bluuebunny/crossref_metadata_2025 huggingface dataset:
What Does it Mean to be a Female Character in “Indie” Game Storytelling? Narrative Framing and Humanization in Independently Developed Video Games
Authors: Perreault Mildred F. , Perreault Gregory , Suarez Andrea
Published: June 2021

Video games have long held a spotty history in their narratives regarding women. Most research has examined large budget games and identified issues of simplification, oversexualization, and a general lack of agency among female characters. The present study explores the gaming niche of “indie”—or independent game developer—video games in their representations of women in particular with Never Alone, Gone Home, and Her Story. These games were released around the time frame of the GamerGate controversy—a controversy which drew attention to the treatment of women in gaming culture—and hence, the games are used to reflect on a potential shift in games culture following the controversy. This article argues that these game narratives emphasized multilayered female characterizations, female-to-female interactions, and internal dramas as a way to potentially reach female gamers and present an alternative, humanizing narrative on women.
The College Gets Its Act Together: Cutting the Costs of Disputes in Organizations
Authors: Crotts John C.
Published: June 2021

This case is framed around the personal experience of a faculty member whose dispute with supervisors lead to the resignation of a chair, the eventual firing of a dean, and the loss of good will with key community stakeholders. It focuses on the analysis of an internal grievance process that brings the student to two decision points, namely, (a) what shortcomings exist in the current internal grievance process and (b) what changes should be made to make them fairer and more effective? The case briefly addresses and illustrates the foundational skills of dispute resolution and mediation designed to resolve conflicts efficiently and fairly at the lowest cost.
Nonlinear isolation performance of 6 × 19 wire rope of different lengths under compression
Authors: Mo Genlin , Liu Jing , Jin Yongxi , Yan Wenmin
Published: June 2021

Stainless steel wire rope isolator is widely used in engineering. To optimize design of the isolator, loading, and unloading characteristics of the 6 × 19 6 mm wire rope under compression are investigated. Ropes of different lengths are tested to get the force-displacement relations. The stiffness, the equivalent damping ratio, and the hysteresis loop of the wire rope are derived. The stiffness decreases with both the length of the rope and the vibration amplitude. It has an approximate linear relationship with the reciprocal of length and amplitude. The equivalent damping ratio has an approximate quadratic relationship with the reciprocal of length and amplitude. The hysteresis loop of the wire rope is described using the proposed quadrilateral model. The loading stage is found to be determined by the length of the rope. The unloading stage is influenced by both the vibration amplitude and the length of the rope. Influences of the excitation amplitude and the frequency on the isolation performance for both steady-state vibration and transient impact vibration are revealed based on the models. The work would help engineers to design the isolators and predict responses of the structures.
Wearing same- and opposite-sex virtual bodies and seeing them caressed in intimate areas
Authors: Mello Manuel , Fusaro Martina , Tieri Gaetano , Aglioti Salvatore Maria
Published: June 2021

Immersive virtual reality enables people to undergo the experience of owning an artificial body and vicariously feeling tactile stimuli delivered to it. However, it is currently unknown how such experiences are modified by the sexual congruency between the human and the artificial agent. In two studies, heterosexual men (Experiment 1) and women (Experiment 2) embodied same-sex and opposite-sex avatars and were asked to evaluate the experience (e.g., pleasantness, erogeneity) of being touched on social or intimate areas of their virtual body by a male or female avatar. Electrocardiogram and galvanic skin response were also recorded. Moreover, participants’ implicit and explicit gender biases were examined via a gender-potency implicit association test and the Ambivalent Sexism Inventory. When embodying a same-sex avatar, men and women rated caresses on intimate areas from an avatar of the opposite sex as more pleasant and erogenous. Conversely, body swap—that is, wearing an opposite-sex avatar—enhanced participants’ perceptions of pleasantness and erogeneity for caresses on intimate areas from a same-sex toucher. This effect was stronger in men than in women. Furthermore, physiological correlates of enhanced processing of arousing stimuli predicted behavioural outcomes during the body swap illusion. Wearing an opposite-sex avatar affects one’s own body representations and may have important implications on people’s attitudes and implicit reactivity to touch-mediated interactions. Men seem more susceptible to this type of body swap illusion. Our paradigm may induce profound changes of cross-sex perspective-taking and provide novel tools for promoting empathy and comprehension of sex-related diversity.
A 4-year study of the use of the short metacarpal cast in the management of metacarpal shaft fractures
Authors: Street Julia , Nessa Luthfun , Logan Andrew , Trickett Ryan W
Published: June 2021

We report on our experience of using a short, moulded metacarpal cast over a 4-year period in the non-surgical management of metacarpal shaft fractures. Between 6 April 2015 and 6 April 2019, 117 patients were treated using this method. The majority were male, and the mean age was 24.6 years. The most common mechanism of injury was a punch injury (73 patients, 62%). Fifteen patients (13%) were treated for multiple metacarpal fractures. Immediately after cast removal, 68% had a full range of finger movement and 68% were pain free. Few required formal hand therapy. Fifteen patients experienced minor complications, primarily soft tissue irritation from the cast and non-limiting extensor lag. The moulded short metacarpal cast is an effective non-surgical treatment for angulated extra-articular metacarpal fractures of the diaphysis and diametaphyseal junction.

Level of evidence: IV
Influences of Physical Layout and Space on Patient Safety and Communication in Ambulatory Oncology Practices: A Multisite, Mixed Method Investigation
Authors: Fauer Alex , Wright Nathan , Lafferty Megan , Harrod Molly , Manojlovich Milisa , Friese Christopher R.
Published: June 2021

Objective:

To examine how physical layouts and space in ambulatory oncology practices influence patient safety and clinician communication.

Background:

Ambulatory oncology practices face unique challenges in delivering safe care. With increasing patient volumes, these settings require additional attention to support patient safety and efficient clinical work processes.

Methods:

This study used a mixed methods design with sequential data collection. Eight ambulatory oncology practices (of 29 participating practices) participated in both the quantitative and qualitative phases. In surveys, clinicians ( n = 56) reported on safety organizing and communication satisfaction measures. Qualitative data included observations and semistructured interviews ( n = 46) with insight into how physical layout influenced care delivery. Quantitative analysis of survey data included descriptive and correlational statistics. Qualitative analysis used inductive and thematic content analysis. Quantitative and qualitative data were integrated using side-by-side comparison tables for thematic analysis.

Results:

Safety organizing performance was positively correlated with clinician communication satisfaction, r(54 df) = .414, p = .002. Qualitative analyses affirmed that the physical layout affected communication around chemotherapy infusion and ultimately patient safety. After data integration, safety organizing and clinician communication were represented by two themes: visibility of patients during infusion and the proximity of clinicians in the infusion center to clinicians in the clinic where providers see patients.

Conclusions:

Physical layouts of ambulatory oncology practices are an important factor to promote patient safety. Our findings inform efforts to construct new and modify existing infusion centers to enhance patient safety and clinician communication.
More or More of the Same: Ownership Concentration and Media Diversity in Egypt
Authors: Badr Zahraa
Published: June 2021

The Egyptian media has witnessed various changes in the ownership spectrum after the 2011 revolution. To explore this evolution, and through the Habermasian lens, this study examined ownership concentration in the 2019 media sphere in Egypt by mapping media outlets and their owners. It also investigated the relationship between this concentration and content diversity in a sample of print outlets in the first quarter of 2019. Three patterns of ownership concentration in the Egyptian media were identified: concentrated state ownership, concentrated private ownership, and not concentrated private ownership. Based on these findings, I argue that the media sphere in Egypt is dominated by a few gatekeepers, mostly the state, that influence content diversity and jeopardize the democratic public sphere in postrevolution Egypt.
Quality of life in ambulatory pulmonary arterial hypertension in connective tissue diseases and its relationship with risk stratification
Authors: Shi Yue , Meng Yanling , Dong Xingbei , Liu Yang , Liu Yongtai , Lai Jinzhi , Tian Zhuang , Zhao Jiuliang , Peng Jinmin , Wang Qian , Li Mengtao , Zeng Xiaofeng
Published: June 2021

The Pulmonary Arterial Hypertension Symptoms and Impact Questionnaire (PAH‐SYMPACT) is a PAH‐specific patient‐reported outcome scale assessing patients’ quality of life from four aspects: cardiopulmonary symptoms, cardiovascular symptoms, physical impacts and cognitive/emotional impacts. This study aimed to validate the Chinese version of PAH‐SYMPACT and explore its relationship with risk stratification in patients with connective tissue disease‐associated pulmonary arterial hypertension (CTD‐PAH). In addition, 75 patients with CTD‐PAH confirmed by right heart catheterization were invited to complete questionnaires including PAH‐SYMPACT, the 36‐item Medical Outcomes Study Short Form Survey (SF‐36) and EuroQol five dimensions questionnaire (EQ‐5D). The demographic, clinical, laboratory and treatment data were collected. The endpoint was treatment goal achievement status in 6–12 months after completing the questionnaires, defined as an integrated outcome. Participants’ mean age was 36.4 ± 11.9 years and the mean pulmonary arterial pressure was 38.9 ± 13.67 mmHg. The reliability of the PAH‐SYMPACT domains ranged from 0.83 to 0.88. Results of factor analysis basically conformed the original PAH‐SYMPACT. The treatment goal achievement (TGA) status in 6–12 months was significantly associated with physical impacts scores (odds ratio: 0.180, 95% confidence interval: 0.036–0.908, P=0.038). The Chinese version of PAH‐SYMPACT is a reliable measurement to evaluate quality of life in CTD‐PAH patients and is also a potential predictor of patient’s condition change in routine clinical practice.
Pulmonary hypertension associated with busulfan
Authors: Hagenburg Jean , Savale Laurent , Lechartier Benoit , Ghigna Maria‐Rosa , Chaumais Marie‐Camille , Jaïs Xavier , Sitbon Olivier , Humbert Marc , Montani David
Published: June 2021

Busulfan is widely used to treat malignant diseases, particularly for therapeutic intensification prior to an autologous stem cell graft. Numerous side effects consecutive to busulfan are described, but few descriptions of pulmonary hypertension exist, while bronchiolitis obliterans remains a rare complication. We report the clinical observations of four patients from the French Pulmonary Hypertension Registry who experienced subacute pulmonary hypertension after receiving busulfan as preparation regimen before an autologous stem cell graft for malignancies (Hodgkin’s disease, Ewing’s sarcoma and primary large B cell lymphoma of the brain). Patients experienced severe pulmonary arterial hypertension 2 to 4.5 months after busulfan administration. Pulmonary hypertension improved after treatment with approved drugs for pulmonary arterial hypertension and/or corticosteroids. During the follow‐up period, two patients developed chronic respiratory insufficiency due to interstitial lung disease, leading to double lung transplantation. The pathological assessment of explanted lungs revealed interstitial lung fibrosis with advanced bronchiolar lesions and severe pulmonary vascular damage. Three of the four patients were still alive after 36 to 80 months and the fourth died unexpectedly and suddenly after 5 months. In conclusion, PAH is a rare but severe complication associated with busulfan chemotherapy in adults. Histological examinations provide evidence for diffuse pulmonary vascular damage combined with interstitial lung injury in most cases.
The wide spectrum of β‐thalassaemia intermedia‐induced pulmonary hypertension: two case reports on the possible role of specific pulmonary arterial hypertension therapy
Authors: Anthi Anastasia , Tsiapras Dimitrios , Karyofyllis Panagiotis , Voudris Vassilios , Armaganidis Apostolos , Orfanos Stylianos E.
Published: June 2021

Pulmonary hypertension (PH) development remains a significant cardiovascular complication of haemoglobinopathies, severely affecting the morbidity and mortality of such patients. According to the 5th World Symposium on PH, PH related with chronic haemolytic anaemias is classified in group 5, mainly due to the multifactorial pathophysiology of PH in this patient population. There are no clear guidelines regarding the management of PH in patients with haemoglobinopathies; the use of specific pulmonary arterial hypertension (PAH) therapy in patients with β‐thalassaemia and PH is based on data derived from other forms of PH, expert opinion and small series or case reports. The existing knowledge on the use of specific‐PAH therapy in β‐thalassaemia patients with PH is limited, and in most cases the diagnosis of PH is based on echocardiographic findings only. We herein report two patients with β‐thalassaemia intermedia (TI) and PH, who got same initial approach but different outcome, to highlight the wide spectrum of TI‐induced PH, the importance of optimal disease‐directed therapy and the possible role of specific‐PAH therapy. We also emphasize the central role of right heart catheterization in the diagnosis and follow‐up of PH, since this information does facilitate the suitable use or withdrawal of specific PAH drugs in these patients.
Discordant storytelling, ‘honest fakery’, identity peddling: How uncanny CGI characters are jamming public relations and influencer practices
Authors: Block Elena , Lovegrove Rob
Published: June 2021

This article critically explores whether and how computer-generated imagery (CGI) characters are jamming public relations and influencer practices. We use Miquela, a virtual character with 3 million Instagram followers as a case study. We examine Miquela’s (and her creators’) communication strategies to identify what makes her so appealing to postmillennial audiences, luxury and indie brands, and civil rights activists alike. Valued at USD125 million, Miquela is algorithmically moulded as a fashionista, singer and civil rights warrior to maximise visibility, influence and emotional release. ‘Her’ discordant, uncanny human/nonhuman ethos simultaneously attracts, intrigues and defies. To study Miquela’s case we built a four-tiered theoretical framework (parasocial relations, identity influence, culture jamming, and algorithmic branding) using the Freudian concept of ‘the uncanny’ as connecting thread; and a mixed method that includes digital ethnography, textual and sentiment analysis. We aim to make a contribution to studies on the use of digital media in PR.
Development of a hybrid sleep and physical activity improvement intervention for adults with osteoarthritis-related pain and sleep disturbance: a focus group study with potential users
Authors: Whibley Daniel , Stelfox Kevin , Henry Alasdair L , Tang Nicole KY , Kratz Anna L
Published: June 2021

Objective:

Suboptimal sleep and physical activity are common among people living with osteoarthritis (OA) and simultaneous improvements in both may have a beneficial impact on pain. This study aimed to gather perspectives of people living with OA on important aspects to incorporate in a hybrid sleep and physical activity improvement intervention for OA pain management.

Design:

Qualitative study using two rounds of two focus groups.

Setting and participants:

Focus groups were conducted with adults living with OA-related chronic pain and sleep disturbances. Eighteen people attended focus groups in January 2020 and, of these, 16 attended subsequent focus groups in February 2020.

Methods:

Discussion at the first round of focus groups informed generation of prototype intervention materials that were shared, discussed and refined at the second round of focus groups. Thematic analysis was used to identify themes and sub-themes from the data.

Results:

Three themes, each with three sub-themes, were identified: facilitators of engagement with the intervention (sub-themes: motivational language, accountability and education); barriers to engagement (sub-themes: suboptimal interaction with healthcare practitioners, recording behaviour as burdensome/disruptive and uncertainty about technique) and characteristics of a physical activity intervention component (sub-themes: tailored, sustainable and supported).

Conclusion:

We have identified important aspects to incorporate into the design and delivery of a hybrid sleep and physical activity improvement intervention for OA pain management. Insights will be incorporated into intervention materials and protocols, with feasibility and acceptability assessed in a future study.
An exercise intervention alters stool microbiota and metabolites among older, sedentary adults
Authors: Erlandson Kristine M. , Liu Jay , Johnson Rachel , Dillon Stephanie , Jankowski Catherine M. , Kroehl Miranda , Robertson Charles E. , Frank Daniel N. , Tuncil Yunus , Higgins Janine , Hamaker Bruce , Wilson Cara C.
Published: June 2021

Background:

Physiologic aging has been associated with gut dysbiosis. Although short exercise interventions have been linked to beneficial changes in gut microbiota in younger adults, limited data are available from older populations. We hypothesized that exercise would produce beneficial shifts in microbiota and short-chain fatty acid (SCFA) levels in older persons.

Methods:

Stool samples were collected before and at completion of a supervised 24-week cardiovascular and resistance exercise intervention among 50–75-year-old participants. SCFA levels were analyzed by gas chromatography and microbiome by 16S rRNA gene sequencing. Negative binomial regression models compared pre- and post-differences using false discovery rates for multiple comparison.

Results:

A total of 22 participants provided pre-intervention samples; 15 provided samples at study completion. At baseline, the majority of participants were men (95%), mean age 58.0 (8.8) years, mean body mass index 27.4 (6.4) kg/m2. After 24 weeks of exercise, at the genus level, exercise was associated with significant increases in Bifidobacterium (and other unidentified genera within Bifidobacteriaceae), Oscillospira, Anaerostipes, and decreased Prevotella and Oribacterium ( p < 0.001). Stool butyrate increased with exercise [5.44 (95% confidence interval 1.54, 9.24) mmol/g, p = 0.02], though no significant differences in acetate or propionate ( p ⩾ 0.09) were seen.

Conclusion:

Our pilot study suggested that an exercise intervention is associated with changes in the microbiome of older adults and a key bacterial metabolite, butyrate. Although some of these changes could potentially reverse age-related dysbiosis, future studies are required to determine the contribution of changes to the microbiome in the beneficial effect of exercise on overall health of older adults. Clinical Trials NCT02404792
A Dynamic Analysis of the Impact of Fiscal Adjustment on Economic Growth: Evidence From Pakistan
Authors: Hussain Ibrar , Hussain Jawad , Ali Arshad , Ahmad Shabir
Published: June 2021

This study claims to be the first in assessing the short-run and long-run impacts of both the size and composition of fiscal adjustment on the growth in Pakistan. Empirical calibration has been made on Mankiw et al.’s model, while the Autoregressive Distributed Lag (ARDL) techniques of Pesaran et al. have been employed to carry out the estimation. To cure the problem of degenerate cases, the ARDL techniques have been augmented with the model of Sam et al. The analysis supports the hypothesis of “expansionary fiscal contraction” in the long run. The analysis reveals that the spending-based adjustment enhances the economic growth, whereas the tax-based adjustment would reduce the growth in the long run in the case of Pakistan. The Granger causality test indicates that the fiscal adjustments have been weakly exogenous, thereby allowing feedback effect from the economic growth toward the fiscal adjustment. Thus, the objective of sustained economic growth can be achieved through the spending-based consolidation measures.
Toward Critical Intercultural Literacy Enhancement of University Students in China From the Perspective of English as a Lingua Franca
Authors: Wang Xiaoli , Jiang Lianjiang , Fang Fan , Elyas Tariq
Published: June 2021

The concept of intercultural communication has become a focus in English language teaching (ELT) against the backdrop of globalization, as English is now used as a lingua franca (ELF) among people with different first languages (L1s). However, the current linguistic landscape of ELF does not reflect well in ELT practices in which native speakerism ideology persists and curriculum design and teaching materials largely remain oriented to native speakerism. To address this gap, data drawn from a participatory action research were analyzed to discuss students’ understanding and reflection of critical intercultural literacy. Several training activities in an adaptive English as a foreign language (EFL) course of intercultural communication that involved reading academic articles related to intercultural literacy were first implemented and two follow-up workshops were conducted with 10 Chinese university students as participants. Data from further interviews and reflective journals from the students in relation to critically evaluate the textbook contents of this course were analyzed using a qualitative content analysis. The results revealed that students acquired a sense of intercultural literacy and that they learnt to challenge textbook content from a critical perspective through the training. This article further addresses the importance of critical pedagogy in teaching linguistic and cultural literacy and concludes that ELT must be conducted from a multilingual and multicultural perspective.
Health and Well-Being of Hispanic/Latino Meatpacking Workers in Nebraska: An Application of the Health Belief Model
Authors: Ramos Athena K. , Carvajal-Suarez Marcela , Trinidad Natalia , Quintero Sophia A. , Molina Diana , Johnson-Beller Rebecca , Rowland Sheri A.
Published: June 2021

Background:

Meatpacking is dirty, dangerous, and demanding work. In the United States, the industry predominately employs people from racial/ethnic minority backgrounds and immigrants, with 45% of the workforce identifying as Hispanic/Latino. Little is known about how the work environment affects worker engagement in health-promoting activities; however, occupational health professionals are uniquely positioned to advance worker health, safety, and general well-being.

Methods:

Hispanic/Latino meatpacking workers with work-related musculoskeletal pain and active health concerns were recruited to participate in a study to explore health, health behaviors, and the work environment. Five focus groups ( N = 28) were conducted in Nebraska between March 2019 and February 2020. Thematic analysis using the Health Belief Model constructs was used to explain workers’ health behaviors including utilization of occupational health services at their workplace.

Findings:

Workers believed that there was little they could do to prevent and treat health problems. They understood the perceived threat of health problems and the benefits of self-care, but the perceived barriers often outweighed the benefits. The workplace had few prompts to motivate or incentivize self-care both in and outside of work. In addition, workers did not trust the occupational health office and saw few benefits to accessing services. Together, these conditions resulted in low self-efficacy and limited engagement in health-promoting behaviors.

Conclusion/Application to practice:

Occupational health professionals should promote Total Worker Health and foster trust by providing culturally, linguistically, and literacy appropriate services and by identifying opportunities and reducing barriers for workers to engage in activities to promote their health, safety, and well-being.
Factors Influencing the Performance of Commercial Banks: A Dynamic Panel Study on India
Authors: Sarkar Sreemanta , Rakshit Debdas
Published: June 2021

The article investigates the determinants of commercial banks’ performance in India over the period from 2000 to 2017 with special reference to the macroeconomic factors. Considering return on assets (ROA), return on equity (ROE) and net interest margin (NIM) as the measure of performance, we have chosen a panel of public and private sector commercial banks of our country. Taking some macro variables such as GDP, inflation and lending interest rate as the prime explanatory variables along with some bank-specific and macroeconomic control variables, first difference generalized method of moments (GMM) method has been applied to observe the impact of these macroeconomic factors on the performance of commercial banks. Results indicate that external variables significantly affect commercial banks’ performance and these findings remain unaltered with the sequential inclusion of all control variables. This work has immense importance to the bankers, planners and policymakers in shaping appropriate policy decisions for the commercial banks.
Association of Prior Anterior Cruciate Ligament Tear With Decreased Career Longevity in Women’s National Basketball Association
Authors: Tramer Joseph S. , Khalil Lafi S. , Jildeh Toufic R. , Sattar Mohammad , Ziedas Alexander , Abbas Muhammad J. , Kolowich Patricia A. , Okoroha Kelechi R.
Published: June 2021

Background:

The incidence of anterior cruciate ligament (ACL) injuries in women’s basketball exceeds that of men. There is a paucity of data regarding career performance in Women’s National Basketball Association (WNBA) athletes with a history of ACL reconstruction.

Purpose:

To determine whether WNBA athletes with a history of ACL injury prior to professional play have reduced career game utilization, defined as games played and started and minutes per game (MPG), as well as statistical performance, defined by player efficiency rating (PER).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 42 WNBA players from 1997 to 2018 who had a history of ACL reconstruction before entering professional leagues. Body mass index (BMI), age, and position were collected for each player. Career data and performance statistics were likewise collected for each player’s entire WNBA career. A control group of WNBA players with no history of ACL injury were matched by position, BMI, and age at the time of WNBA debut. Statistics compared game utilization and performance to assess the impact of ACL reconstruction.

Results:

Athletes who sustained an ACL tear before entering the league played in fewer games per season in their first 3 professional seasons compared with healthy controls (24.2 ± 8.4 vs 28.2 ± 6.1; P = .02). Among athletes with a history of ACL reconstruction, 11 (26.2%) played only a single WNBA season, while no control athletes played in just 1 season. Additionally, athletes who had a previous ACL tear started significantly fewer games per season (9.0 ± 9.4 vs 14.0 ± 9.0; P < .01) and played fewer MPG (15.5 ± 7.2 vs 20.7 ± 5.5; P < .01) during their WNBA career. Athletes with a history of ACL tear had significantly shorter WNBA careers (4.8 ± 4.1 vs 8.1 ± 3.3 seasons; P < .001). Total professional play duration (WNBA + overseas) was significantly reduced in players with an ACL tear compared with controls ( P < .05). PER was not significantly different between cohorts at any time point.

Conclusion:

WNBA athletes with a history of an ACL tear before professional play had decreased career game utilization and workload throughout their career despite having similar PER compared with healthy controls.
Return to Sport After Bone–Patellar Tendon–Bone Autograft ACL Reconstruction in High School–Aged Athletes
Authors: Rauck Ryan C. , Apostolakos John M. , Nwachukwu Benedict U. , Schneider Brandon L. , Williams Riley J. , Dines Joshua S. , Altchek David W. ,   the HSS ACL Registry Group, Pearle Andrew , Allen Answorth , Stein Beth Shubin , Dines David , Ranawat Anil , Kelly Anne , Kelly Bryan , Rose Howard , Maynard Michael , Strickland Sabrina , Coleman Struan , Hannafin Jo , MacGillivray John , Marx Robert , Warren Russell , Rodeo Scott , Fealy Stephen , O’Brien Stephen , Wickiewicz Thomas
Published: June 2021

Background:

Anterior cruciate ligament (ACL) injuries are occurring with increasing frequency in the adolescent population. Outcomes after ACL reconstruction (ACLR) are inconsistently reported in homogeneous patient populations.

Purpose/Hypothesis:

To evaluate outcomes after bone–patellar tendon–bone (BTB) autograft ACLR in competitive high school–aged athletes by examining return to sport (RTS), patient satisfaction, and reinjury rates. Our hypothesis was that RTS rates and satisfaction will be high and reinjury rates will be low.

Study Design:

Case series; Level of evidence, 4.

Methods:

An institutional ACL registry was utilized to identify competitive high school–aged athletes (14-18 years old) who underwent primary ACLR using BTB autograft with a minimum 2-year follow-up. A postoperative questionnaire was administered to determine rates and types of RTS, quality of sports performance, reinjury, and satisfaction. Uni- and multivariable analyses were used to identify demographic, sport-specific, and clinical factors related to RTS.

Results:

A total of 53 patients were included (mean ± SD age at the time of surgery, 16.6 ± 1.34 years). Mean follow-up was 3.78 ± 0.70 years (range, 2.60-4.94 years). The overall ipsilateral ACL retear rate was 7.5% (n = 4). There were 10 subsequent ACL tears to the contralateral knee (19%). Forty-four (83%) patients successfully returned to at least their prior level of sport at a mean 10.5 ± 8.7 months (range, 3-48 months). Overall satisfaction was high, with 91% of patients very satisfied with the outcome. Higher confidence levels regarding performance of the reconstructed knee were associated with increased probability of RTS on multivariate analysis.

Conclusion:

BTB autograft ACLR results in high rates of RTS and satisfaction and low rates of subsequent ipsilateral ACL injuries in competitive high school–aged athletes. Patients with higher confidence in performance of the reconstructed knee are more likely to return to at least their prior level of sport.
From Tutoring to Mentoring: Centering Adolescents’ Identities as Readers and Mentors in a High School Literacy Class
Authors: Frankel Katherine K. , Fields Susan S. , Ward Alessandra E.
Published: June 2021

Prior research on peer literacy teaching tends to be conceptualized as peer tutoring and often focuses on the cognitive aspects of reading (e.g., skills, strategies). In this multiple case study, we draw on theories of identity and positioning to propose a conceptual shift from tutoring to mentoring to also describe the affective and relational dimensions of peer literacy teaching. In our analysis, we explore how two 11th graders positioned themselves as readers and mentors in a cross-age literacy mentorship class in a public high school in the northeastern United States. Data sources include mentor interviews, field notes, and artifacts. Our multiphase coding process identified three main themes: the importance of (a) texts and (b) relationships and reciprocity to mentors’ positioning, and (c) complexities of the mentor position. Findings suggest that school-based opportunities for youth to work collaboratively to understand their own and others’ reading processes may contribute insights into both the affective and the cognitive aspects of peer literacy teaching.
Multilab Direct Replication of Flavell, Beach, and Chinsky (1966): Spontaneous Verbal Rehearsal in a Memory Task as a Function of Age
Authors: Elliott Emily M. , Morey Candice C. , AuBuchon Angela M. , Cowan Nelson , Jarrold Chris , Adams Eryn J. , Attwood Meg , Bayram Büşra , Beeler-Duden Stefen , Blakstvedt Taran Y. , Büttner Gerhard , Castelain Thomas , Cave Shari , Crepaldi Davide , Fredriksen Eivor , Glass Bret A. , Graves Andrew J. , Guitard Dominic , Hoehl Stefanie , Hosch Alexis , Jeanneret Stéphanie , Joseph Tanya N. , Koch Chris , Lelonkiewicz Jaroslaw R. , Lupyan Gary , McDonald Amalia , Meissner Grace , Mendenhall Whitney , Moreau David , Ostermann Thomas , Özdoğru Asil Ali , Padovani Francesca , Poloczek Sebastian , Röer Jan Phillip , Schonberg Christina C. , Tamnes Christian K. , Tomasik Martin J. , Valentini Beatrice , Vergauwe Evie , Vlach Haley A. , Voracek Martin
Published: June 2021

Work by Flavell, Beach, and Chinsky indicated a change in the spontaneous production of overt verbalization behaviors when comparing young children (age 5) with older children (age 10). Despite the critical role that this evidence of a change in verbalization behaviors plays in modern theories of cognitive development and working memory, there has been only one other published near replication of this work. In this Registered Replication Report, we relied on researchers from 17 labs who contributed their results to a larger and more comprehensive sample of children. We assessed memory performance and the presence or absence of verbalization behaviors of young children at different ages and determined that the original pattern of findings was largely upheld: Older children were more likely to verbalize, and their memory spans improved. We confirmed that 5- and 6-year-old children who verbalized recalled more than children who did not verbalize. However, unlike Flavell et al., substantial proportions of our 5- and 6-year-old samples overtly verbalized at least sometimes during the picture memory task. In addition, continuous increase in overt verbalization from 7 to 10 years old was not consistently evident in our samples. These robust findings should be weighed when considering theories of cognitive development, particularly theories concerning when verbal rehearsal emerges and relations between speech and memory.
Esophageal Physiologic Testing of Obese Subjects as a Part of Bariatric Surgery Planning
Authors: Rogers Benjamin D. , Bennett Michael , Hobbs Paul , Eckhouse Shaina R. , Eagon J. Chris , Gyawali C. Prakash
Published: June 2021

Background:

Choice of bariatric procedure may be impacted by esophageal motor disorders and reflux disease, which are not routinely evaluated in obese subjects.

Methods:

Clinical characteristics on validated questionnaires and esophageal physiologic test findings were collected in 110 consecutive obese subjects (median age 48.5 years, 82% F, median BMI 46.9 kg/m2) evaluated for bariatric surgery. High resolution manometry (HRM) metrics included intragastric pressure (IGP), basal lower esophageal sphincter pressures (LESP), end-expiratory LESP, EGJ contractile integral (EGJ-CI), integrated relaxation pressure (IRP), distal contractile integral (DCI), and Chicago classification (CC) v4.0 diagnoses; acid exposure time (AET, normal if <4%) was obtained from ambulatory reflux monitoring. Comparative analyses determined differences between obese subjects and 15 institutional normal controls (median age 24.7 years, 53% F, median BMI 24.7 kg/m2) and if symptoms predicted abnormal tests.

Results:

Basal LESP and EGJ-CI were higher in obese subjects ( P = .03) compared to controls, while end-expiratory LESP was similar ( P = .97). IGP was also higher in obese subjects ( P < .0001), which modestly correlated with BMI. The most common CC 4.0 diagnosis was ineffective esophageal motility (IEM, 11.8%). EGJ outflow obstruction was seen in 9.1% and achalasia in 0.9%. Hiatus hernia (type 2 or 3 EGJ morphology) was found in 28%. Of 34 patients completing ambulatory reflux monitoring, 15 (44%) had elevated AET, without symptom or motor predictors.

Conclusions:

Achalasia, esophageal outflow obstruction, and reflux were encountered in higher than expected proportions without specific symptoms in pre-bariatric surgery patients. Thus, esophageal physiologic testing may be of value prior to bariatric surgery.
Inflammatory epithelial cytokines afterin vitrorespiratory syncytial viral infection are associated with reduced lung function
Authors: Duan Wenming , Cen Yuchen , Lin Cindy , Ouyang Hong , Du Kai , Kumar Anushree , Wang Borui , Avolio Julie , Grasemann Hartmut , Moraes Theo J.
Published: June 2021

Respiratory syncytial virus (RSV) infections in early life predispose children with cystic fibrosis (CF) to more severe lung function decline in later life. The mechanisms explaining the associations between RSV and progression of CF lung disease are not clear.

In this study, a human bronchial epithelial cell line and primary human nasal epithelial cells (PNECs) from individuals with CF and healthy control donors were infected with RSV. Real-time PCR, plaque assay, cytokine detection, immunofluorescence and Western blot analyses were performed.

RSV is replicated to a higher degree in CF epithelial cells as compared to control cells; however, no defects in innate immune pathways were identified in CF cells. Rather, primary p.Phe508del cystic fibrosis transmembrane conductance regulator PNECs produced more cytokines after RSV infection than control cells. Moreover, interleukin-8 and tumour necrosis factor-α production post RSV negatively correlated with lung function (% predicted forced expiratory volume in 1 s) in the individuals who donated the cells.

These data suggest that CF epithelium has a dysfunctional response to RSV allowing for enhanced viral replication and an exaggerated inflammatory response that ultimately may predispose to greater airway inflammation and reduced lung function.
Platelet-rich plasma inhibits Adriamycin-induced inflammation via blocking the NF-κB pathway in articular chondrocytes
Authors: Zhao Haijun , Zhu Weijie , Mao Wude , Shen Chengkai
Published: June 2021

Background

Previous studies showed that doxorubicin could lead to osteoarthritis (OA) by inducing chondrocyte inflammation and apoptosis. Besides, it is reported that platelet-rich plasma (PRP) could suppress the activation of inflammatory NF-κB signaling. Here, we aimed to determine whether PRP was able to exert a protective effect against doxorubicin-induced chondrocyte damages.

Methods

To determine whether PRP protects chondrocytes against destabilization of the medial meniscus (DMM)-induced osteoarthritis, mice were treated with PRP and doxorubicin, and the cartilage destruction was observed through Safranin O-fast green staining and osteoarthritis scoring. ELISA assay was used to check the release of TNF-α and ILs. In vitro, we treated chondrocytes with doxorubicin and PRP; CCK-8 was used to measure cell viability. Western blot, real-time PCR, and ELISA were applied to check apoptosis-related signaling and inflammation-associated factors.

Results

The results from the mouse model suggested that PRP attenuated doxorubicin-induced cartilage destruction in vivo. Doxorubicin promoted chondrocyte apoptosis while PRP ameliorated this damage. PRP inhibited doxorubicin-induced dysregulation of cell matrix-related factors, including SOX9, Col2A1, Col10A1, and Aggrecan, reduced protein levels of doxorubicin-induced inflammatory markers, COX-2, and iNOS, and blocked doxorubicin-induced phosphorylation of IκB and NF-κB in articular chondrocytes.

Conclusions

PRP improved doxorubicin-induced damage on chondrocytes. This research might provide a new theoretical basis for the clinical treatment of osteoarthritis caused by doxorubicin.
Genome-Wide Association Study of the Genetic Basis of Effective Tiller Number in Rice
Authors: Ren Mengmeng , Huang Minghan , Qiu Haiyang , Chun Yan , Li Lu , Kumar Ashmit , Fang Jingjing , Zhao Jinfeng , He Hang , Li Xueyong
Published: June 2021

Background

Effective tiller number (ETN) has a pivotal role in determination of rice (Oryza sativa L.) grain yield. ETN is a complex quantitative trait regulated by both genetic and environmental factors. Despite multiple tillering-related genes have been cloned previously, few of them have been utilized in practical breeding programs.

Results

In this study, we conducted a genome-wide association study (GWAS) for ETN using a panel of 490 rice accessions derived from the 3 K rice genomes project. Thirty eight ETN-associated QTLs were identified, interestingly, four of which colocalized with the OsAAP1, DWL2, NAL1, and OsWRKY74 gene previously reported to be involved in rice tillering regulation. Haplotype (Hap) analysis revealed that Hap5 of OsAAP1, Hap3 and 6 of DWL2, Hap2 of NAL1, and Hap3 and 4 of OsWRKY74 are favorable alleles for ETN. Pyramiding favorable alleles of all these four genes had more enhancement in ETN than accessions harboring the favorable allele of only one gene. Moreover, we identified 25 novel candidate genes which might also affect ETN, and the positive association between expression levels of the OsPILS6b gene and ETN was validated by RT-qPCR. Furthermore, transcriptome analysis on data released on public database revealed that most ETN-associated genes showed a relatively high expression from 21 days after transplanting (DAT) to 49 DAT and decreased since then. This unique expression pattern of ETN-associated genes may contribute to the transition from vegetative to reproductive growth of tillers.

Conclusions

Our results revealed that GWAS is a feasible way to mine ETN-associated genes. The candidate genes and favorable alleles identified in this study have the potential application value in rice molecular breeding for high ETN and grain yield.
Upregulation of PD-1 expression on circulating CD8+ but not CD4+ T cells is associated with tuberculosis infection in health care workers
Authors: Shi Cui-lin , Zhang Jian-ping , Xu Ping , Li Jin , Shen Jie , Wu Mei-ying , Ye Zhi-jian , Yu Xin , Song Hua-feng , Chen Hui , Xu Jun-chi , Pang Yu , Huang Jian-an
Published: June 2021

Background

Health care workers (HCWs) are at risk for occupationally acquired Mycobacterium tuberculosis infection and tuberculosis (TB) disease due to repeated exposure to workplace tubercle bacilli. To determine whether continual mycobacterial stimulation correlates with increased expression of inhibitory T cell receptors, here we compared PD-1 receptor expression on surfaces of circulating T cells between naïve (uninfected) HCWs and HCWs with latent TB infection (LTBI).

Result

Data collected from 133 medical workers who met study selection criteria were included in the final analysis. QuantiFERON-TB Gold In-​Tube (QFT-GIT) testing yielded positive results for 32 HCWs, for an overall LTBI rate of 24.1%. Multivariate analysis identified HCW length of service > 15 years as an independent risk factor for a positive QFT-GIT result. In addition, comparisons of blood T cell subgroup profiles between QFT- and QFT+ groups indicated QFT+ subjects possessed greater proportions of mature (TM), transitional memory (TTM) and effector memory (TEM) CD4+ T cell subgroups and lower proportions of naïve T cells (TN). Moreover, the QFT+ group percentage of CD8+ T cells with detectable surface PD-1 was significantly higher than the corresponding percentage for the QFT- group. Meanwhile, no statistical intergroup difference was observed in percentages of CD4+ T cells with detectible surface PD-1.

Conclusions

Our data demonstrated that upregulated PD-1 expression on circulating CD8+, but not CD4+ T cells, was associated with latent TB infection of HCWs. As compared to other hospitals, occupational TB infection risk in our hospital was substantially mitigated by implementation of multitiered infection control measures.
Regulation of virulence and β-lactamase gene expression in Staphylococcus aureus isolates: cooperation of two-component systems in bloodstream superbugs
Authors: Dehbashi Sanaz , Tahmasebi Hamed , Zeyni Behrouz , Arabestani Mohammad Reza
Published: June 2021

Background

Methicillin-resistant Staphylococcus aureus (MRSA)-bloodstream infections (BSI) are predominantly seen in the hospital or healthcare-associated host. Nevertheless, the interactions of virulence factor (VFs) regulators and β-lactam resistance in MRSA-BSI are unclear. This study aims to characterize the molecular relationship of two-component systems of VFs and the expression of the β-lactamase gene in MRSA-BSI isolates. In this study, 639 samples were collected from BSI and identified by phenotypic methods. We performed extensive molecular characterization, including SCCmec type, agr type, VFs gene profiles determinations, and MLST on isolates. Also, a quantitative real-time PCR (q-RT PCR) assay was developed for identifying the gene expressions.

Results

Ninety-one (91) S. aureus and 61 MRSA (67.0%) strains were detected in BSI samples. The presence of VFs and SCCmec genes in MRSA isolates were as follows: tst (31.4%), etA (18.0%), etB (8.19%), lukS-PVL (31.4%), lukF-PV (18.0%), lukE-lukD (16.3%), edin (3.2%), hla (16.3%), hlb (18.0%), hld (14.7%), hlg (22.9%), SCCmecI (16.3%), SCCmecII (22.9%), SCCmecIII (36.0%), SCCmecIV (21.3%), and SCCmecV (16.3%). Quantitative real-time PCR showed overexpression of mecRI and mecI in the toxigenic isolates. Moreover, RNAIII and sarA genes were the highest expressions of MRSA strains. The multi-locus sequence typing data confirmed a high prevalence of CC5, CC8, and CC30. However, ST30, ST22, and ST5 were the most prevalent in the resistant and toxigenic strains.

Conclusion

We demonstrated that although regulation of β-lactamase gene expressions is a significant contributor to resistance development, two-component systems also influence antibiotic resistance development in MRSA-BSI isolates. This indicates that resistant strains might have pathogenic potential. We also confirmed that some MLST types are more successful colonizers with a potential for MRSA-BSI.