bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of organoclay filler and dicumyl peroxide (DCP) on the properties of the low-density polyethylene (LDPE)/thermoplastic starch (TPS) blend
Authors: Smail Dalila , Chaoui Saliha
Published: December 2020

In this study low-density polyethylene (LDPE)/thermoplastic starch (TPS)/nanoclay (O-Mt) nanocomposites were prepared by a melt blending process using a Brabender mixer. Dicumyl peroxide (DCP) and nanoclay (O-Mt) were studied to improve interfacial adhesion and to obtain the various desired properties of the nanocomposites. The structure and properties of the materials were studied by X-Ray Diffraction (XRD), Differential Scanning Calorimetry (DSC), Thermogravimetric Analysis (TGA), Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM) and by tensile and Izod impact tests. X-ray diffraction analysis of the nanocomposites showed that the characteristic peaks of the clay were shifted to the lower angles, indicating an intercalated structure in the presence of dicumyl peroxide (DCP). The TGA curve indicated an improvement in the thermal stability of the materials with the amount of silicate and DCP. The mechanical properties of the materials were improved as a consequence of the increase in phase adhesion which gave an improvement in crystallinity confirmed by DSC. In addition, the impact strength of the modified materials was improved compared to the original materials. A modification of morphology as well as roughness was demonstrated by SEM and AFM.
Electronic Assessment and Tracking of Pain at Home: A Prospective Study in Children With Hematologic or Solid Tumors
Authors: Tiozzo Emanuela , Fondi Serena , Biagioli Valentina , Piccinelli Elisa , Alibrandi Francesca , Gawronski Orsola , Dall’Oglio Immacolata , Margarella Erika , Piga Simone , Ricci Riccardo , Ciaralli Italo
Published: December 2020

This study aimed to evaluate the intensity and characteristics of pain, which was assessed at home by children with cancer or their parents using an app for mobile devices, for a 1-month poststudy enrollment. The participants of this observational prospective study were outpatients at the hematology/oncology department of an academic hospital in Italy, aged between 0 and 21 years, and receiving hospital-at-home care. Patients or their parents were asked to assess pain levels for one month at home using the Faces, Legs, Arms, Cry, and Consolability (FLACC) scale for patients aged <4 years and the Ospedale Pediatrico Bambino Gesù (OPBG) tool for patients aged 4 to 21 years. At study conclusion, parents were asked to complete a survey about their satisfaction with the app and to rate their child’s health in general, pain intensity, and frequency in the past 4 weeks. Of the 124 participants using the app, 94 (75.8%) reported pain (≥1) at least once during the 1 month. Of these, 53 (56.4%) at most reported mild pain, 33 (35.1%) moderate pain, and eight (8.5%) severe pain. The abdomen was identified as the most frequent (56.3%) pain site by patients aged 4 to 21 years. The child’s maximum pain intensity during the study period was negatively correlated with the parent’s report of the child’s health during the past month ( r = −.29, p < .01). Most of the participants were satisfied with the app and the information received about app usage. In conclusion, the app facilitated pain assessment and tracking in patients receiving hospital-at-home care.
Prejudiced Attitudes of Nursing Students in Southern Spain Toward Migrant Patients
Authors: Alemany-Arrebola Inmaculada , Plaza del Pino Fernando J. , Sánchez-Ojeda María A.
Published: December 2020

Introduction

The increase in the migrant population in Spain has transformed the cultural profile of public health care users. The purpose of this study is to recognize the subtle and blatant prejudices nursing students have toward migrant patients.

Method

An ex post facto descriptive study, using a transversal design ( N = 1,393).

Results

Males showed a higher degree of prejudice ( p < .05). Students in their first year have more subtle prejudices than those in their fourth year ( p < .005). Blatant prejudice increases from the first year to the fourth year of the degree program ( p < .05). Regarding context, there were differences found between subtle and blatant prejudice (both, p < .05), as students in areas with high migratory pressure showed more prejudiced attitudes toward migrant patients.

Discussion

Students display subtle prejudices, which is why education in culturally congruent health care must be integrated across all levels of nursing education, with the objective of diminishing prejudice against the migrant population.
“Something Is Wrong Here”: An Interview With Sarah Cox About Damming Canadian Rivers for Hydroelectricity
Authors: Sheehan Margaret
Published: December 2020

Only one-third of the world’s rivers remain free flowing, and one million species face extinction. In the climate crisis, the race for “clean energy” is on. Over the last century, the Canadian government has built hundreds of hydropower dams and is pushing ahead with more big dams despite decades of science showing their irreversible and significant social, environmental, and economic harms. Canada markets its hydropower as “clean” and “renewable.” In her book, Breaching the Peace: The Site C Dam and a Valley’s Stand Against Big Hydro, journalist Sarah Cox documents the externalities caused by Canada’s megadams and the ongoing struggle by indigenous people, farmers, and activists to stop one of the largest and most controversial dams located on the Peace River in British Columbia, Canada. Meg Sheehan, environmental attorney, interviewed Cox during the COVID-19 pandemic to get the story behind Canada’s hydropower policy and how things can change.
Lessons on Older LGBTQ Individuals’ Sexuality and Spirituality for Hospice and Palliative Care
Authors: Fair Tyler Mark
Published: December 2020

Hospice and palliative care are in the beginning stages of providing inclusive care to older lesbian, gay, bisexual, transgender, queer (LGBTQ) patients. This inclusivity is exceedingly more pressing given the growing population of out and aging LGBTQ individuals. Hospice and palliative literature recognizes that spirituality and religion can be fraught topics for LGBTQ patients. A few resources are available to help providers give more inclusive care. Few in hospice and palliative care, however, explicitly outline the direct connection for LGBTQ elders between their sexuality and their spiritual lives. 16 LGBTQ individuals born before 1964 were interviewed in the Colorado Front Range. Keeping with the tradition of critical theory, participants were asked “is there a connection for you between your sexuality and your spirituality? if so, what?” The interviews were analyzed using a qualitative conceptual content analysis method. All 16 participants responded that there was a connection for them. The participants expanded on this connection using five themes in their answers: the sexual act itself is spiritual; their authentic LGBTQ journey as spiritual; love/attraction is spiritual; spirituality and sexuality are inseparable; and finally, noting the ineffability of the sexuality-spirituality connection.
Leveraging peer-to-peer farmer learning to facilitate better strategies in smallholder dairy husbandry
Authors: Nyambo Devotha G , Luhanga Edith T , Yonah Zaipuna O , Mujibi Fidalis DN , Clemen Thomas
Published: December 2020

Peer-to-peer learning paradigm is seldom used in studying how farmers can increase yield. In this article, agent-based modelling has been applied to study the chances of dairy farmers increasing annual milk yield by learning better farming strategies from each other. Two sets of strategies were considered; in one set ( S), each farmer agent would possess a number of farming strategies based on their knowledge, and in a second set [Formula: see text], farmer agents would possess farming strategies that they have adopted from their peers. Regression models were used to determine litres of milk that could be produced whenever new strategies were applied. By using data from Ethiopia and Tanzania, 28 and 25 determinants for increase in milk yield were fitted for the two countries, respectively. There was a significant increase in average milk yield as the farmer agents interacted and updated their [Formula: see text]– from baseline data, average milk yield of 12.7 ± 4.89 and 13.62 ± 4.47 to simulated milk yield average of 17.57 ± 0.72 and 20.34 ± 1.16 for Tanzania and Ethiopia, respectively. The peer-to-peer learning approach details an inexpensive method manageable by the farmers themselves. Its implementation could range from physical farmer groups to online interactions.
Dietary Inflammatory Index and Epithelial Ovarian Cancer in Southern Chinese Women: A Case-Control Study
Authors: Tang Li , Pham Ngoc Minh , Lee Andy H. , Shivappa Nitin , Hébert James R. , Zhao Jian , Su Dada , Binns Colin W. , Li Chunrong
Published: December 2020

The association between inflammatory properties of diet and ovarian cancer risk has been investigated in some Western populations. However, little evidence is available from Asian women whose ovarian cancer incidence rates are low and dietary and lifestyle patterns are very different from their Western counterparts. We aimed to examine whether more pro-inflammatory diets, as indicated by higher dietary inflammatory index (DII®) scores, are associated with increased odds of epithelial ovarian cancer in southern China. A case-control study was conducted during 2006-2008 in Guangzhou, Guangdong Province. Energy-adjusted DII (E-DII) scores were calculated based on dietary intake assessed by a validated food frequency questionnaire administered to 500 incident epithelial ovarian cancer patients and 500 hospital-based controls. Logistic regression models were used to assess the relationship between E-DII scores and odds of ovarian cancer. Positive associations were observed between higher E-DII scores and ovarian cancer odds, using both continuous DII scores (odds ratio (OR) 1.87; 95% confidence interval (CI) 1.65, 2.13) and by DII tertiles (ORtertile3vs1 7.04, 95% CI: 4.70, 10.54, p for trend < 0.001). Likewise, a more pro-inflammatory diet was associated with a higher chance of serous and mucinous ovarian tumors. Our results suggest that a pro-inflammatory diet was associated with increased odds of developing epithelial ovarian cancer in southern Chinese women. The findings add to epidemiological evidence for the role of dietary inflammatory potential in ovarian cancer development.
Mixed Methods Evaluation of Reasons Why Care Deviates From Clinical Guidelines Among Patients With Multimorbidity
Authors: Cohen-Stavi Chandra J. , Key Calanit , Molcho Tchiya , Yacobi Mili , Balicer Ran D. , Shadmi Efrat
Published: December 2020

Reasons why care does not conform to single-disease guideline recommendations for multimorbid patients have not been systematically measured in practice. Using a mixed methods approach, we identified and quantified types of reasons why care deviates from nine sets of disease guideline recommendations for multimorbid patients. Utilizing a focus group concept mapping technique, we built on a categorization of reasons explaining guideline deviation, and surveyed treating nurses about these reasons for patients’ specific care processes. Directed content analysis was conducted to classify the responses into reasons categories. Of 4,386 guideline-recommended care processes evaluated, 920 were not guideline-concordant (944 reasons). Three broad categories of reasons and 18 specific reasons were identified: Biomedical-related occurred 35.2% of the time, patient personal-related (30.4%), context-related (18.4%), and unknown (16.0%). Patient- and context-related factors are prevalent drivers for guideline deviation in multimorbidity, demonstrating that patient-centered aspects are as much a part of care decisions as biomedical aspects.
The international normalised ratio predicts perioperative complications in revision total hip arthroplasty
Authors: Arnold Nicholas R , Samuel Linsen T , Karnuta Jaret M , Acuña Alexander J , Kamath Atul F
Published: December 2020

Background:

Standard preoperative protocols in total joint arthroplasty utilise the international normalised ratio (INR) to determine patient coagulation profiles. However, the relevance of preoperative INR values in joint arthroplasty remains controversial. Therefore, we examined (1) the relationship between preoperative INR values and various outcome measures, including, but not limited to: surgical site complications, medical complications, bleeding, number of readmissions, and mortality. Additionally, we sought to determine (2) specific INR values associated with these complications and (3) cutoff INR levels which correlated with specific outcomes. We additionally applied these analyses to (4) examine the relationship between INR and length-of-stay (LOS).

Methods:

The American College of Surgeons National Surgical Quality Improvement Program database (ACS-NSQIP) was queried for rTHA procedures performed between 2006 and 2017. INR ranges were used to stratify cohorts: ⩽1.0, 1.0–⩽1.25, 1.25–⩽1.5, >1.5. INR values were determined using receiver operating characteristics (ROC) curves for each outcome of interest. Optimal cutoff INR values for each outcome were then obtained using univariate/multivariate models. 2012 patients who underwent rTHA met inclusion criteria.

Results:

Patients with progressively higher INR values had a significantly different risk of mortality within 30 days ( p = 0.005), bleeding requiring transfusion ( p < 0.001), sepsis ( p = 0.002), stroke ( p < 0.001), failure to wean from ventilator within 48 hours ( p = 0.001), readmission ( p = 0.01), and hospital length of stay ( p < 0.001). Similar results were obtained when utilising optimal INR cutoff values. When correcting for other factors, the following poor outcomes were significantly associated with the respective INR cutoff values (Estimate, 95% CI, p-value): LOS >4 days (1.67, 1.34–2.08, p < 0.001), bleeding requiring transfusion (1.65, 1.30–2.09, p < 0.001), sepsis (2.15, 1.11–4.17, p = 0.022), and any infection (1.82, 1.01–3.29, p = 0.044).

Conclusions:

Our analysis illustrates a direct relationship between specific preoperative INR levels and poor outcomes following rTHA, including increased LOS, transfusion requirements and infection. Therefore, current INR guideline targets may need to be re-examined when optimising patients for revision arthroplasty.
The pericapsular nerve group block: a step towards outpatient total hip arthroplasty?
Authors: Remily Ethan A , Hochstein Steven R , Wilkie Wayne A , Mohamed Nequesha S , Thompson John V , Kluk Matthew W , Nace James , Delanois Ronald E
Published: December 2020

Introduction:

A new regional anaesthetic technique, coined the pericapsular nerve group (PENG) block, targets the anterior hip capsule by blocking the articular branches of the femoral nerve and accessory obturator nerve. In this study, we evaluated: (1) patient outcomes; (2) postoperative pain scores; and (3) postoperative opioid consumption in total hip arthroplasty (THA) patients who received a PENG block in comparison to a control group.

Methods:

A retrospective chart review was performed for patients who underwent primary THA and met criteria at a single institution ( n = 48), with an additional cohort of patients collected as controls ( n = 48). Postoperative pain scores were measured by obtaining the cumulative visual analogue scores (VAS) at 12-hour intervals until the 48-hour benchmark. All administered opioids were collected from postoperative day (POD) 0 to POD2 and converted to morphine milligram equivalents (MME).

Results:

In the PENG group, length of stay was significantly shorter ( p  < 0.001) and the initial postoperative distance walked was significantly farther ( p = 0.001). The PENG group consistently demonstrated significantly lower mean cumulative pain scores until the 48-hour mark ( p  < 0.001 for all). Patients receiving the PENG block also experienced a significantly longer therapeutic window before requiring their first opioid ( p  < 0.002). The PENG group required significantly less opioid MMEs on POD1, POD2, and cumulatively over the entire stay ( p  < 0.022 for all).

Conclusions:

Our findings suggest that the PENG block has the potential of impacting THA recovery pathways and contributing to cost savings. Thus, its use further supports the transition to the outpatient setting and drives us towards achieving value-driven healthcare.
Short- to midterm results of early cannulation arteriovenous grafts (Gore® ACUSEAL) for hemodialysis: Experience with the ACUSEAL in a Japanese cohort
Authors: Honma Kenichi , Eguchi Daihiko
Published: December 2020

Background:

In patients without suitable vasculature for autologous arteriovenous fistula, vascular access using a prosthetic graft is an option for hemodialysis. Gore® ACUSEAL Vascular graft is an early cannulation arteriovenous graft (AVG) that allows early puncture within 24 h after surgery. We aimed to report the outcomes of using this graft in patients from a single center.

Methods:

This study included 113 patients who underwent surgery for a new AVG using ACUSEAL, between December 2015 and December 2017, and were followed up. The primary outcomes were primary patency, assisted-primary patency, and secondary patency. Secondary outcomes were postoperative complications such as graft infection and steal syndrome.

Results:

Of the 113 patients, 60 were male and 53 were female. The average age was 74.4 ± 10.7 years. We could cannulate 69.1% of patients within 24 h. The average follow-up period was 20.1 ± 10.8 months. The primary patency rates after 3 months, 6 months, and 1 year were 76.2%, 60.4%, and 33.8%, respectively. The assisted-primary patency rates after 3 months, 6 months, and 1 year were 88.8%, 73.2%, and 58.9%, respectively. The secondary patency rates after 3 months, 6 months, and 1 year were 100%, 100%, and 98.8%, respectively. Fourteen patients (12.4%) developed graft infection and two patients (1.8%) developed steal syndrome.

Conclusion:

In our study, ACUSEAL showed satisfactory patency and acceptable complication rates in the short to medium term, similar to previous studies. ACUSEAL is beneficial for surgeons who are familiar with using AVG and for medical staff who control bleeding after dialysis. However, due to the large outer diameter of the graft, surgical wounds might become dehiscent, and careful designing of the subcutaneous graft route is necessary. It might be possible to reduce the rate of graft infection by planning the site and skin incision.
“Return of the repressed”: Exposure to police violence increases protest and self-sacrifice intentions for the Yellow Vests
Authors: Adam-Troian Jais , Çelebi Elif , Mahfud Yara
Published: December 2020

Worldwide, it is not uncommon to observe violent police reactions against social movements. These are often rationalized by decision makers as efficient ways to contain violence from protesters. In France for instance, the ongoing Yellow Vests protests have generated an unprecedented number of casualties, injuries, and convictions among protesters. But was this response efficient in diminishing violence stemming from the Yellow Vests? To this day, little is known about the psychological consequences of police violence in the context of protests. Combining insights from Significance Quest Theory and the Social Identity perspective on collective action, we predicted that exposure to police violence could “backfire” and lead to increased radicalization of protesters. A cross-sectional investigation of 523 Yellow Vests yielded evidence for this hypothesis. We found positive direct effects of exposure to police violence on intentions to attend future demonstrations and to self-sacrifice for the Yellow Vests. Moreover, these effects were serially mediated by perceived Loss of Significance and Identification with the Yellow Vests. Paradoxically, these results highlight for the first time the mechanism through which political repression may contribute to the formation of radical politicized identities. Thus, we recommend that decision makers privilege the use of de-escalation techniques in protest policing whenever possible.
Radicalization and violent extremism: Perspectives from research on group processes and intergroup relations
Authors: Gøtzsche-Astrup Oluf , van den Bos Kees , Hogg Michael A.
Published: December 2020

Radicalization and violent extremism leading to violent protests, repression, and terrorist attacks constitute important issues in our world. Social psychological group processes and intergroup dynamics play a key role in creating resilience against or facilitating the path towards violent extremism. The present body of work brings together and furthers our understanding of these factors by integrating insights from other fields, most centrally political science. In this introductory article, we summarize the state of the literature and suggest a social psychological research agenda for studying radicalization and violent extremism. This agenda (a) focuses on how the radicalization process commences and festers in ordinary people; (b) is ambitious in bringing research into the real world with protesters, the repressed, and groups engaged in conflict; (c) is pragmatic in measuring outcomes of interest; and (d) applies field experimental methodology, among other methodologies. With this perspective, we argue, social psychology is ideally positioned for a new decade of impactful research into radicalization and violent extremism.
The influence of workforce agility on high-growth firms: The mediating role of innovation
Authors: Abrishamkar Mohammed Mahdi , Abubakar Yazid Abdullahi , Mitra Jay
Published: December 2020

An agile workforce refers to a workforce that is proactive, flexible and resilient in dealing with non-routine and unpredictable circumstances. Even though past research suggests that agility could have a positive effect on firm performance, there is hardly any empirical evidence on whether agility matters for high-growth firms (HGFs). The purpose of this research is therefore to investigate the extent to which workforce agility increases the likelihood of firms becoming HGFs in the high-tech manufacturing sector of a developing economy, and whether the relationship is mediated by new product innovation.

We develop a theoretical framework that explains how and why a firm that has an agile workforce that is proactive in creating new products, flexible in responding to changing environment, and resilient in turbulent times, is more likely to create innovative products, and thus secure temporary monopoly, which increases the likelihood of the firm becoming a HGF. Then, utilizing firm-level data from high-tech manufacturing sector of a developing country, Iran, we test several hypotheses using logistic regressions. We find that workforce agility significantly increases the probability of high-tech manufacturing firms becoming HGFs, but that this relationship is mediated by new product innovation. Implications are drawn for theory and practice.
The next Pandora’s Box of criminal background checks
Authors: Rovira Marti
Published: December 2020

The use of criminal background checks (CBCs) – requests for information on previous convictions during the employment recruitment process – is growing worldwide. This article seeks to explain the proliferation in CBCs by examining whether novel legislation introducing mandatory requests for some jobs also leads to an increase in requests for CBCs for jobs outside the scope of the law. The present research makes use of survey data collected from individuals requesting criminal records certificates before and after the introduction of new CBC regulation in Spain – EU Directive 93/2011/EU – which established the obligation to request a criminal record certificate covering sexual crimes for jobs involving frequent contact with children. The analysis detects only a small and unsustained growth in non-mandatory checks following introduction of the new law. However, the results suggest that the danger of the new legislation lies in employers requesting certificates with a higher level of disclosure than is required for the positions on which checks were made mandatory by the new law. In addition, the growth in non-mandatory CBCs observed during this period seems to be related not to the new legislation but to the emergence of tech companies, raising alarm regarding the role of novel forms of policy mobility and the new collaborative economy in limiting the re-entry of individuals with criminal records to the labour market.
Who Should Get “Ineffective”? A Principal’s Ethical Dilemmas on Teacher Evaluation
Authors: Kim Taeyeon , Lowery Charles
Published: December 2020

School principals play a critical role in evaluating teachers and providing feedback, but high-stakes evaluation policies at the local and state levels can create ethical dilemmas for principals. In this case, an underresourced rural school principal has to report a certain number of “ineffective” teachers to meet a requirement from the district teacher evaluation, even though the principal does not think any teacher in his school deserves to receive an “ineffective” rating. This study can be used to help students unpack issues of dilemmas coming from consequential accountability policies that overlook the relational ethos of educators and leaders in school practice.
The Health of Health Care Professionals
Authors: Holtzclaw Lauren , Arlinghaus Katherine R. , Johnston Craig A.
Published: December 2020

Health care professionals represent a population at high risk for poor health. Although this may be counterintuitive given their expertise in health, the high stress and long hours of many medical work environments present challenges for health care professionals to engage in healthy lifestyle behaviors. This is extremely problematic for the health and well-being of both health care professionals and the patients they treat. Medical settings are encouraged to implement interventions that intervene at both the enviornmental and personal level to help faciliate behavior change among health care providers.
Prospective Comparison of Subtalar Arthroereisis With Calcaneal Lengthening in the Management of Planovalgus Feet of Ambulatory Children With Spastic Cerebral Palsy?
Authors: Ahmed Amr H. , Hanna Atef A. , Arafa Amr S. , El-Sherbini Mostafa H. , Omran Ahmed A.
Published: December 2020

Background

Pes planovalgus (PPV) deformity is common among cerebral palsy (CP) patients. There is no true consensus about the best way of treating this common deformity, especially when surgical interference is required. Treatment options range from orthotics to complex surgical procedures. The purpose of this prospective study was to evaluate and compare the effectiveness of 2 different procedures in the correction of symptomatic flexible PPV in ambulatory CP patients.

Methods

A total of 57 feet in 35 patients were divided into 2 groups: group 1, subtalar arthroereisis group, using the calcaneostop technique; group 2, lateral column lengthening group, using Evans osteotomy. Patients were assessed clinically by the clinical score proposed by Yoo et al and radiologically by measuring 7 weight-bearing angles, both preoperatively and 12 months postoperatively. Patients’ (or parents’) satisfaction and their tolerance to braces or shoes were assessed 12 months after surgery as secondary outcome parameters.

Results

There was a statistically significant improvement in both primary and secondary outcome parameters after both procedures in comparison to the preoperative parameters. No statistically significant differences were observed between the 2 groups regarding the outcomes of both procedures except for the greater power of arthroereisis in the correction of hindfoot valgus, which was statistically significant both clinically and radiographically.

Conclusion

Both procedures are valid options for the surgical management of PPV in ambulatory children with spastic CP. The less-invasive nature and lower potential morbidity suggest that judicious use of arthroereisis is appropriate for some patients, especially in the context of single-event multilevel surgery.

Levels of Evidence:

Level II: Prospective, comparative study.
Sequential Epiphyseal Cartilage Changes of Femoral Heads in C57BL/6 Female Mice Treated with Excessive Glucocorticoids
Authors: Jin Shengyang , Yang Liang , Meng Chunqing , He Yu , Ma Kaige , Huang Wei , Wang Hong
Published: December 2020

Objective

Excessive use of glucocorticoids (GCs) may cause adverse effects on the skeletal system in children. However, only a few studies have reported the effects of GCs on the epiphyseal cartilage. This study aimed to uncover the subsequent epiphyseal cartilage changes of immature femoral heads after excessive GC treatment in a mouse model and explain the pathological changes preliminarily.

Design

Female C57BL/6 mice were divided into control and model (excessive GC treatment) groups. The structure of the femoral heads was evaluated by using micro-computed tomography, hematoxylin-eosin staining, and safranin staining analyses. Immunohistochemistry was used to detect angiogenesis and cartilage metabolism. Western blotting and TUNEL staining were used to examine epiphyseal cartilage chondrocyte apoptosis. Primary chondrocytes were isolated from the femoral heads of healthy mice for in vitro studies. The effects of GCs on chondrocyte apoptosis and metabolism were determined by flow cytometry and Western blotting.

Results

The epiphyseal cartilage ossification had started at 4 weeks posttreatment in a portion of mice; the ossification presented as a sequential process in the model group, while the epiphyseal cartilage maintained an unossified state in the control group. Vascular invasion into the epiphyseal cartilage of the model mice was observed at 4 weeks posttreatment. GCs induced chondrocyte apoptosis and altered chondrocyte metabolism in the epiphyseal cartilage.

Conclusions

The epiphyseal cartilage ossification accelerated in the femoral heads of female C57BL/6 mice after excessive GC treatment. Increased chondrocyte apoptosis, altered chondrocyte metabolism, as well as increased vascular invasion, are the potential factors influencing epiphyseal cartilage ossification.
Conditioning team cognition: A meta-analysis
Authors: Niler Ashley A. , Mesmer-Magnus Jessica R. , Larson Lindsay E. , Plummer Gabriel , DeChurch Leslie A. , Contractor Noshir S.
Published: December 2020

Abundant research supports a cognitive foundation to teamwork. Team cognition describes the mental states that enable team members to anticipate and to coordinate. Having been examined in hundreds of studies conducted in board rooms, cockpits, nuclear power plants, and locker rooms, to name a few, we turn to the question of moderators: Under which conditions is team cognition more and less strongly related to team performance? Random effects meta-analytic moderator analysis of 107 independent studies ( N = 7,778) reveals meaningful variation in effect sizes conditioned on team composition and boundary factors. The overall effect of team cognition on performance is ρ = .35, though examining this effect by these moderators finds the effect can meaningfully vary between ρ = .22 and ρ = .42. This meta-analysis advances team effectiveness theory by moving past the question of “what is important?” to explore the question of “when and why is it important?” Results indicate team cognition is most strongly related to performance for teams with social category heterogeneity ( ρ = .42), high external interdependence ( ρ = .41), as well as low authority differentiation ( ρ = .35), temporal dispersion ( ρ = .36), and geographic dispersion ( ρ = .35). Functional homogeneity and temporal stability (compositional factors) were not meaningful moderators of this relationship. The key takeaway of these findings is that team cognition matters most for team performance when—either by virtue of composition, leadership, structure, or technology—there are few substitute enabling conditions to otherwise promote performance.
Increased risk of second primary tumours in patients with oesophageal squamous cell carcinoma: a nationwide study in a Western population
Authors: van de Ven Steffi E. M. , Falger Janne M. , Verhoeven Rob H. A. , Baatenburg de Jong Robert J. , Spaander Manon C. W. , Bruno Marco J. , Koch Arjun D.
Published: December 2020

Background

Patients with primary oesophageal squamous cell carcinoma are at risk of developing multiple primary tumours in the upper aero digestive tract. To date, most studies are performed in the Asian population. We aimed to evaluate the risk of multiple primary tumours in the upper aero digestive tract and stomach in patients with oesophageal squamous cell carcinoma in a Western population.

Methods

We performed a nationwide, retrospective cohort study in collaboration with the Netherlands Cancer Registry. Patients with primary oesophageal squamous cell carcinoma, diagnosed between 2000 and 2016, were included. Primary endpoints were synchronous and metachronous multiple primary tumour risk.

Results

The cohort consisted of 9058 patients, diagnosed with oesophageal squamous cell carcinoma (male: 57.3%, median age 67 years). In 476 patients (5.3%), 545 multiple primary tumours have been diagnosed. Most of them were located in the head and neck region (49.5%). Among all multiple primary tumours, 329 (60.4%) were diagnosed synchronously (<6 months after oesophageal squamous cell carcinoma diagnosis) and 216 (39.6%) metachronously (6 months). Patients with oesophageal squamous cell carcinoma had a significantly increased risk of both synchronous (standardised incidence ratio 10.95, 99% confidence interval 9.40–12.53) and metachronous multiple primary tumours (standardised incidence ratio 4.36, 99% confidence interval 3.56–5.10), compared to the general population. The median interval to metachronous second primary tumour diagnosis was 3.0 years (interquartile range 1.8–5.9).

Conclusion

Approximately one in 20 patients with primary oesophageal squamous cell carcinoma have a second primary tumour in the upper aero digestive tract or stomach, either at the time of oesophageal squamous cell carcinoma diagnosis or at a later stage. As second primary tumours occur at an increased risk compared to the general population, prospective studies are necessary to investigate the yield and survival benefit of screening for second primary tumours in patients with oesophageal squamous cell carcinoma.
Political engagement and turnout among same-sex couples in Western Europe
Authors: Turnbull-Dugarte Stuart J. , Townsley Joshua
Published: December 2020

This paper presents and addresses a simple, yet overlooked, research question: is there a sexuality gap in political engagement and participation between sexual minority individuals and the heterosexual majority in Western Europe? To answer this question, we employ a recently applied method of identifying lesbian, gay and bisexual (LGB) individuals using data on the gender composition of cohabiting partner households from the European Social Survey. Relying on a total sample of more than 110,000 individuals across 12 different countries with an identified sample of 1542 LGB individuals, we test the divergence in political interest and political participation, both electoral and non-electoral, between LGB and non-LGB individuals. The results of our empirical analyses conform with our expectations. Theorising that LGBs, as a marginalised social stratum, are incentivised to participate and ‘vote like their rights depended on it’, we find empirical evidence of a significant and positive ‘sexuality gap’ in levels of political interest, turnout and other forms of political participation in Western Europe over and above what can be determined by socio-economic determinants of political participation.
In vitro and in vivo evaluation of a ciprofloxacin delivery system based on poly(DLLA-co-GA-co-CL) for treatment of chronic osteomyelitis
Authors: Liu Yixiu , Bai Xizhuang , A Liang
Published: December 2020

Chronic osteomyelitis causes serious injury to patients. Antibiotic delivery systems based on poly(lactide-co-glycolide) (PLGA) have great potential for treatment of chronic osteomyelitis. However, PLGA has a glass-transition temperature that is higher than physiological temperatures, resulting in a lack of flexibility for implantation into the bone marrow cavity. As an alternative, poly(d, l-lactide-co-glycolide-co-ε-caprolactone) (PLGC) presents good flexibility due to the introduction of poly(ε-caprolactone) segments. To develop a new strategy for treatment of chronic osteomyelitis, a ciprofloxacin delivery system was prepared using PLGC as carriers, the antibacterial effects of which were evaluated both in vivo and in vitro. The in vitro release behavior showed that the average release reached 268.5 μg/days on day 33, with a cumulative release rate of 56.01%. A bacteriostatic ring, with a diameter of 26.83 ± 0.83 mm, was produced by ciprofloxacin against Staphylococcus aureus after 30 days of release via our ciprofloxacin-PLGC system. After 4 weeks of treatment in vivo, chronic-osteomyelitis-model rats had a bodyweight of 385.83 ± 17.23 g and a normal white-blood-cell count, as well as a lower number of bacterial colonies per gram of bone tissue of (10.6 ± 3.0) × 101 CFU/g. Furthermore, no inflammatory cells were observed via hematoxylin-and-eosin staining, and normal bone structure was observed via X-ray. Taken together, our findings indicate that our novel ciprofloxacin-PLGC system yielded noteworthy antibacterial effects both in vitro and in vivo, suggesting that it may be useful for treating patients with chronic osteomyelitis.
Biomechanics in an Incomplete Versus Complete Supraspinatus Tear: A Cadaveric Study
Authors: Rybalko Danil , Bobko Aimee , Amirouche Farid , Peresada Dmitriy , Hussain Awais , Patetta Michael , Sood Anshum , Koh Jason , Goldberg Benjamin
Published: December 2020

Background:

Degenerative and traumatic changes to the rotator cuff can result in massive and irreparable rotator cuff tears (RCTs).

Purpose/Hypothesis:

The study objective was to conduct a biomechanical comparison between a small, incomplete RCT and a large, complete RCT. We hypothesized that the incomplete supraspinatus (SS) tear would lead to an incremental loss of abduction force and preserve vertical position of the humeral head, while a complete SS tear would cause superior humeral migration, decrease functional deltoid abduction force, and increase passive range of motion (ROM).

Study Design:

Controlled laboratory study.

Methods:

Six cadaveric shoulders were evaluated using a custom testing apparatus. Each shoulder was subjected to 3 conditions: (1) intact/control, (2) 50%, full-thickness, incomplete SS tear, and (3) 100%, complete SS tear. Deltoid abduction force, superior humeral head migration, and passive ROM were measured in static conditions at 0°, 30°, and 60° of glenohumeral abduction, respectively.

Results:

The intact SS resulted in a mean deltoid abduction force of 2.5, 3.3, and 3.8 N at 0°, 30°, and 60° of abduction, respectively. Compared with the intact shoulder, there was no significant difference in mean abduction force seen in the incomplete tear, while the force was significantly decreased by 52% at 30° of abduction in the complete tear ( P = .009). Compared with the incomplete tear, there were significant decreases in abduction force seen in the complete tear, by 33% and 48% (0.9 N and 1.1 N) at 0° and 30° of abduction, respectively ( P = .04 and .004). The intact configuration experienced a mean superior humeral head migration of 1.5, 1.4, and 1.1 mm at 0°, 30°, and 60° of abduction, respectively. The complete tear resulted in a superior migration of 3.0 and 4.4 mm greater than the intact configuration at 0° and 30° of abduction, respectively ( P = .001). There was a 5° and 10° increase in abduction ROM with 50% and 100% tears, respectively ( P = .003 and .03).

Conclusion:

An incomplete SS tear does not significantly alter the biomechanics of the shoulder, while a large, complete SS tear leads to a significant superior humeral migration, a decreased deltoid abduction force, and a mild increase in passive ROM.

Clinical Relevance:

Our findings demonstrate the effects of large SS tears on key biomechanical parameters, as they progress from partial tears.
Return to Work After Distal Femoral Varus Osteotomy
Authors: Puzzitiello Richard N. , Liu Joseph N. , Garcia Grant H. , Redondo Michael L. , Forlenza Enrico M. , Agarwalla Avinesh , Yanke Adam B. , Cole Brian J.
Published: December 2020

Background:

Distal femoral varus osteotomy (DFVO) is a well-described procedure to address valgus deformity of the knee. There is a paucity of information available regarding patients’ ability to return to work (RTW) after DFVO.

Purpose:

To report the objective findings for RTW rates and times for patients receiving a DFVO for lateral compartment osteoarthritis secondary to valgus deformity of the knee.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This was a retrospective study of patients who received a lateral-wedge opening DFVO. Patients must have worked within 3 years before their operation to be included for analysis. Patients were contacted at a minimum of 2 years postoperatively for interview and questionnaire evaluation, including a subjective work questionnaire, visual analog scale (VAS) for pain, Single Assessment Numerical Evaluation (SANE), and a satisfaction questionnaire.

Results:

Overall, 32 patients were contacted at a mean follow-up of 7.1 ± 4.1 years (range, 2.2-13.3 years). The mean ± SD age at the time of surgery was 30.8 ± 8.8 years (range, 17.2-46.5 years), and 65.6% of patients were female. Eleven patients (34.4%) received a concomitant meniscal allograft transplant, and 12 (37.5%) received a cartilage grafting procedure. The average VAS pain score decreased significantly from 6.1 preoperatively to 3.2 postoperatively ( P = .03). All patients were able to RTW, at a mean time of 6.0 ± 13.2 months postoperatively (range, 0-72 months). When stratified by work intensity, the average time to return was 13.8, 3.1, 2.7, and 2.9 months for high, moderate, light, and sedentary occupations, respectively. There was no significant difference between these RTW times ( P = .16), although this analysis may have been limited by the small sample size. Four patients whose work was classified as heavy work (50%) and 3 whose work was classified as moderate work (18.8%) either switched jobs or kept the same job with lighter physical duties as a result of their procedures.

Conclusion:

In a young and active population, DFVO for valgus deformity reliably afforded the ability to RTW within a relatively short time for patients with sedentary, light, and moderate occupational demands. However, patients with moderate- to high-intensity occupational demands may be unable to RTW at their preoperative level.
Transition Planning for Chronic Illnesses in the Time of COVID-19
Authors: Hunt William R , Linnemann Rachel W , Middour-Oxler Brandi
Published: December 2020

Transition from pediatric to adult care for those with chronic illnesses must have special considerations during the COVID-19 pandemic. The SARS-CoV-2 coronavirus has significantly disrupted social, economic, and health care practices globally. Young adults with special health care needs are at increased risk for poor outcomes during this unprecedented time. We have found that heightened anxiety, health care service disruption, and other logistical complications surrounding the new virus may further confound health care transitions. Increased communication and collaboration with young adults is necessary to provide patient-centered care and ensure they successfully cross the transition chasm.
“No More Money, Hannah!”: Using HBO’s Girls to Teach Force Field Analysis
Authors: Cox Pamela L.
Published: December 2020

Research suggests that students today favor a collaborative learning style, short cases, and group activities over semester-long case studies, and they respond well to classroom activities characterized by the use of technology, entertainment, and excitement. Accordingly, this article presents an exercise designed using these types of activities to engage students while teaching them about Lewin’s force field analysis, resistance to change, and tactics for overcoming resistance to change. The exercise is designed for late undergraduates or graduate students in a change management course or in a change management module in an organizational behavior course. It provides students an easy, initial exercise to learn and apply force field analysis to a short video scene and a personal experience of change as well as to a more complicated follow-on case study.
Prescription of blood pressure lowering treatment after intracerebral haemorrhage: Prospective, population-based cohort study
Authors: Bonello Karl , Nelson Amy PK , Moullaali Tom J , Al-Shahi Salman Rustam ,   for the Lothian Audit of the Treatment of Cerebral Haemorrhage Collaborators
Published: December 2020

Introduction

Blood pressure (BP) lowering reduces the risk of recurrent stroke after intracerebral haemorrhage (ICH). However, implementation of BP lowering in clinical practice in the UK is unknown.

Patients and methods

We identified adults with first-ever incident ICH to quantify the proportion who survived >14 days after hospital discharge and were prescribed BP-lowering medication in a prospective, population-based, inception cohort study in the Lothian region of Scotland during June 2010–May 2012 and January–December 2019. After the first cohort, we analysed reasons for avoiding BP-lowering medication in a sample from the Lothian region of the Scottish Stroke Care Audit during January 2017–November 2017, which informed a quality improvement intervention that was implemented in the second cohort.

Results

After efforts to improve monitoring and lowering of BP amongst ICH survivors, there was an increase in the proportion of patients prescribed BP-lowering medication at hospital discharge between the first and second population-based cohorts (81/130 [62%] vs. 68/89 [76%]; P = 0.028). Compared with patients not prescribed BP-lowering medication at hospital discharge, patients prescribed BP-lowering medication presented with higher systolic BP (177 vs. 156 mm Hg, P = 0.002 and 180 vs. 149 mm Hg, P < 0.001, in the first and second population-based cohorts, respectively), and were more likely to have pre-morbid hypertension (85% vs. 33%, P < 0.001 and 72% vs. 29%, P < 0.001) and atrial fibrillation (35% vs. 4%, P < 0.001 and 26% vs. 5%, P < 0.034).

Conclusion

In this population-based study, the proportion of patients with ICH who were prescribed BP-lowering medication at hospital discharge increased after a quality improvement intervention.