with high school students. Drawing on theoretical perspectives from critical inquiry and social action and employing a collective case study approach, we focused on six diverse students from two of the 18 teams who participated in a PBI Global examining global water and sanitation over a two-month period. Data sources included semi-structured student interviews, students’ posts and uploads in a shared writing space, and students’ multimodal products of learning. Three themes emerged from the analysis across the data sources: synergistic collaboration, critical analysis and creation of multimodal texts, and understanding global and local interdependence to take social action. The discussion illuminates how students’ engagement in critical inquiry and social action ignite the emergence of Freire’s notion of critical consciousness.
The Mode Heuristic in Service Consumers’ Interpretations of Online Rating Distributions
Authors: Köcher Sarah , Köcher Sören
Published: May 2021

In this article, the authors demonstrate a tendency among consumers to use the arithmetic mode as a heuristic basis when drawing inferences from graphical displays of online rating distributions in such a way that service evaluations inferred from rating distributions systematically vary by the location of the mode. The rationale underlying this phenomenon is that the mode (i.e., the most frequent rating which is represented by the tallest bar in a graphical display) attracts consumers’ attention because of its visual salience and is thus disproportionately weighted when they draw conclusions. Across a series of eight studies, the authors provide strong empirical evidence for the existence of the mode heuristic, shed light on this phenomenon at the process level, and demonstrate how consumers’ inferences based on the mode heuristic depend on the visual salience of the mode. Together, the findings of these studies contribute to a better understanding of how service customers process and interpret graphical illustrations of online rating distributions and provide companies with a new key figure that—aside from rating volume, average ratings, and rating dispersion—should be incorporated in the monitoring, analyzing, and evaluating of review data.
An Ex Post Facto Study Examining Implementation of Positive Behavioral Interventions and Supports Across School and Community Variables From an Inclusive Innovation Perspective
Authors: Goodman-Scott Emily , McMahon George , Kalkbrenner Michael T. , Smith-Durkin Stephanie , Patel Shruti , Czack Anna , Weeks Natalie
Published: May 2021

Schools implementing Positive Behavioral Interventions and Supports (PBIS) with fidelity demonstrate a wealth of student and school benefits. At the same time, there exists limited research from an inclusive innovation perspective: examining whether schools and communities have equitable access to PBIS based on sociodemographic school and community variables. This article presents the results of an ex post facto research design examining PBIS implementation and access across sociodemographic school and community variables from an inclusive innovation lens, examining data from schools ( N = 489) in the state of Georgia. The significant interaction effects revealed that between both PBIS and non-PBIS schools, those located in suburban areas had significantly higher median household incomes compared with rural and urban schools. Additional findings included the following: PBIS rural schools had higher household incomes and lower percentages of free/reduced-price lunch than non-PBIS schools in rural communities, and PBIS schools included significantly higher proportions of students who identified as White compared with non-PBIS schools.
Dual therapy with clopidogrel and rivaroxaban in cats with thromboembolic disease
Authors: Lo Sara T , Walker Ashley L , Georges Catherine J , Li Ronald HL , Stern Joshua A
Published: May 2021

Objectives

Feline arterial thromboembolism (ATE), an often devastating outcome, was recently shown to affect 11.3% of cats with hypertrophic cardiomyopathy over 10 years. Current American College of Veterinary Internal Medicine guidelines recommend the use of clopidogrel in cats at risk for ATE, with addition of a factor Xa inhibitor in very high risk or post-ATE cases. To date, no studies have examined the safety or efficacy of this combined antithrombotic therapy. This retrospective case series aimed to assess the frequency and type of adverse events that occurred in cats prescribed dual clopidogrel and rivaroxaban therapy. Secondary aims were to evaluate indications for dual therapy and clinical outcome.

Methods

The study included 32 cats prescribed clopidogrel (18.75 mg PO q24h) and rivaroxaban (2.5 mg PO q24h) on an outpatient basis over a 5-year period.

Results

Cats were prescribed dual therapy for at least one of the following: ATE event (n = 18), presence of an intracardiac thrombi (n = 17) or presence of spontaneous echocardiographic contrast (SEC) (n = 16). Five cats experienced adverse effects that could be attributed to medications, a median of 13 days from initiation (epistaxis, hematemesis, hematochezia or hematuria). No cat required hospitalization as a result of these events. Median survival time from onset of therapy was 257 days (interquartile range [IQR] = 38–497) for all cats, 502 days (IQR = 171–663) for ATE cats, 725 days (IQR = 133–856) for cats with an ATE to two or more limbs and 301 days (IQR = 221–431) for cats with only one limb affected. Recurrence rate of ATE while on dual therapy was 16.7%; no cat newly developed an ATE while on dual therapy.

Conclusions and relevance

Dual antithrombotic therapy with clopidogrel and rivaroxaban resulted in a low reported incidence of adverse events. Cats placed on dual therapy for an ATE event experienced a low rate of recurrence and effective thromboprophylaxis was achieved in cats with intracardiac thrombi or SEC.
How tourism industry agglomeration improves tourism economic efficiency?
Authors: Li Zhoufei , Liu Huiyue
Published: May 2021

The agglomeration of the tourism industry has important effects on its efficiency. This article used panel data on the Chinese provincial tourism industry for the 2011–2016 period, applied the location quotient index and three-stage data envelopment analysis method to, respectively, measure the degree of agglomeration and efficiency, and explained the impact of agglomeration on tourism efficiency. The empirical results of this study indicate the following. (1) China’s tourism industry shows a trend towards agglomeration, revealing gradient differences where the highest degree of agglomeration is in the eastern region, followed by the western and central regions. (2) After eliminating random and environmental factors, the adjusted efficiencies are lower than the unadjusted efficiencies. The average overall tourism efficiency is higher in the eastern region than in the central and western regions. (3) From the national perspective, industrial agglomeration can significantly improve the overall efficiency (TE), pure technical efficiency (PTE), and scale efficiency of the tourism industry. (4) Based on regional analysis, the agglomeration of the eastern tourism industry can significantly enhance its TE and PTE. Agglomeration for the western area has a significant positive impact on PTE. There is no significant relationship between agglomeration and efficiency in the central region.
Mapping the transnational imaginary of social media genres
Authors: Hallinan Blake , Kim Bumsoo , Scharlach Rebecca , Trillò Tommaso , Mizoroki Saki , Shifman Limor
Published: May 2021

This article presents a transnational study of the classification and evaluation of social media content. We conducted a large-scale survey ( N = 4770) in five countries (Germany, Italy, Japan, South Korea, and the United States) with open-ended questions about the types of content people like and dislike. Through iterative and inductive coding, we identified 29 topics, or broad areas of interest, and 213 recurrent genres, or narrower categories that share elements of form and content. We compared the results according to country, gender, age, and education level, identifying patterns of cultural difference and commonality. While we found significant differences in the prominence and preferentiality of content, these distictions were less pronounced for disliked topics around which social media users tended to converge. Finally, we discuss genre imaginaries as normative maps that reflect ideas about morality in general and the purpose of social media in particular.
International studies of school design – Lessons for Europe on innovation and risk
Authors: Deppeler Joanne , Thompson Ian , Corrigan Deborah
Published: May 2021

This editorial sets out the context and agenda for this special issue of European Educational Research Journal, which brings together four accounts of research from diverse international contexts in relation to schools that are being designed and promoted as innovative learning environments (ILEs). The overall purpose is to advance what is known about innovation and the challenges and risks involved for those engaged in the design and occupation of ILEs. We begin by outlining some of the important considerations for researchers working in ILE projects that specifically place an emphasis on participatory approaches to innovation and put educational and social change, at the centre of the work. We then highlight some themes for readers to keep in mind as they consider the arguments developed in the papers.
Gender Differences in Older Adults’ Perceptions of Falls and Fall Prevention
Authors: Patton Susan , Vincenzo Jennifer , Lefler Leanne
Published: May 2021

Aim

To explore gender differences in older adults’ perceptions about preventing falls.

Background

Falls are a major problem for older adults and health care systems and a challenge to the aging population. Consideration of older adults’ perceptions of fall prevention is needed to increase their engagement in evidence-based prevention strategies.

Method

A qualitative analysis of secondary data was performed.

Results

Three major themes emerged: We’ve Seen It, Women Are Caregivers, and Men Are Analyzing Risks and Modifying Behaviors. The men and women in this study shared information about falls and fall prevention in alignment with traditional role expectations. The women learned about falling through their roles as caregivers and prevented falls by controlling extrinsic risk factors indoors such as holding onto handrails on stairs or making home modifications. The men demonstrated an analytical approach to reducing risk such as employing improved safety measures during outdoors activities as a responsibility to maintain independence.

Implications

The different perceptions of men and women influence what they do to engage in fall prevention. Health care professionals need to consider gender differences and take an individualized approach that includes allowing older adults to share their experiences, acknowledging their successful fall prevention behaviors, and validating and addressing their concerns.
The Utility of MRI With Multiacquisition Variable-Resonance Image Combination (MAVRIC) in Diagnosing Deep Total Hip Arthroplasty Infection
Authors: Levack Ashley E. , Koch Chelsea , Moore Harold G. , Cross Michael B.
Published: May 2021

Background: The 2010 American Academy of Orthopaedic Surgeons Clinical Practice Guidelines report insufficient evidence to address the diagnostic efficacy of magnetic resonance imaging (MRI) for periprosthetic joint infection (PJI). Questions/Purposes: The purpose of this study was to determine the utility of MRI with multiacquisition variable-resonance image combination (MAVRIC) metal artifact suppression techniques in diagnosing PJI in the setting of total hip arthroplasty (THA). Methods: Multiacquisition variable-resonance image combination MRIs obtained of THAs between November 2012 and November 2016 were queried. Radiology reports were classified as positive (suspicious for infection), negative (no features of infection), or inconclusive (infection cannot be excluded or correlation with aspiration suggested if clinically concerned). Chart review identified cases of deep PJI according to the modified Musculoskeletal Infection Society criteria. Results: Of 2156 MRIs of THAs included, MRI was concerning for infection in 1.8% (n = 39), inconclusive in 1.2% (n = 26), and negative in 97.0% (n = 2091). Deep PJI was identified in 53 (2.5%) patients, 30 of whom (56.6%) had conclusively positive finding on MRI (false-negative rate: 43.4%, sensitivity: 56.6%). Of 2103 aseptic THAs, only 9 (0.4%) MRIs were read as suspicious for infection (false-positive rate: 0.4%; specificity: 99.6%). Conclusion: Magnetic resonance imaging with MAVRIC is a highly specific test for PJI with a low false-positive rate. This indicates that when clinicians are provided with an MRI that unexpectedly suggests infection, a formal evaluation for infection is indicated. In patients with otherwise equivocal diagnostic findings, MRI may help confirm, but not refute, a diagnosis of PJI. Prospective study with more experienced image reviewers may further support the use of MRI in PJI.
The Impact of COVID-19 on Orthopedic Surgery Fellowship Training: A Survey of Fellowship Program Directors
Authors: Heaps Braiden M. , Dugas Jeffrey R. , Limpisvasti Orr
Published: May 2021

Background: The COVID-19 pandemic has had a wide-reaching impact. Graduate medical education of orthopedic surgeons was not spared from the jarring changes. Purpose: We sought to survey fellowship program directors in the field of orthopedic surgery about how the COVID-19 pandemic affected the education of the 2019 to 2020 and 2020 to 2021 fellowship classes and the future of their programs. Methods: In October 2020, an 18-item survey was distributed by an official of the American Academy of Orthopedic Surgeons (AAOS) to the specialty societies that govern fellowship training. Each specialty society then distributed the survey to its respective program directors. A reminder email was sent during the enrollment period. Each respondent was able to complete the survey once. Survey questions were grouped into 3 sections: general information about the fellowship training programs, the impact of COVID-19 on the 2019 to 2020 fellowship class, and the future impact of COVID-19 on the fellowship training programs. Results: Of the 564 accredited orthopedic surgery fellowship programs in the United States, 190 directors responded. Of these, 73.59% reported COVID-19 had a negative impact on the 2019 to 2020 fellowship class. A normal distribution of responses was found regarding didactic and academic learning, research, and mentorship opportunities. A majority of respondents said they believe that there will be no negative impact on patient care the fellows provide in the years to come. Conclusion: Orthopedic surgery fellowship program directors acknowledged that while there were negative effects to training in the pandemic, they did not think these would negatively affect patient care provided by 2019 to 2020 fellows in the short and medium term. They also reported positive outcomes from the experience of the pandemic, including new ways to educate fellows.
Effect of north wall internal surface structure on heat storage-release performance and thermal environment of Chinese solar greenhouse
Authors: Li Yiming , Yue Xiang , Zhao Lei , Xu Hui , Liu Xingan , Li Tianlai
Published: May 2021

Chinese solar greenhouse (CSG) is an energy-saving agricultural building which is used to grow vegetables in winter. The north wall of CSG plays an crucial role in concerning the production yield and quality during the winter months. To improve the thermal performance of north wall, different internal surface structures (ISS) with same materials were compared. Based on the field experiment and the proposed valuation, the dynamic heat storage-release characteristics of the north walls have been analyzed and discussed. The results showed that compared with the flat wall and the striped wall, the alveolate wall has better properties of heat storage and thermal insulation. Moreover, relative humidity in this type of greenhouse is more suitable for growing crops. The alveolate wall can improve indoor thermal environment and reduce the sensitivity to external environment. The obtained results can provide a basis for the scientific construction of the CSG north wall. It has significant potential for the area in high latitude, high altitude and long winter.
A roadmap: Social distancing physical activity data collection to protect those with intellectual disabilities
Authors: Stone Whitley J , Baker Kayla M
Published: May 2021

The novel coronavirus may impact exercise habits of those with intellectual disabilities. Due to the mandated discontinuation of face-to-face research, investigators must adapt projects to protect all involved while collecting objective physical activity metrics. This brief report outlines a modification process of research methods to adhere to social distancing mandates present during COVID-19. Actions taken included electronic consent and assent forms, an electronic survey, and mailing an accelerometer with included instructions. The amended research methods were implemented without risk for virus transmission or undue burden on the research team, participant, or caregiver. Recruitment was likely impacted by the coronavirus-mediated quarantine, plausibly resulting in bias. Objective physical activity data collection can be sufficiently modified to protect those with intellectual disabilities and investigators. Future research designs may require greater participant incentives and the creation of in-home participation.
Negotiating the practicalities of informed consent in the field with children and young people: learning from social science researchers
Authors: Sherwood Gina , Parsons Sarah
Published: May 2021

The real-world navigation of ethics-in-practice versus the bureaucracy of institutional ethics remains challenging. This is especially true for research with children and young people who may be considered vulnerable by the policies and procedures of ethics committees but agentic by researchers. Greater transparency is needed about how this tension is navigated in practice to provide confidence and effective strategies for social researchers, including those new to the field, for negotiating informed consent. Twenty-three social science researchers with a range of experience were interviewed about their practices for gaining informed consent from children and young people in social research and the development of their ‘ethics in practice’ over time. Main themes focused on navigating ethics protocols within institutions, practices to prepare for data collection, and a critical evaluation of the resources that can be applied to gaining consent and managing relationships. A range of methods and concrete steps that address ethical challenges are outlined to illustrate what can be done in practice to achieve authentic consent and appropriate participation.
A window into the future? MRI for evaluation of neuromyelitis optica spectrum disorder throughout the disease course
Authors: Solomon Jacqueline M. , Paul Friedemann , Chien Claudia , Oh Jiwon , Rotstein Dalia L.
Published: May 2021

Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing, inflammatory disease of the central nervous system marked by relapses often associated with poor recovery and long-term disability. Magnetic resonance imaging (MRI) is recognized as an important tool for timely diagnosis of NMOSD as, in combination with serologic testing, it aids in distinguishing NMOSD from possible mimics. Although the role of MRI for disease monitoring after diagnosis is not as well established, MRI may provide important prognostic information and help differentiate between relapses and pseudorelapses. Increasing evidence of subclinical disease activity and the emergence of newly approved, highly effective immunotherapies for NMOSD adjure us to re-evaluate MRI as a tool to guide optimal treatment selection and escalation throughout the disease course. In this article we review the role of MRI in NMOSD diagnosis, prognostication, disease monitoring, and treatment selection.
Injury Profile in Professional Handball Players During 4 Consecutive Seasons According to Playing Positions: A Longitudinal Study
Authors: Raya-González Javier , García-Esteban Sergio , Castillo Daniel , de Ste Croix Mark
Published: May 2021

Background:

The injury profile of each playing position in handball is a key factor in being able to improve the injury risk management process. Therefore, the aim of this study was to longitudinally analyze the differences in professional handball players’ injury profile according to their playing position (ie, goalkeeper, back, wing, and line).

Hypothesis:

Injury incidence and burden would be higher in back players compared with the other playing positions, while ligament and knee would be the most common injury type and location.

Study Design:

Prospective cohort design.

Level of Evidence:

Level 4.

Methods:

Sixty-eight male handball players belonging to the same professional team participated in this study over 4 consecutive seasons. Injury incidence and injury burden were recorded as well as the severity, type, and location following the International Olympic Committee consensus statement.

Results:

Although nonsignificant differences in injury incidence were found according to playing position (rate ratios [RRs] from 0.43 to 2.47; P > 0.05), back players reported the highest burden (60.65 absence days/1000 h; RR from 0.12 to 7.75; P < 0.05), with wing players showing a greater burden (54.29 absence days/1000 h; RR from 0.09 to 4.91; P < 0.05) in comparison with goalkeepers (12.19 absence days/1000 h) and line players (13.10 absence days/1000 h). Muscle/tendon injuries and sprains presented higher incidence and burden than other type of injuries, and a greater incidence and burden was reported for knee injuries in all playing positions.

Conclusion:

The highest injury incidence and injury burden is in back players in professional handball.

Clinical Relevance:

This study provides comprehensive information on the injury profile of professional handball players, which can be useful for strength and conditioning coaches when developing specific injury risk management programs.
Children in Boxing and Martial Arts Should Be Better Guarded From Facial Injuries
Authors: Gotlieb Rachael J. , Sorenson Thomas J. , Borad Vedant , Schubert Warren
Published: May 2021

Study Design:

Cross-sectional study

Objective:

Childhood participation in boxing and martial arts has increased over the past decade, and these activities are well-known causes of traumatic injury. We hypothesized that the face is frequently injured in the setting of pediatric boxing and martial arts trauma in the United States and that there are identifiable injury patterns.

Methods:

We performed a cross-sectional study of consecutive pediatric patients in the National Electronic Injury Surveillance System (NEISS) from January 1, 2010 to December 31, 2019. Patients were included in our study if they were younger than 18 years of age and evaluated in the emergency department (ED) after boxing or martial arts trauma. Primary outcome was facial injury. Other variables of interest include age, sex, ED disposition, type and location of injury. Descriptive and univariate statistics of the primary outcome were computed with these variables.

Results:

There were 4,978 total pediatric patients injured due to boxing and martial arts trauma reported by NEISS-participating EDs during the study period, and 264 patients experienced injury to the face (264/4978; 5.3%). Over 20% (n = 60) of reported facial injuries were fractures; the most fractured structure was the nose (42/60; 70), orbit (11/60; 18.3%), and mandible (6/60; 10%). Almost 20% (11/60%) of pediatric facial fractures due to boxing and martial arts trauma involved fighting a family member or friend, and a punch was the most common mode of fracture (42/58; 72.4%).

Conclusions:

Facial injuries comprise about 5% of injuries after boxing and martial arts trauma and 22% of these facial injuries are fractures. If children choose to participate, parents, coaches, trainers, officials, and community leaders should make the greatest effort possible to minimize risk, including the mandatory use of head and face protective gear and elimination of training fighting, or “sparring.”
Recognition of anxiety disorder and depression and literacy of first-aid support: A cross-sectional study among undergraduate students in Ha Noi, Viet Nam 2018
Authors: Thai Quynh-Chi Nguyen , Hoang-Minh Dang , Thi Kim-Anh Le
Published: May 2021

This study is aimed at exploring undergraduate students’ abilities to recognize anxiety disorder and depression symptoms, and their literacy of mental first-aid supports for these problems. Using a mixed-method, cross-sectional design, data were collected from 724 undergraduate students in Hanoi. This used a questionnaire on literacy of anxiety disorder and depression, adapted from the Australian National Survey of Mental Health Literacy and Stigma. The prevalence of the respondents who could identify anxiety disorder and depression symptoms were 25.9% and 42.3%, respectively. Literacy of mental first-aid supports focused on: listening to the person in an understanding way, encouraging the person to be more active, seeking professional help, make appointment with the general doctor.
Outpatient satisfaction with primary health care services in Vietnam: Multilevel analysis results from The Vietnam Health Facilities Assessment 2015
Authors: Quyen Bui Thi Tu , Ha Nguyen Thanh , Van Minh Hoang
Published: May 2021

Patient satisfaction has implications for resource distribution across primary, secondary, and tertiary care, as well as accessibility of quality services and equity of service delivery. This study assessed outpatient satisfaction with health services and explored the determinants at the individual and contextual levels in Vietnam. Data on 4372 outpatients were extracted from the Vietnam Health Facility Assessment survey 2015. Three levels of logistic regression were applied to examine the association between outpatient satisfaction and three types of explanatory variables. Outpatients satisfied with their community health center or district hospital accounted for relatively high proportions (85% and 73%, respectively). Patients’ age, occupation, and individual characteristics were significant predictors of patient satisfaction, whereas provincial level factors were not significantly associated with the dependent variable. When individual-level characteristics were controlled, outpatients who had a longer waiting time for health services were less likely to report being satisfied. Interventions for improving outpatient satisfaction should pay attention to simplifying the health procedure at health facilities to reduce patients’ waiting time and increase their examining time.
Media diversity and the analysis of qualitative variation
Authors: Deacon David , Stanyer James
Published: May 2021

Diversity is recognised as a significant criterion for appraising the democratic performance of media systems. This article begins by considering key conceptual debates that help differentiate types and levels of diversity. It then addresses a core methodological challenge in measuring diversity: how do we model statistical variation and difference when many measures of source and content diversity only attain the nominal level of measurement? We identify a range of obscure statistical indices developed in other fields that measure the strength of ‘qualitative variation’. Using original data, we compare the performance of five diversity indices and, on this basis, propose the creation of a more effective diversity average measure. The article concludes by outlining innovative strategies for drawing statistical inferences from these measures, using bootstrapping and permutation testing resampling. All statistical procedures are supported by a unique online resource developed for this article.
Cytohistologic analyses of β cell dedifferentiation induced by inflammation in human islets
Authors: Liang Rui , Liu Na , Wang Guanqiao , Sun Peng , Liu Yaojuan , Zou Jiaqi , Wang Le , Ding Xuejie , Zhang Boya , Shen Zhongyang , Liu Tengli , Wang Shusen
Published: May 2021

β cell dedifferentiation is a key mechanism for β cell dysfunction in type 2 diabetes mellitus (T2DM). Although it has been indicated in previous studies that β cell dedifferentiation could be induced by inflammation, the cytohistologic analyses of inflammation-induced β cell dedifferentiation in human islets is lacking. The present study aims to cytohistologically characterize the β cell dedifferentiation of human islets treated by proinflammatory cytokines Interleukin-1β/Tuman necrosis factor-α/Interferon-γ (IL-1β/TNF-α/IFN-γ), which is a frequently-used method to mimic the islet inflammation in previous studies. The loss of cytosolic FOXO1 expression, the loss of nucleic NKX6.1 expression, and the gain of ALDH1A3 expression in β cells are proclaimed as marking events for β cell dedifferentiation. Taking advantages of islets from organ donors and the immunofluorescence staining methods, the present study visualized the β cell dedifferentiation events marked by different markers, and quantified the frequency of each event as well. We successfully captured and described the characteristics of the differentiating/differentiated β cells. We found that dedifferentiated β cells were increased in the cytokines treated islets, evidenced by the increase of β cells with FOXO1 translocated to the nucleus (INS+FOXOnuc), β cells with NKX6.1 exported from the nucleus (INS+NKX6.1cyt), and β cells loss of NKX6.1 expression (INS+NKX6.1-), and β cells with dual expression of insulin and progenitor marker ALDH1A3. Consistently, we found that proinflammatory cytokines IL-1β/TNF-α/IFN-γ treatment reduced the mRNA expression of key β cell markers, but elevated the expression of progenitor marker genes. This study gives the most direct evidence for inflammation-induced β cell dedifferentiation in human islets, and supports the concept that anti-inflammation treatments may facilitate alleviating the β cell dedifferentiation in human T2DM islets.