bluuebunny/crossref_metadata_2025 huggingface dataset:
On the necessity of prefigurative politics
Authors: Monticelli Lara
Published: November 2021

The purpose of this article is to elaborate on the concept of prefiguration by outlining the necessity of its contribution to a progressive public philosophy for the 2020s. In the introduction, I explain how the object of critique for many social theorists has shifted over the course of the last decade from neoliberal globalization to capitalism understood as an encompassing form of life. In light of this, I enumerate the features that should define a progressive public philosophy: radical, emancipatory, and decolonized. The introduction is followed by an overview of the academic debates emerging after the North Atlantic financial crisis of 2007–8. Among these, accelerationism fundamentally rejects the incorporation of prefigurative politics in any emancipatory political agenda. To better understand this position, I examine the origin and meaning of prefiguration and prefigurative practices in more detail in Section III. In it, I argue that prefigurative politics entails a holistic approach to social change that digs its roots in feminist and ecological thought and focuses on social reproduction and the preservation of life rather than solely economic production. Subsequently, I deploy the case of Occupy Wall Street to show that a growing number of contemporary social movements are implementing a dualistic strategy that simultaneously combines repertoires of action typical of protest movements with prefigurative practices focused on the embodiment of alternatives. This dualism, along with the limited success of Occupy Wall Street in concretizing its claims and goals, has led prefigurative politics to being labelled as incompatible with, if not even hindering, any emancipatory strategy. My argument instead is that prefigurative politics constitutes a fundamental and necessary component of any political strategy aimed at transcending contemporary capitalism since it conceives progressive social change in an ontologically and epistemologically different way with respect to political parties and protest movements. Taking this into consideration, I conclude that conventional politics and prefigurative politics can be seen as having the potential to mutually reinforce each other and that prefigurative politics should be acknowledged as a pivotal concept in establishing a progressive public philosophy for the 2020s. Only by doing so, will this philosophy be truly radical, emancipatory, and decolonial.
Iterative Metaplasticity Across Timescales: How Circadian, Ultradian, and Infradian Rhythms Modulate Memory Mechanisms
Authors: Hartsock Matthew J. , Strnad Helen K. , Spencer Robert L.
Published: November 2021

Work in recent years has provided strong evidence for the modulation of memory function and neuroplasticity mechanisms across circadian (daily), ultradian (shorter-than-daily), and infradian (longer-than-daily) timescales. Despite rapid progress, however, the field has yet to adopt a general framework to describe the overarching role of biological rhythms in memory. To this end, Iyer and colleagues introduced the term iterative metaplasticity, which they define as the “gating of receptivity to subsequent signals that repeats on a cyclic timebase.” The central concept is that the cyclic regulation of molecules involved in neuroplasticity may produce cycles in neuroplastic capacity—that is, the ability of neural cells to undergo activity-dependent change. Although Iyer and colleagues focus on the circadian timescale, we think their framework may be useful for understanding how biological rhythms influence memory more broadly. In this review, we provide examples and terminology to explain how the idea of iterative metaplasticity can be readily applied across circadian, ultradian, and infradian timescales. We suggest that iterative metaplasticity may not only support the temporal niching of neuroplasticity processes but also serve an essential role in the maintenance of memory function.
Witnessing Intimate Partner Violence as a Child and Associated Consequences
Authors: Stiller Anja , Neubert Carolin , Krieg Yvonne
Published: November 2021

Intimate partner violence (IPV) continues to be a global problem. The increasing international research, focussing on children who witness IPV between their parents, indicates that these circumstances might influence children in different ways. Despite these efforts, little evidence stems from Germany. Using data from a German school student survey from 2017 and 2019 ( N = 21,382), this paper aims to examine the consequences of witnessing IPV. The present paper takes a closer look at children’s violent behaviour, attitudes and quality of life while controlling for other potential influences (e.g. physical and psychological child abuse). Results indicate that IPV has a significant negative effect on children’s quality of life, in particular on children’s sense of security at home and children’s life satisfaction. No other effects were significant. In discussing these complex dynamics, the results of the present study highlight the importance of considering children who witness IPV as direct victims. A home with personal threats cannot provide emotional and physical security. Coping with this absence of a secure base at home may lead to the neglect of important developmental tasks during that time, which can have possible far-reaching implications on different areas of children’s lives (e.g. social competence). Further research examining the severity and duration of witnessing IPV within the context of a longitudinal design is recommended.
Treatment after Pollution?
Authors: Chang Tsangyao , Chang Yu-Cheng , Liu Tei-Ying , Su Chi-Wei , Wang Mei-Chih
Published: November 2021

The paper considers the causal relationship about CO2 emissions, traffic density and urbanization development in China's provinces by the quantile causality test The method can capture the structural breaks under different quantiles from the nonlinear perspective. The robust results don't find the causality relationship between traffic density and CO2 emissions. Urbanization will increase CO2 emission at the high quantile level while the impact of CO2 emissions on urbanization presents a symmetric relationship. The promoting effect of transportation on urbanization only occurs at the beginning of urbanization. It shows the environmental pollution is a key factor to the whole process of urbanization. With the advancement of urbanization, the increase of traffic line density has no significant impact on the urbanization process. The results can provide references for the government in the layout of local traffic lines and the improvement of urbanization.
Problems and Prospects of Rural Entrepreneurship in Mayurbhanj District of Odisha
Authors: Das Sitaram , Patnaik Sandeep Kumar , Patra Abhijeet
Published: November 2021

Rural entrepreneurs make vital contribution to economic growth. People who carry out entrepreneurial activities by setting up industrial and business units in the rural sectors of the economy may be defined as rural entrepreneurs. This research is based on an empirical study that reviews literature of various authors at different periods. For this research, secondary data regarding micro, small, and medium enterprises (MSMEs) have been collected and analysed to draw conclusions. Keeping the above facts in view, an attempt was made to study the present position of MSMEs, amount invested and employment generated, and problems and prospects of rural entrepreneurs with special reference to the Mayurbhanj district.
Influence of Entrepreneurship Psychology on Small Business Creation and Organisational Success
Authors: Saseendran Harris , Salman Shafeeqa
Published: November 2021

The study is a quantitative research on the psychological make-up of successful small business entrepreneurs. The researchers begin with a review of literature in the area of entrepreneurship psychology. The article then provides details of the research methodology applied, profile of the participants, samples of quotes from transcripts based on the hermeneutic phenomenological study conducted with the small business entrepreneurs and their staff, phenomenological themes and sub-themes developed based on participant reflection and researchers’ analysis, leading to the deduction of a conceptual framework on entrepreneurship psychology. Findings are then presented along with recommendations on applications of the framework for entrepreneurship education and successful management of small businesses.
Influence of Content Type Over Online Engagement on Facebook Brand Pages of SMEs
Authors: Dash Ajitabh
Published: November 2021

The purpose of this study is to analyse how various dimensions brand post characteristics, such as vividness, novelty and content type, influence the online engagement on Facebook brand pages managed by small and medium enterprises (SMEs) in India. A sample of 162 brand posts published by 10 brand pages managed by SMEs in India for a selected time period between 1 April and 1 June 2019. Poisson regression models were deployed to analyse the collected data and assess the effect of these brand post characteristics on online engagement. The findings of this study not only contribute to the existing literature but also will help the SMEs to craft their content strategy for social media marketing in Indian context.
Role of Entrepreneurship in Boosting Economic Growth and Employment in India
Authors: Kumar Raj , Raj Tilak
Published: November 2021

Entrepreneurship is the engine of economic growth of a country. It increases the economic activities in every sphere of economic life of the people. The main objective of the present study is to examine the role of entrepreneurship in the economic growth of a country. An attempt has also been made to provide an overview of employment and unemployment in India. The present study concludes that entrepreneurship in India is a key contributor in the area of employment generation, innovations and product improvement. Not only does it create self-employment but it has also built a structure for large-scale employment opportunities. It contributes to the economic growth of a country by promoting capital formation, increasing per capita income, improving the standard of living and balanced growth by removing regional disparities.
Rural Business Owners, Banker and Services: A Behaviour Model
Authors: Kar Brajaballav
Published: November 2021

Rural business owners have a continual need for credit. The lack of access to institutional finance is partly mitigated by the mega financial inclusion program in India (Pradhan Mantri Jan Dhan Yojana, PMJDY) in August 2014. Other than access, exclusion can also be caused by individual characteristics, intention, attitude, perceived barriers, awareness, and suitability of product and services, banking requirements as well as banker’s behaviour. This research proposes and validates a comprehensive model of outcome based on these factors in the context of PMJDY. Business owners from rural areas who opened bank accounts under PMJDY were the respondents. The study finds that the banking outcome is significantly influenced by banker behaviour, product awareness, and the general attitude towards banking. The attitude towards specific products, demographics and income level of the rural businessmen do not influence the outcome of the banking process. Perceived inconveniences in banking or deterrence influence the intention and general attitude. Thus, the general attitude moderates the inconvenience and outcome. The product awareness is influenced by the customer’s attitude and banker’s behaviour, which in turn influence the outcome; an increase in the level of awareness will positively influence the outcome and should be the second step of financial inclusion.
Impact of Organisational, Personal and Interpersonal Factors on Employee Performance in Small and Medium Size Enterprises
Authors: Parray Zahoor Ahmad
Published: November 2021

The purpose of this study is to examine the impact of organisational level factors (management support, dynamic environment and organisational culture), personal level factors (personal effectiveness, locus of control) and interpersonal level factors (transactional styles and conflict management styles) on employee performance. The study also examines the interrelation between organisational, personal and interpersonal factors.

In this study, organisational, personal and interpersonal level factors are included in a single model using data from small- and medium-scale enterprises. The structural equation modelling is used to examine the proposed model describing the relationship between employee performance and three-level factors.

The results of this study indicate that management support and personal effectiveness have the strongest impacts (direct and indirect) on employee performance, while locus of control and transactional styles directly affect job performance. Overall 29% (first-level analysis) and 38% (second-level analysis) of employee performance (EP) variance can be explained.

The findings of this study have implications for practitioners, academicians and policy makers for effective decision making as organisations are facing intense competition for survival and sustenance in the turbulent business environments. The employee performance is considered one of the important factors and there is a need to identify the factors affecting the performance of employees.
An Analysis of MSME’s Efficiency: A Study of Two Comparable Northern Indian Regions
Authors: Majeed Mehak , Khan Javaid Iqbal , Mushtaq Saeed Owais
Published: November 2021

Jammu and Kashmir (J&K) and Himachal Pradesh (HP) are the two northern states of the Indian union. The two neighbouring states are mountainous and backward as compared to the rest of the country. Of the two, J&K has more natural resources and population. On the contrary, HP, over time, has demonstrated higher outcomes in terms of basic indicators, gross state domestic product (GSDP) and economic growth. This article examines these two economies and attempts to compare them on the basis of their respective efficiencies in industrial production. Although data on GSDP show that HP has grown over time and has surpassed that of J&K in 2017–2018, technical efficiencies of the two regions, as drawn from Annual Survey of Industries (2017), are low and converging. Stochastic frontier results demonstrate that industrialisation in both regions is labour-intensive. Tobit regression results point to low contribution of inputs towards technical efficiency. Also, minimal use of communication and technology, low profits and weak policies contribute negatively in the direction of the technical efficiency of the firms in the two regions. The results specifically imply that in the region of J&K, government support and interventions are needed to address both endogenous and exogenous factors contributing to firms’ inefficiencies.
COVID-19 Pandemic and Problems of Micro-enterprises in Dibrugarh District of Assam: An Empirical Study
Authors: Nomani Rubab Fatema
Published: November 2021

Small-scale industries play a crucial role in industrialisation of India. These industries face numerous problems, some of which are peculiar to them, while others are common to both small-scale and large-scale industries. The COVID-19 pandemic has unleashed unprecedented threats as well as opportunities on this sector. This article tries to analyse the problems affecting the entrepreneurs associated with 141 micro-manufacturing enterprises in the Dibrugarh district of Assam and puts forward some policy suggestions. In order to identify the most pressing problem faced by the entrepreneurs, the Garrett ranking method is employed in the study. It is found that dearth of skilled labour is the most acute problem encountered by the sector. Lack of proper marketing arrangements, shortage of quality and cheap raw materials, obsolete technology and lack of timely finance are other important hindrances. The significance of skilled labour points to the intense need for continuous skill development of the local workforce by establishing more technical institutes, training programmes, etc. Furthermore, the government should provide special assistance for technological upgradation, develop institutional marketing facilities, and supply cheap and quality raw materials. Further, simplification of procedures in banks’ lending policies, relaxation of requirements like collateral security and margin money may go a long way in enhancing both confidence and performance of small entrepreneurs.
A Comparative Analysis of Women and Men-Owned MSMEs with Special Emphasis on Women Entrepreneurship: A Case Study of Cachar District, Assam
Authors: Sanu Md Sahnewaz , Ahmad Md Firdos , Anjum Shabana
Published: November 2021

The purpose of this research is to investigate the effect of micro, small and medium enterprises on women entrepreneurship development with particular reference to Cachar district of Assam. The study also aims to compare the characteristics and performance of women-owned MSMEs with those owned by men. A survey method is used to gather information from 200 MSME owner-managers located in various revenue circles/ tehsils of Cachar district. The results of the study indicate that, though very slowly, MSMEs are significantly promoting women entrepreneurship. The most important reasons for women entrepreneurs to join MSMEs appear to be (a) ‘profit motive’ or ‘to earn better income’, (b) ‘desire for independence’ and (c) ‘to support family’ or ‘the desire to provide financial security to the family’. The results of the Kruskal Wallis test demonstrate that women entrepreneurs’ background characteristics such as their marital status, age, levels of educational attainment, previous business experience and place of residence significantly affect their motivations to join MSMEs. While the employment growth in female-owned MSMEs is much higher than their male counterparts, net-return per owner-manager is found to be significantly higher in men-owned MSMEs than in women-owned MSMEs.
Retrospective analysis of failures of ambulatory elastomeric pumps containing 5-FU in a hospital pharmacy unit
Authors: Chefchaouni Ali Cherif , Ouedraogo Jean-Marie , Bechar Hafsa , Belahcen Mohammed Jaouad , Rahali Younes
Published: November 2021

Introduction

Ambulatory chemotherapy is an important and major advance in clinical oncology practice since it allows the administration of chemotherapy in the comfort of the patient's home without the assistance of a health professional by means of an elastomeric pump. However, these pumps are not without risks and can be the cause of incidents due to technical failures. Our objective is to study the technical failures of elastomeric pumps in the Cytotoxic Preparation Unit and in the patient's home, to evaluate the possible impact of these failures on the patient and on the staff and to propose measures to reduce them.

Materials and methods

This is a retrospective study conducted at the pharmacy of the National Institute of Oncology in Rabat. It gathered all the specific reports on elastomeric pumps issued during the period (January 2017–May 2021) by the cytotoxic preparation unit to the materiovigilance cell via a notification form.

Results

205 cases of elastomeric pump materialovigilance were identified during the study period. The main technical failures were: chemotherapy product leakage (44%), flow rate anomalies (30%) and injection difficulties (20%). Following these incidents, certain actions were undertaken such as alerts sent to the supplier and letters sent to the competent health authorities.

Conclusion

Despite the failures that may have occurred, elastomeric pumps have revolutionized home chemotherapy delivery. They are considered reliable, consistent, easy to use and handle, and are well accepted in the population.
National Culture and the Stream Analogy of Lethal Violence
Authors: Chon Don Soo
Published: November 2021

This is the first study to explore the relationship between Inglehart and Baker’s national cultural measures and the stream analogy of lethal violence. Using data for 70 developed and developing countries, the regression analysis indicates that a country with self-expressionism or secularism is likely to have a high suicide rate relative to its homicide rate. In contrast, a country with a survivalism or traditionalism orientation is likely to have a high homicide rate relative to its suicide rate. This study suggests that national culture is related to the direction of lethal violence (i.e., suicide vs. homicide).
Revisiting the constructivist turn in political representation
Authors: Wolkenstein Fabio
Published: November 2021

In recent times, representation theory has become one of the most productive and interesting sub-fields in democratic theory. Arguably, the most important theoretical innovation are the so-called ‘constructivist’ approaches to political representation. These approaches play a central role in Creating Political Presence: The New Politics of Democratic Representation and The Constructivist Turn in Political Representation, two impressive volumes that take stock of the state of the art in representation theory. I discuss the two volumes by focusing on three broader and interconnected themes: the problem that constructivism is meant to respond to, the tendency of representation theorists to expand the possibilities of representation as broadly as possible, and the normative aspects of political representation and how constructivists deal with them.
Communicative Perspectives on Strategic Organization
Authors: Vaara Eero , Langley Ann
Published: November 2021

While in the past, perspectives that focus on language and communication have perhaps not received the attention they deserve in the mainstream literature in strategy and organization, interest in this area has been growing in recent years. The present essay serves to introduce a collection of insightful papers (independently submitted and reviewed, but brought together in this themed issue) that offer an opportunity to reflect on the contributions of a rich variety of research perspectives on communication to research in strategic organization. Building on the seven contributions featured in this issue, we show how communicative perspectives speak to questions of the who, how, what, and what then, of strategy. We then discuss dualisms that underpin research on strategic organization adopting a communicative lens and propose directions for future work that might bridge these divides.
The relationship between ethical climate and moral distress from the perspective of operating room staff: A correlational study
Authors: Esmaelzadeh Fatemeh , Rajabdizavandi Fatemeh , Nematollahi Monirsadat
Published: November 2021

Background

The organizational climate in the operating room is special due to the specific conditions of the patient, and the ethical climate may affect moral distress of the operating room staff.

Objective

This study determined the relationship between ethical climate and moral distress from staff working in operating rooms of hospitals affiliated to Mashhad University of Medical Sciences.

Method

This analytical study was performed on 169 operating room staff in Mashhad, Iran. The operating room staff was selected using stratified random sampling. The data were collected via Olson's Hospital Ethical Climate Survey and the Corley Moral Distress Scale and analyzed with IBM Statistical Package for the Social Sciences (SPSS) software version 21.

Results

The results showed no relationship between the ethical climate, the frequency, and intensity of moral distress of the operating room staff ( p > 0.05). In addition, the mean score of the ethical climate was 3.32 ± 0.48, indicating the average ethical climate in the operating room. The mean frequency and intensity of moral distress were 36.36 ± 11.68 and 48.8 ± 15.92, showing a moderate rate. There was a significant inverse relationship between the dimensions of ethical climate, the relationship with physicians, and the intensity of moral distress ( p <0.05). A significant relationship was found between the intensity of moral distress, the level of education, and field of study ( p <0.05).

Conclusion

The results of the current study showed that interventional programs should be implemented to reduce moral distress and improve the ethical climate in the operating room.
Role of dynamic ultrasound in assessment of the snapping elbow and distal biceps tendon injury
Authors: Ooi Michelle Wei Xin , Tham Jun-Li , Al-Ani Zeid
Published: November 2021

Introduction

Ultrasound is useful in assessing patients with snapping syndromes around the elbow joint. The dynamic nature of the examination allows for direct visualisation of the underlying causative factor. Topic description: We discuss the role of dynamic ultrasound in assessing various snapping syndromes around the elbow, such as ulnar nerve instability, snapping triceps and less commonly, snapping brachialis. Ultrasound is also useful in evaluating the distal biceps tendon, particularly in differentiating partial from complete tendon injury.

Discussion

Ulnar nerve instability and snapping triceps can be assessed via a medial approach with the transducer placed transversely between the medial epicondyle and the olecranon. In ulnar nerve instability, the nerve can be seen crossing over the medial epicondyle on elbow flexion. In snapping triceps syndrome, both the ulnar nerve and the distal triceps can be seen dislocating over the medial epicondyle. Dynamic assessment of the distal biceps tendon using a lateral approach minimises anisotropy artefact often seen on the anterior approach. Passive pronation and supination of the forearm will reveal little or no movement in a completely torn tendon whereas moving tendon fibres will be appreciated in partial tears. In a snapping brachialis, the medial portion of brachialis will be seen abnormally translocating anterolateral to the medial border of the trochlea during elbow flexion and snapping back into its normal position on elbow extension.

Conclusion

Dynamic ultrasound of the elbow is valuable in diagnosing patients with snapping sensations around the joint and in evaluating the integrity of the distal biceps tendon.
Empowering refugee families in transit: the development of a culturally competent and compassionate training and support package
Authors: Papadopoulos Irena , Lazzarino Runa , Sakellaraki Ourania , Dadãu Victor , Apostolara Paraskevi , Kuckert-Wöstheinrich Andrea , Mauceri Manuela , Kouta Christiana
Published: November 2021

Background

Refugee parents who fled conflicts suffered violence and traumas and face huge challenges in supporting the health and welfare of their children while in transit.

Aims

To describe the development of a culturally competent and compassionate training and support package (TSP) for nurses, social and health care workers and volunteers, with a focus on parenting needs among unsettled refugees fleeing conflict.

Methods

The multi-method approach included: a scoping review covering parenting needs of refugees fleeing conflict zones; collection of stories from refugee parents, healthcare workers and volunteers via a mobile application; discussions between team members; a piloted and evaluated curriculum.

Results

High levels of family distress and deterioration of parental identity were identified. Informed by these results, the curriculum is articulated along 20 bite-sized learning units, covering four age stages of childhood as well as targeting adults’ well-being. Pilot training was evaluated positively, confirming feasibility and usefulness of the TSP.

Conclusions

Unsettled refugee parents fleeing conflicts face psycho-social and practical difficulties negatively affecting their parenting skills. The care workforce should be trained in order to provide culturally competent and compassionate support to help these families. Open access digital platforms are promising as autodidactic and self-help tools among hard-to-reach populations.
Chronic Workload, Subjective Arm Health, and Throwing Injury in High School Baseball Players: 3-Year Retrospective Pilot Study
Authors: Mehta Sameer , Tang Sisi , Rajapakse Chamith , Juzwak Scott , Dowling Brittany
Published: November 2021

Background:

Baseball workloads are monitored by pitch counts, appearances, innings per appearance, ball velocity, and distance, whereas current workload standards neglect throws made during nongame situations. The association between total workloads, subjective measures, and injury in baseball is poorly understood. The question remains whether baseball athletes are at higher risk of injury by throwing more often or if they generate injury resilience when appropriately transitioned into the higher demands of throwing.

Hypothesis:

Increased chronic load, along with subjective arm health measures, are related to decreased injury risk.

Study Design:

Clinical research.

Level of evidence:

Level 3.

Methods:

A total of 49 male baseball players (age 17.9 ± 0.4 years, height 181.8 ± 6.8 cm, body mass 80.6 ± 9.1 kg) competing at the varsity high school level were included in this 3-year retrospective data analysis from 2016 to 2019. Players wore the motusTHROW sleeve and sensor during all throwing activities.

Results:

A total of 898,492 throws and 9455 athletic exposures were captured with the motusTHROW sensors. There were 24 injuries recorded throughout the 3-year analysis, with 11 throwing-related and 13 non–throwing related injuries. Results of the 1-way analysis of variance found chronic load was significantly related to throwing-injury occurrence ( P < 0.01). Six of the throwing-related injuries occurred when athletes had a chronic load greater than 11.3, marking 75th percentile across all observations. There was a relationship between arm health and throwing arm–related injury occurrence ( P < 0.01). Higher chronic load was associated with increased throwing-related injuries even when adjusted for arm health ( P = 0.01). Specifically, injuries were more likely to occur in pitchers (either as a combination player or pitcher only) with a chronic load greater than 9.2.

Conclusion:

This study revealed a significant relationship between chronic load, subjective arm health, and throwing-related injury in varsity high school baseball players. Contrary to our hypothesis, increased chronic load was associated with increased injury risk. However, subjective arm health measures remain a relevant factor in assessing injury risk. Normative data for this population also provide key information around positional demands along with overall demands of the sport during the competitive season and off-season.
Ignorance of History and Political Differences in Perception of Racism in the United States
Authors: Zell Ethan , Lesick Tara L.
Published: November 2021

According to the Marley hypothesis, White Americans are more ignorant of historical racism than Black Americans, which explains their greater tendency to deny racism in the present. We extended the Marley hypothesis by testing whether it explains political differences in perception of racism among White Americans in the United States. Two preregistered studies measured participants’ knowledge of historical racism as well as their perception of present racism in individual cases and in society ( N = 463). White Republicans had less knowledge of historical racism and perceived less individual and systemic racism than White Democrats. Consistent with the Marley hypothesis, political differences in perception of individual racism were significantly mediated by knowledge of historical racism. These findings suggest that ignorance of historical racism may partly explain why White Republicans perceive less racism than White Democrats, and therefore extend the Marley hypothesis to the political realm.
Failure to Achieve Threshold Scores on Patient-Reported Outcome Measures Within 1 Year Has a Predictive Risk of Subsequent Hip Surgery Within 5 Years of Primary Hip Arthroscopy: A Case-Control Study
Authors: Feingold Jacob D. , Swartwout Erica L. , Roberts Sacha A. , Nwachukwu Benedict U. , Ranawat Anil S.
Published: November 2021

Background:

Research has identified factors that influence achievement rates of threshold scores on patient-reported outcome measures (PROMs) after hip arthroscopy. However, little data exist on whether failure to achieve a threshold score (minimal clinically important difference [MCID] or substantial clinical benefit [SCB]) in the short term after hip arthroscopy predicts the risk of future hip surgery.

Purpose/Hypothesis:

The purpose of this study was to determine if failure to achieve the MCID or SCB on PROMs within 1 year of hip arthroscopy can be considered a risk factor for repeat surgery within 5 years of primary hip arthroscopy. It was hypothesized that failure to achieve threshold scores would increase the risk of subsequent hip surgery.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A retrospective review of prospectively collected data was completed. Four PROMs were collected preoperatively and within 1 year of hip arthroscopy: modified Harris Hip Score, Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports, and the 33-Item International Hip Outcome Tool.

Results:

Two cohorts were formed: (1) a study cohort (n = 88) composed of patients who underwent repeat hip surgery within 5 years of hip arthroscopy and (2) a control cohort (n = 288) composed of patients who did not require repeat hip surgery. The study cohort had significantly ( P < .001) lower scores on all postoperative PROMs, and a significantly ( P < .001) smaller percentage of the study cohort met the MCID and SCB. Multivariable regression analysis demonstrated that not achieving the MCID or SCB on each of the PROMs is an independent risk factor for repeat hip surgery. For every PROM in which a patient failed to achieve the MCID, the odds of subsequent surgery increased by 1.68 (95% CI, 1.42-1.98; P < .001). For every PROM in which a patient failed to achieve the SCB, the odds of subsequent surgery increased by 1.63 (95% CI, 1.35-1.97; P < .001).

Conclusion:

Failure to meet threshold scores on PROMs after hip arthroscopy was an independent risk factor for subsequent hip surgery. This study establishes a novel utility of PROMs and confirms the importance of these metrics in the orthopaedic literature.
Updating estimates of the number of UK stroke patients eligible for endovascular thrombectomy: incorporating recent evidence to facilitate service planning
Authors: McMeekin Peter , Flynn Darren , James Martin , Price Christopher I , Ford Gary A , White Philip
Published: November 2021

Introduction

Endovascular thrombectomy (EVT) is a highly effective treatment for acute ischaemic stroke due to large arterial occlusion (LAO). To support decisions about service provision, we previously estimated the annual UK population eligible for EVT as ∼10% of stroke admissions. Since then, several trials have produced evidence that could alter these figures. We update our estimates considering information from studies and trials reporting 2018–2021 on incidence, presentation time and stroke severity and consider the possible impact of predicted demographic changes in the next 10–20 years.

Patients and Methods

We produce an updated decision tree describing the EVT eligible population for UK stroke admissions. One-way sensitivity analyses (using upper and lower confidence intervals for estimates at each branch of our decision tree) were used to identify where further research evidence is necessary to increase certainty around estimates for numbers of EVT eligible patients.

Results

The updated estimate for the number of UK stroke patients eligible for EVT annually was between 10,020 (no advanced imaging in early presenting patients) and 9,580 (advanced imaging in all early presenting patients), which compared with our estimates in 2017 is a minimal reduction. One-way sensitivity analyses established that enhanced evidence about eligibility for milder strokes, ASPECTS scores and pre-stroke disability are offset by evidence regarding a lower incidence of LAO. Importantly, predicted increases in life expectancy by 2040 may increase thrombectomy need by 40%.

Discussion

Information from additional randomised trials published during 2018–2020 with updated estimates of LAO prevalence had a minimal impact on overall estimates of stroke patients eligible for EVT in the UK. Ongoing research into the benefits of EVT for patients with mild stroke or European Stroke Journal For Peer Review lower ASPECTS scores has the potential to increase the estimates of the eligible population; future need for EVT will increase with the ageing population.

Conclusion

Our updated analyses show overall numbers eligible little changed, but evidence from ongoing trials and demographic changes have the potential to increase the need for EVT significantly.
Lifestyle Medicine and Otolaryngology: Embracing the Future
Authors: Juszczak Hailey M. , Rosenfeld Richard M.
Published: November 2021

Lifestyle medicine is a relatively new specialty that focuses on behavior change to prevent, treat, and reverse chronic disease and promote wellness. It is relevant to any medical or surgical field that deals with noninfectious chronic disease and to any individual or community pursuing health and wellness. Lifestyle medicine offers evidence‐based interventions and tools to foster wellness and resiliency in ourselves and our patients. This commentary gives a brief background of lifestyle medicine and how embracing the discipline could benefit the American Academy of Otolaryngology–Head and Neck Surgery and the field of otolaryngology overall. Specifically, we describe opportunities to improve patient health, promote personal wellness, combat burnout, and foster unity among otolaryngology subspeciality societies.
Explaining the Factors Influencing Consumer Perception, Adoption Readiness, and Perceived Usefulness toward Digital Transactions: Online Retailing Experience of Millennials in India
Authors: Joshi Sudhanshu , Sharma Manu , Bisht Priya , Singh Sumanjeet
Published: November 2021

The present study intends to identify and evaluate the factors affecting the perception and readiness of young online shoppers regarding digital transactions. Thirty variables were identified through systematic literature review that can influence consumers’ perception of digital transactions. Data were collected from 525 millennials from north India. After performing factor analysis, five broad factors were identified namely (a) personal characteristics and incentives, (b) knowledge technical capability, (c) perceived usefulness, (d) sense of security, and (e) transaction risk, which affect the perception and intention as well as adaption of young consumers regarding the digital transactions. Using regression analysis, factors affecting consumer’s perception and readiness regarding digital transactions are modeled out. The study also examines the influence on intention to adopt digital transactions and the actual adaption of digital transactions. Further, the study concludes that consumer intention to make digital transactions mediates the relationship between factors of digital transactions and digital transaction adaption behavior.
Thinking Time in Music Practice
Authors: Palese Richard S. , Duke Robert A.
Published: November 2021

We asked school- and college-aged instrumentalists ( N = 32) to imagine an ideal performance of a brief passage of music, record a performance of the passage, and describe discrepancies they noticed between their imagined and actual performances. The more experienced participants took at least as much time to imagine their idealized performances as it took to perform them; less experienced participants took less time to imagine what they were about to play. There were no differences among experience levels in the numbers or types of discrepancies identified. The differences between more and less experienced participants were also evident in a subsequent practice period. More experienced musicians’ practice included more frequent moments of pause, whereas school-aged participants seldom paused and tended to address performance issues other than those identified in their commentaries.
Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial
Authors: Kask-Flight Liina , Durak Koray , Suija Kadri , Rätsep Anneli , Kalda Ruth
Published: November 2021

Background

Coronary heart disease (CHD) mortality among young men is very high and the prevention methods usable in family practice (FP) settings are limited (1,2). The objectives of this study were to investigate the cardiovascular risk profile among young males (18–50) visiting their family doctor (FD) and to find out if using an interactive computer-based decision aid (DA) has advantages in reducing cardiovascular risk factors compared to usual counselling at the FD’s office.

Methods

The study was a cluster-randomized controlled trial including hypertensive male patients aged 18–50 recruited by their FD in 2015–2016. Patients with cardiovascular complications were not included. FDs were randomly divided into intervention groups (n = 9) and control groups (n = 11). Altogether, FDs recruited 130 patients, 77 into the intervention group (IG) and 53 into the control group (CG). IG patients were counselled about cardiovascular risk factors using a computer-based DA. CG patients received usual counselling by their FD. Data was collected with questionnaires, clinical examinations and laboratory analyses at the baseline and at the follow-up visit three months later. We compared the cardiovascular risk factors of the IG and CG patients.

Results

Baseline characteristics of the IG and CG patients were comparable. Of the whole study group, 51.5% (n = 67) of the patients had hypertension grade 1, 45.4% (n = 59) had grade 2 and 3.1% (n = 4) had grade 3. Twenty-seven per cent (n = 21) of the IG and 42% (n = 22) of the CG patients were smokers. We found that shared decision making with the DA was more effective in smoking reduction compared to usual FD counselling: 21 smoking patients in the IG reduced the number of cigarettes per day which is significantly more than the 22 smoking patients in the CG (− 3.82 ± 1.32 (SE Mean) versus + 2.32 ± 1.29; p = 0.001). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and the number of cigarettes per day, all showed a statistically significant reduction among patients who were using the DA. Male patients with hypertension grade 2 had a significantly greater reduction in their SBP (− 6.003 ± 2.59 (SE Mean) versus + 1.86 ± 2.58; p = 0.038) grade 1. Reduction of DBP, cigarettes per day and CVD risk in general were nearly significant in the IG whereas the CG showed an increase in all of these parameters.

Conclusion

Using interactive DAs at FD’s offices for counselling of young hypertensive male patients is one possibility to help patients understand their risk factors and make changes in their treatment choices. DAs can be more effective in achieving behavioural changes like reducing smoking or blood pressure compared to normal counselling.
Preparing a healthcare workforce for geriatrics care: an Interprofessional team based learning program
Authors: Bhattacharya Shelley B. , Jernigan Stephen , Hyatt Myra , Sabata Dory , Johnston Shane , Burkhardt Crystal
Published: November 2021

Background

Improving the care of older adults in our healthcare system involves teams working together. As the geriatrics population rises globally, health science learners need to be prepared to work collaboratively to recognize and treat common conditions in geriatrics. To enable workforce preparation, the Institute of Medicine and the National League for Nursing emphasize the need to implement interprofessional active learning activities for undergraduate healthcare learners at academic medical centers.

Methods

The Geriatrics Champions Program was a team-based learning activity created to meet this task. It was a 24-month program, repeated twice, that impacted 768 learners and 151 faculty from medicine, occupational therapy, physical therapy, nursing, social welfare, psychology, pharmacy and dietetics. Each class was intentionally divided into 20 interprofessional teams that met four times annually. Each session focused on one geriatrics domain. The objectives were centered around the specific geriatrics competencies for each health profession, divided into the eight domains written in the “American Geriatrics Society IM-FM Residency Competencies”. Evaluation consisted of individual and team Readiness Assessment Tests (iRAT and tRAT). Surveys were also used to collect feedback using a Likert scale. Wilcoxon signed rank tests were used to compare iRAT and tRAT scores. Other analyses identified characteristics associated with tRAT performance group (Unpaired t-tests) and tRAT performance on the raw scale (Pearson correlation). Paired t-tests using a 7-level Likert Scale measured pre-post change in learner knowledge.

Results

Student tRAT scores were 30% higher than iRAT scores (p < 0.001). Teams were more likely to score 100% on the initial tRAT attempt if more team members attended the current session (p < 0.001), more health professions were represented by team members in attendance (p = 0.053), and the team had a better track record of past attendance (p < 0.01). In the post-program evaluation, learners felt this program was helpful for their career preparation in interprofessional geriatrics care.

Conclusions

Learners understood that teams performed better than individuals in the care of older adults. Feedback from the learners and faculty was consistently positive and learners felt better prepared for geriatrics care. The program’s benefits may extend beyond individual sessions.
The construction and analysis of ceRNA network and patterns of immune infiltration in lung adenocarcinoma
Authors: Li Jinglong , Liu Wenyao , Dong Xiaocheng , Dai Yunfeng , Chen Shaosen , Zhao Enliang , Liu Yunlong , Bao Hongguang
Published: November 2021

Background

Competitive Endogenous RNA (ceRNA) may be closely associated with tumor progression. However, studies on ceRNAs and immune cells in LUAD are scarce.

Method

The profiles of gene expression and clinical data of LUAD patients were extracted from the TCGA database. Bioinformatics methods were used to evaluate differentially-expressed genes (DEGs) and to form a ceRNA network. Preliminary verification of clinical specimens was utilized to detect the expressions of key biomarkers at the tissues. Cox and Lasso regressions were used to identify key genes, and prognosis prediction nomograms were formed. The mRNA levels of 9 genes in the risk score model in independent clinical LUAD samples were detected by qRT-PCR. The interconnection between the risk of cancer and immune cells was evaluated using the CIBERSORT algorithm, while the conformation of notable tumor-infiltrating immune cells (TIICs) in the LUAD tissues of the high and low risk groups was assessed using the RNA transcript subgroup in order to identify tissue types. Finally, co-expression study was used to examine the interconnection between the key genes in the ceRNA networks and the immune cells.

Result

A ceRNA network of 115 RNAs was established, and nine key genes were identified to construct a Cox proportional-hazard model and create a prognostic nomogram. This risk-assessment model might serve as an independent factor to forecast the prognosis of LUAD, and it was consistent with the preliminary verification of clinical specimens. Survival analysis of clinical samples further validated the potential value of high risk groups in predicting LUAD prognosis. Five immune cells were identified with significant differences in the LUAD tissues of the high and low risk groups. Besides, two pairs of biomarkers associated with the growth of LUAD were found, i.e., E2F7 and macrophage M1 (R = 0.419, p = 1.4e− 08) and DBF4 and macrophage M1 (R = 0.282, p < 2.2 e− 16).

Conclusion

This study identified several important ceRNAs, i.e. (E2F7 and BNF4) and TIICs (macrophage M1), which might be related to the development and prognosis of LUAD. The established risk-assessment model might be a potential tool in predicting LUAD of prognosis.