bluuebunny/crossref_metadata_2025 huggingface dataset:
Engineered Cell Sheets for the Effective Delivery of Adipose-Derived Stem Cells for Tendon-to-Bone Healing
Authors: Shin Myung Jin , Shim In Kyong , Kim Dong Min , Choi Jae Hee , Lee Yu Na , Jeon In-Ho , Kim Hyojune , Park Dongjun , Kholinne Erica , Yang Ha-Sol , Koh Kyoung Hwan
Published: October 2020

Background:

Efforts are being made to treat rotator cuff tears (RCTs) that exhibit poor healing and high retear rates. Tendon-to-bone healing using mesenchymal stem cells is being explored, but research is needed to establish effective delivery options.

Purpose:

To evaluate the effects of an adipose-derived stem cell (ADSC) sheet on mesenchymal stem cell delivery for tendon-to-bone healing of a chronic RCT in rats and to demonstrate that ADSC sheets enhance tendon-to-bone healing.

Study Design:

Controlled laboratory study.

Methods:

Mesenchymal stem cells were obtained from rat adipose tissue, and a cell sheet was prepared using a temperature-responsive dish. To evaluate the efficacy of stem cells produced in a sheet for the lesion, the experiment was conducted with 3 groups: repair group, cell sheet transplantation after repair group, and cell sheet–only group. Histological, biomechanical, and micro–computed tomography (micro-CT) results were compared among the groups.

Results:

Hematoxylin and eosin staining for histomorphological analysis revealed that the cell sheet transplantation after repair group (5.75 ± 0.95) showed statistically significant higher scores than the repair (2.75 ± 0.50) and cell sheet–only (3.25 ± 0.50) groups ( P < .001). On safranin O staining, the cell sheet transplantation after repair group (0.51 ± 0.04 mm2) had a larger fibrocartilage area than the repair (0.31 ± 0.06 mm2) and cell sheet–only (0.32 ± 0.03 mm2) groups ( P = .001). On micro-CT, bone volume/total volume values were significantly higher in the cell sheet transplantation after repair group (23.98% ± 1.75%) than in the other groups ( P < .039); there was no significant difference in the other values. On the biomechanical test, the cell sheet transplantation after repair group (4 weeks after repair) showed significantly higher results than the other groups ( P < .005).

Conclusion:

Our study shows that engineered stem cells are a clinically feasible stem cell delivery tool for rotator cuff repair.

Clinical Relevance:

This laboratory study provides evidence that ADSCs are effective in repairing RCTs, which are common sports injuries.
Anticoagulation with temporary Impella device in patients with heparin-induced thrombocytopenia: A case series
Authors: Hohlfelder Benjamin , Militello Michael A , Tong Michael Z , Soltesz Edward G , Wanek Matthew R
Published: October 2020

The Impella device is a percutaneous ventricular assist devices that requires administration of heparin via a continuous purge solution. Patients on Impella device support may experience hemolysis with accompanying thrombocytopenia generating suspicion for heparin-induced thrombocytopenia (HIT). However, data and recommendations for use of non-heparin anticoagulants with Impella device are lacking. Therefore, we performed a retrospective cohort analysis of patients requiring bivalirudin during Impella device support to describe the safety and efficacy of bivalirudin as an alternative anticoagulant during Impella device support. Nine patients were included in the evaluation which analyzed Impella device purge flow and purge pressure along with bivalirudin dosing requirements, incidence of thrombosis, and incidence of pump failure. All patients had a positive platelet factor-4 IgG ELISA test, and the serotonin release assay was positive in four patients. After initiation of bivalirudin, the median (15th, 85th percentile) nadir purge flow decreased by 76% (5%, 88%) and the median (15th, 85th percentile) peak purge pressure increased by 86% (21%, 143%). At the time of bivalirudin discontinuation, the median final purge flow and pressure were 2.4 mL/h (74% decrease) and 969 mmHg (89% increase), respectively. Zero patients experienced catastrophic pump failure. Adding low concentration bivalirudin to the purge solution along with systemic bivalirudin may be a reasonable approach.
Exercise and Cognitive Training Intervention Improves Self-Care, Quality of Life and Functional Capacity in Persons With Heart Failure
Authors: Gary Rebecca A. , Paul Sudeshna , Corwin Elizabeth , Butts Brittany , Miller Andrew H. , Hepburn Kenneth , Waldrop Drenna
Published: October 2020

This study evaluated a 12-week, home-based combined aerobic exercise (walking) and computerized cognitive training (EX/CCT) program on heart failure (HF) self-care behaviors (Self-care of HF Index [SCHFI]), disease specific quality of life (Kansas City Cardiomyopathy Questionnaire [KCCQ]), and functional capacity (6-minute walk distance) compared to exercise only (EX) or a usual care attention control (AC) stretching and flexibility program. Participants ( N = 69) were older, predominately female (54%) and African American (55%). There was significant improvement in self-care management, F(2, 13) = 5.7, p < .016; KCCQ physical limitation subscale, F(2, 52) = 3.4, p < .039; and functional capacity (336 ± 18 vs 388 ± 20 m, p < .05) among the EX/CCT participants. The underlying mechanisms that EX and CCT targets and the optimal dose that leads to improved outcomes are needed to design effective interventions for this rapidly growing population.
Lessons learned for COVID-19 in the cruise ship industry
Authors: Brewster Rebecca K , Sundermann Alexander , Boles Corey
Published: October 2020

The coronavirus disease 2019 (COVID-19) pandemic has created widespread disruption in individuals’ personal and occupational lives all around the world. Vacationers and tourism, recreation, and leisure employees were among those who experienced substantial disruption. Cruise ships, especially, faced turmoil on a global scale for both their customers and workers. COVID-19 outbreaks were reported on cruise ships beginning in February 2020, presenting new and unique challenges for the industry. Conditions on cruise ships, including close and frequent contact between passengers and crew members, use of common areas, the confined nature of the vessels, and gathering of passengers from different countries, aided in transmitting the disease both onboard and in the community. As the pandemic evolved, federal and state governments and industries worldwide, including cruise ship companies, developed response plans. In this article, we provide a high-level overview of the US government and cruise ship industry’s response to the COVID-19 pandemic, as well as a brief commentary on lessons learned, and recommendations for the cruise ship sector going forward. The outlined suggestions may be used as a starting point to increase emergency preparedness and to inform outbreak response plans in the event of future infectious disease outbreaks.
Weapon Carrying and Weapon Brandishing at School: Responses to Strain Among Same-Sex Attracted Youth
Authors: Teasdale Brent , Bradley Mindy S.
Published: October 2020

Studies consistently find lesbian, gay, bisexual, and questioning youth are more likely than other youth to experience discrimination, fear for their safety, and be victimized at school. We argue that same-sex attracted youth may be more likely to both carry weapons and to brandish those weapons as coping mechanisms in response to the strain of real or perceived mistreatment school. Using data from the National Longitudinal Study of Adolescent to Adult Health (Wave 1, 1994–1995), we examine the relationships between same-sex attraction, fear, victimization, weapon carrying, and weapon brandishing at school. We find that same-sex attracted youth are significantly more likely than other youth to carry a weapon to school, and to brandish the weapon in front of peers. Consistent with general strain explanations, victimization, discrimination, and fear mediate the association between sexual minority status and both outcomes. We discuss the implications of these patterns for primary prevention interventions.
Character Strengths Involving an Orientation to Promote Good Can Help Your Health and Well-Being. Evidence From two Longitudinal Studies
Authors: Weziak-Bialowolska Dorota , Bialowolski Piotr , VanderWeele Tyler J. , McNeely Eileen
Published: October 2020

Purpose:

We examined the impact of an orientation to promote good—one aspect of strengths of character, understood as having consistent thoughts and taking actions that contribute to the good of oneself and others—on flourishing outcomes.

Design:

We used data from 2 longitudinal observational studies. The primary study used 2 waves of data collected in June 2018 and July 2019. The secondary study used 3 waves of data collected in February 2017, March 2018, and March 2019.

Setting:

Two culturally different populations of adults were examined: (1) a large service organization based in the United States and (2) a Mexican apparel company in the supply chain of a major global brand.

Subjects:

1,209 U.S. employees and 495 Mexican apparel workers were included in the study.

Measures:

Self-reports of orientation to promote good, Well-Being Assessment, Flourishing Index, the CDC Health-Related Quality of Life and the Job-Related Affective Well-Being Scale were used.

Analysis:

An outcome-wide approach and lagged regression analyses were applied. To combine the estimates across samples meta-analytic estimates were computed. Bonferroni correction was used to correct for multiple testing. Robustness of the results to potential unmeasured confounding was examined using E-values.

Results:

Orientation to promote good was positively associated with subsequently higher levels of life satisfaction and happiness (β = 0.14, 95% CI: 0.09, 0.19), self-assessed mental health (β = 0.11, 95% CI: 0.06, 0.15) and physical health (β = 0.08, 95% CI: 0.04, 0.12), social connectedness (β = 0.102, 95% CI: 0.06, 0.15) and purpose in life (β = 0.07, 95% CI: 0.03, 0.11). It was also associated with decreased anxiety (β = -0.11, 95% CI: -0.17, -0.06), depression (β = -0.07, 95% CI: -0.1, -0.02) and loneliness (β = -0.09, 95% CI: -0.13, -0.04). Possible effects on both positive affect (feeling happy) and negative affect (feeling sad, stressed and lonely) in general and while-at-work were also identified.

Conclusions:

Policymakers and practitioners should consider orientation to promote good as an important factor for improving population health and human flourishing while also at work.
Use of Cystatin C to Assess Immunotherapy Toxicity in a Patient With Melanoma
Authors: Barth Dylan M. , Otto Danielle , Wang Peng , Alkhasova Maria S. , Barreto Erin F.
Published: October 2020

The advent of immunotherapy has improved outcomes of patients in a number of cancers.1 While immunotherapy helps the immune system recognize malignant cells, it also can lead to adverse effects that mimic autoimmune diseases including, but not limited to, rash, colitis, pneumonitis, and nephritis. Diagnosis of immunotherapy related nephritis is based on serum creatinine trends, which can be falsely elevated in the setting of high muscle mass. Cystatin C is an adjunctive kidney biomarker that can estimate glomerular filtration rate independent of muscle mass. We present a case where the use of cystatin C avoided unnecessary therapy interruption in a young, athletic man being treated with nivolumab for melanoma. Further research is needed to define the role cystatin C in monitoring kidney function during immunotherapy.
Continuous Infusion Low-Dose Unfractionated Heparin for the Management of Hypercoagulability Associated With COVID-19
Authors: Li Matthew , Gitarts Steven , Nyabera Akwe , Kondaveeti Ravali , Hammudeh Yousef , Gonzalez Carlos , Trandafirescu Theo , Penumadu Arunakumari , Lopez Ricardo , Sahibzada Asad , La Cruz Angel De , Rahman Habibur
Published: October 2020

Introduction:

The Coronavirus Disease 2019 (COVID-19) is associated with severe hypercoagulability. There is currently limited evidence supporting the routine use of therapeutic anticoagulation in the setting of COVID-19.

Objectives:

The primary objective was to compare the incidence of thromboembolic events in adult patients with COVID-19 treated with an unfractionated heparin (UFH) infusion versus prophylactic dose anticoagulation. Secondary objectives included exploration of the efficacy and safety of an UFH infusion through the evaluation of organ function and incidence of minor and major bleeding.

Methods:

Retrospective observational cohort study with propensity score matching of COVID-19 patients who received an UFH infusion targeting an aPTT between 40 and 60 seconds.

Results:

Fifty-six patients were included in this study. There was no difference in the composite of thromboembolic events comprised of venous thromboembolism, arterial thrombosis, and catheter-related thrombosis between the UFH and control group (17.9% vs. 3.6%, P = 0.19). There was a significant increase in median D-dimer concentrations from day 1 to day 7 in the control group (475 ng/mL [291-999] vs. 10820 ng/mL [606-21033], P = 0.04). Patients treated with UFH had a higher incidence of minor bleeding (35.7% vs. 0%, P < 0.005) and required more units of packed red blood cell transfusion (0.8 units ± 1.6 vs. 0 units, P = 0.01).

Conclusion:

Continuous infusion of UFH for patients with COVID-19 infection did not decrease the overall incidence of thromboembolic complications. UFH was associated with stabilization of D-dimer concentrations and increased rates of minor bleeding and transfusions.
Engaging with local communities: Five key lessons that businesses can learn from universities
Authors: Misra Debananda , Pinheiro Rómulo
Published: October 2020

As businesses are coming to terms with the challenges derived from the Covid-19 crisis, they are realizing the need to do more for and with their local communities than being co-located or having business relationships. Business leaders are learning that engaging with local communities can be helpful in steering their business through crises and helping to prepare for the future. The central idea of this article is that businesses can learn from universities about engaging with local communities. It outlines five key lessons, illustrating them with examples and relating them to key concepts and perspectives from the literature. The emphasis in these lessons is on their potential to make businesses self-reliant, socially responsible and resilient. As businesses look for lessons, frameworks and best practices for engaging with their communities during and after a significant crisis, these five lessons from universities can point them toward new directions that would be hard to find within the business community. The lessons can be used by business leaders to design initiatives and implement policies and practices for engaging with their local communities in ways that are mutually beneficial and promote long-term sustainability.
A novel approach to calculating the dynamic error reflected on an S-shaped test piece
Authors: He Weiwei , Wang Liping , Guan Liwen
Published: October 2020

This paper proposes a novel approach to calculating the dynamic error distribution reflected on an S-shaped test piece. First, a numerical model of an S-shaped test piece is established, and the distribution characteristics for the twist angle and curvature are analysed. Second, a delay continuous method (DCM), which can transform the discrete input into a delayed step input, is presented to express the single-axis dynamic error affected by the input quantitatively in the form of a mathematical expression. Based on the sinusoidal input, the feasibility of the DCM is verified by comparing the experimental results of a Simulink simulation model and a mathematical expression derived by the DCM. Third, according to a new three-point tangential (NTPT) positioning algorithm and the DCM, this article makes the first attempt to investigate the quantitative calculation method of the influence of the dynamic performance of a servo feed system for five-axis numerical control (NC) machine tools on the dynamic error distribution for S-shaped test pieces after processing. Parameter p, representing the dynamic characteristic of the servo feed system, is varied to compare the difference of the dynamic error distribution law on S-shaped test pieces. The calculation results show that the parameter p can be adjusted to reduce the dynamic error of the final machined test pieces. It is important to improve the dynamic performance of servo feed systems for five-axis NC machine tools and enhance the machining quality of test pieces. In addition, compared with the calculation results of the dynamic error distribution for an NAS979 test piece, the S-shaped test piece can reflect the dynamic performance of the servo feed system for five-axis NC machine tools more accurately and effectively. Finally, the effectiveness of the proposed calculation method is verified through processing experiments on a five-axis NC machine tool.
Parametric investigation into fatigue life behaviour of spot welded tensile shear test samples
Authors: Akbulut Mustafa
Published: October 2020

Resistance spot welding is a widely used joining process in the structural components of various engineering products such as white goods, aerospace equipment and especially automobiles. Hence it is crucial that the mechanical performance of such joints be well understood in order to design and manufacture reliable engineering products. In service, Spot-welded joints undergo fatigue failure under cyclic loadings. In order to examine and improve the fatigue life of spot welded structures, various assessment methods have been used on standardized test samples such as tensile shear (TS), modified tensile shear (MTS), coach peel (CP) and modified coach peel (MCP) specimens. The fatigue life studies have shown that among the most important design variables for spot-welded structures influencing joint strengths, sheet thickness, spot weld nugget diameter, number of spot welds and the joint type can be counted. In this study, a numerical examination was carried out to observe the effects of sheet thickness and nugget diameter on the fatigue life of tensile shear (TS) samples. In the analysis both Morrows mean stress and Coffin Manson approach were utilized. The performance of both methods was verified on the basis of experimental data available in literature. The elastic and plastic strains necessary for the calculations were found out by means of finite element method. The results presented herein provide variation of fatigue life predictions according to selected geometry parameters along with valuable interpretations that can be used as guidelines for designers.
Comparison of partial least squares-discriminant analysis, support vector machines and deep neural networks for spectrometric classification of seed vigour in a broad range of tree species
Authors: Liu Wenjian , Liu Jun , Jiang Jingmin , Li Yanjie
Published: October 2020

Seed vigour significantly influences the seed production and plant regeneration performance. The capability of NIR spectroscopy to identify seed vigour across multiple tree species rapidly and cost-effectively has been examined. The NIR spectra of seeds from five different tree species have been taken. Standard germination testing has also been used to verify seed vigour. Three classification models were trained, i.e., partial least squares-discriminant analysis (PLSDA), support vector machine (SVM) and multilayer deep neural network (DNN). Three types of spectral pre-processing methods and their combination were used to fit for the best classification model. The DNN model has shown good performance on all pre-processing methods and yielded higher accuracy than other models in this study, with accuracy, sensitivity, precision and specificity all equal to 1. Compared with other pre-processing methods, the second derivative spectra have shown a robust and consistent classification result in both PLSDA and DNN models. Five important regions including 1270, 1650, 1720, 2100, 2300 nm were found highly related to the seed vigour. This study has found a rapid and efficient methodology for seed vigour classification, which could serve for industrial use in a rapid and non-destructive way.
Transition to comfort-focused care: Moral agency of acute care nurses
Authors: Meeker Mary Ann , White Dianne
Published: October 2020

Background:

Moving into the last phase of life comprises a developmental transition with specific needs and risks. Facilitating transitions is an important component of the work of nurses. When curative interventions are no longer helpful, nurses enact key roles in caring for patients and families.

Aim:

The aim of this study was to examine the experiences of registered nurses in acute care settings as they worked with patients and families to facilitate transition to comfort-focused care.

Research design:

Sampling, data collection, and data analysis were guided by constructivist grounded theory, chosen because of its strength in identifying and explicating social processes.

Participants and context:

A purposeful sample of 26 registered nurses working in acute care hospitals in one community in the northeastern United States participated in this study through semi-structured interviews.

Ethical considerations:

The study received approval from the university’s Institutional Review Board for the Protection of Human Subjects. Participants provided informed consent.

Findings:

Nurses facilitated transition to comfort-focused care by enacting their moral commitments to patients and families. They focused on building relationships, honoring patient self-determination, and maintaining respect for personhood. In this context, they discerned a need for transition, opened a discussion, and used diverse strategies to facilitate achieving consensus on the part of patients, family members, and care providers. Regardless of how the process unfolded, nurses offered support throughout.

Discussion:

Achievement of consensus by all stakeholders is critical in the transition to comfort-focused care. This study deepens our understanding of how nurses as moral agents utilize specific strategies to assist progress toward consensus. It also offers an example of recognizing the moral agency of nurses through listening to their voices.

Conclusion:

Increased understanding of effective nursing strategies for facilitating transition to comfort-focused care is essential for developing needed evidence for excellent care and strengthening end-of-life nursing education.
ICU Pharma Pakistan: Growth Crossroads
Authors: Bajwa Sami Ullah , Shaikh Adeel S. , Azeem Muhammad Umer , Shahzad Khuram , Kitchlew Naveda
Published: October 2020

Growth from a small-scale venture to a medium-sized company entails different challenges and strategies to tackle them. This case provides an account of one such company operating in the pharmaceutical sector of Pakistan. International Collaborated Unit Pharma (ICU Pharma) started in 2005 in the small town of Dera Ghazi Khan, in the province of Punjab, as a distributor of Ferozsons (Private) Ltd, a leading pharmaceutical manufacturer in Pakistan. Going through various phases of growth and strategic shifts, it had become a well-established company by 2019, with PKR 200 million net worth and a sales network covering thirty-four districts in Punjab, Khyber Pakhtunkhwa and Sindh provinces. In 2018, the company faced a growth dilemma when, despite the growing demand for its products, it had to curtail sales growth and divert resources towards building a manufacturing facility in Lahore. This case illustrates how industry growth, country-level initiatives for the implementation of Sustainable Development Goals on Health (SDG No. 3), policies of the Drug Regulation Authority of Pakistan (DRAP), weak contract enforcement in Pakistan and threats from suppliers, along with other external forces, constrained a company’s decision to opt for a backward integration strategy instead of going for the more plausible strategy of product and market development.
Equine dental and skeletal fluorosis induced by well water consumption
Authors: Kelly Larry H. , Uzal Francisco A. , Poppenga Robert H. , Kinde Hailu , Hill Ashley E. , Wilson W. David , Webb Brett T.
Published: October 2020

Two horses that consumed well water with high fluoride content exhibited clinical signs of chronic dental and skeletal fluoride toxicosis and were later euthanized and autopsied. Both horses had degenerative disease of multiple joints and multiple dental defects. Elevated fluoride concentrations were found in bone and tooth samples of both horses, well water, and feed. Microscopically, abnormalities were noted in bone and tooth samples, and consisted mostly of foci of cement necrosis and hypercementosis. Horses exhibiting bilateral, highly symmetrical dental and/or skeletal lesions, with chronic lameness, should be evaluated for the possible presence of fluoride toxicosis.
Fibrous osteodystrophy in a dromedary camel
Authors: Hines Elizabeth S. , Stevenson Valentina B. , Patton Molly E. , Leventhal Hannah R. , Diaz-Portalatin Noah , Meyerhoeffer Mitchell A. , Dahlgren Linda A. , Sponenberg D. Phillip
Published: October 2020

A 6-y-old female dromedary camel ( Camelus dromedarius L.) was presented for assessment of firm, bilateral swellings rostral and ventral to the eyes. Serum biochemistry revealed hyperglycemia (28.5 mmol/L), hypocalcemia (1.27 mmol/L), hyperphosphatemia (3.39 mmol/L), hypoproteinemia (total protein 50 g/L), and hypoalbuminemia (20 g/L). Based on the poor prognosis associated with the presumptive diagnosis of fibrous osteodystrophy, the camel was euthanized. Gross postmortem findings revealed expanded fibrous tissue replacing the maxilla and mandible, and bilaterally prominent parathyroid glands. Histology of the maxilla revealed proliferative loose fibrous tissue with widely scattered, regularly spaced, small spicules of mineralized bone. The parathyroid glands were prominent bilaterally; the internal and external parathyroid glands were composed of plump cells with abundant pale basophilic cytoplasm and open nuclei. The pathologic findings were consistent with the antemortem diagnosis of fibrous osteodystrophy. The camel’s diet, which was not specifically balanced for a camel, included grass hay, sweet feed, and alfalfa pellets. The camel’s caregivers reported feeding her treats of cookies. A feed analysis was not available. The biochemistry abnormalities and clinical and postmortem findings, along with a diet that was not balanced for a camel, are consistent with a diagnosis of nutritional secondary hyperparathyroidism.
A Randomized Controlled Trial of Cognitive Behavioral Group Prevention Program for Mainland Chinese University Students in Hong Kong
Authors: Pan Jia-Yan , Ye Shengquan , Ng Petrus Yat-Nam , Lu Lucy
Published: October 2020

Purpose:

This study developed a culturally appropriate cognitive behavioral group prevention program for Mainland Chinese university students in Hong Kong and tested its effectiveness.

Method:

A total of 74 Chinese students were recruited and randomly assigned to an 8-week cognitive behavior prevention program (experimental group) or a waiting list control (WLC) group.

Results:

Compared with the WLC group, participants in the experimental group significantly reduced psychological distress, acculturative stress, negative emotions, and negative thoughts and increased positive emotions, positive thoughts, and postmigration growth, with medium to large effect sizes. Upon immediate completion of the program, about 46% and 30% of the participants in the experimental group and WLC group, respectively, were classified as non-at-risk cases for developing mental health problems.

Discussion:

The positive intervention effects and clinical implication of cultural adaptation of cognitive behavioral group therapy to Chinese students are discussed.
Entrepreneurship Education as a First-Person Transformation
Authors: Dimov Dimo , Pistrui Joseph
Published: October 2020

As entrepreneurship education spreads and aims to transform mindsets, its theories and methods need to be attuned to the first-person perspective of the learner. We provide a map for entrepreneurship education that bridges the subjective, inter-subjective, and objective as distinct varieties of knowledge and turns the classroom into a space for practical reasoning. It focuses on the world as it could be, brought alive in the first-person sense of possibility and shaped by new ways of seeing and doing.
Designing Automated Vehicle Interiors for Different Cultures: Evidence From China, Germany, and the United States
Authors: Sauer Vanessa , Mertens Alexander , Groß Stefan , Heitland Jens , Nitsch Verena
Published: October 2020

The advent of automated driving is a global trend. It is likely that views on what will make an automated vehicle trustworthy, comfortable, usable, and enhance passengers’ well-being while driving will differ between markets. Therefore, we conducted an expert survey ( n = 28) to identify cultural-specific design requirements of Level 4 automated vehicles for China, Germany, and the United States. Our results indicate a tendency toward hedonic vehicle design in China and pragmatic design in Germany. United States lies between these two markets. The results imply that car manufacturers can influence passengers’ well-being through vehicle design and, in turn, increase acceptance of automated vehicles.
Risk Factors for Anterior Tibial Tendon Pathology
Authors: Levitsky Matthew M. , Freibott Christina E. , Greisberg Justin K. , Vosseller J. Turner
Published: October 2020

Background:

Though the tibialis anterior (TA) serves a vital role in ankle dorsiflexion, there is little information regarding risk factors and demographic information that might predispose one to tendinopathy or rupture. This study investigates the features of patients in a single institution who presented with either TA tendinopathy or rupture. The circumstances surrounding rupture were also noted.

Methods:

ICD-9/10 codes were used to find patients who presented with TA pathology to 2 foot and ankle surgeons at 1 academic medical center from 2011 to 2018. Patient characteristics were noted, including age, sex, body mass index, and the presence of a gastrocnemius equinus contracture. Characteristics of patients with traumatic and atraumatic ruptures were compared.

Results:

Ninety-four patients presented between 2011 and 2018 (79 cases of tendinopathy and 15 ruptures). The average patient age was 56 years, and the ratio of women to men was 74:20 (3.7:1). With regard to those who experienced rupture, there were 2 ruptures directly related to athletic activity (traumatic), whereas 13 ruptures were found on examination with no overt history of injury (atraumatic). The average age for patients with traumatic ruptures was 39 years compared with 73 years for those with atraumatic rupture ( P < .05).

Conclusion:

This study investigates the features of patients in a single institution who presented with TA pathology. With regard to tendon ruptures, traumatic ruptures tend to occur in younger patients, whereas older patients are more likely to suffer atraumatic ruptures. Nonoperative treatment often appears to be effective for TA pathology.

Level of Evidence:

Level III, retrospective comparative series.
Risk Factors for Early Pancreatic Allograft Thrombosis Following Simultaneous Pancreas-Kidney Transplantation: A Systematic Review
Authors: Blundell Jian , Shahrestani Sara , Lendzion Rebecca , Pleass Henry J. , Hawthorne Wayne J.
Published: October 2020

Simultaneous pancreas-kidney (SPK) transplantation remains the most effective treatment for providing consistent and long-term euglycemia in patients having type 1 diabetes with renal failure. Thrombosis of the pancreatic vasculature continues to contribute significantly to early graft failure and loss. We compared the rate of thrombosis to graft loss and systematically reviewed risk factors impacting early thrombosis of the pancreas allograft following SPK transplantation. We searched the MEDLINE, EMBASE, The Cochrane Library, and PREMEDLINE databases for studies reporting thrombosis following pancreas transplantation. Identified publications were screened for inclusion and synthesized into a data extraction sheet. Sixty-three studies satisfied eligibility criteria: 39 cohort studies, 22 conference abstracts, and 2 meta-analyses. Newcastle-Ottawa Scale appraisal of included studies demonstrated cohort studies of low bias risk; 1127 thrombi were identified in 15 936 deceased donor, whole pancreas transplants, conferring a 7.07% overall thrombosis rate. Thrombosis resulted in pancreatic allograft loss in 83.3% of reported cases. This review has established significant associations between donor and recipient characteristics, procurement and preservation methodology, transplantation technique, postoperative management, and increased risk of early thrombosis in the pancreas allograft. Further studies examining the type of organ preservation fluid, prophylactic heparin protocol, and exocrine drainage method and early thrombosis should also be performed.
Optimal Dosage and Administration Practices for Vitamin K Antagonist Reversal With 4-Factor Prothrombin Complex Concentrate
Authors: Rhoney Denise H. , Chester Katleen W. , Darsey Damon A.
Published: October 2020

Expert consensus and international guidelines recommend urgent co-administration of vitamin K and 4-factor prothrombin complex concentrates (4F-PCCs) to rapidly reverse VKA-related bleeding. This narrative review examined real-world evidence and strategies to optimize international normalized ratio (INR) reversal, hemostasis, and outcomes in patients receiving 4F-PCC in this setting. Key determinants for success include the appropriate use of alternative dosing and administration strategies, such as fixed dosing and increased infusion speed, adherence to institutional guidelines, and removing significant institutional barriers to reduce time to treatment. In the opinion of authors, minimizing the time to treatment with 4F-PCCs is of paramount importance when treating patients with VKA-related bleeding. Practices that safely and feasibly shorten the time to administration should be included in guidelines for institutions responsible for anticoagulant care, and adhered to in centers that perform invasive procedures on patients receiving VKA therapy. Further studies are required to optimize use of 4F-PCC, particularly in relation to the ideal dosing strategy and the role of INR.
Students’ Perspectives: How Will COVID-19 Shape the Social Determinants of Health and Our Future as Public Health Practitioners?
Authors: Asfaw Eliyas K. , Guo Emily S. , Jang Sarah S. , Komarivelli Swathi R. , Lewis Katherine A. , Sandler Claire B. , Mehdipanah Roshanak
Published: October 2020

We are the next generation of public health practitioners. As public health students, we acknowledge that the COVID-19 (coronavirus disease 2019) pandemic will continue to fundamentally alter the field that we are preparing to enter. We will be the first wave of public health professionals whose education is being shaped by this pandemic. For decades to come, we will be working to address the impacts of this pandemic. In this commentary, we are lending our voice to discuss and highlight the importance of considering the intersections of various determinants of health and COVID-19, including education, food insecurity, housing instability, and economic hardship. We provide a discussion on what is being done across the United States in attempts to reduce the growing health inequities. As the next generation of public health leaders, we believe that only by investing in these issues can we begin to address the social and economic impact of the COVID-19 pandemic.
Fake News, Information Herds, Cascades, and Economic Knowledge
Authors: Butkovich Lazarina , Butkovich Nina , Devdariani Saba , Plott Charles R. , Seo Han
Published: October 2020

This article focuses on principles of information aggregation in the presence of false, public reports (fake news). The analysis explores news has been having a public goods feature characterized by models of information and economic efficiency. The analysis is not tied to any particular theory about how or why unreliable news emerges. The reports could be purposeful deception, intentions to mislead or profit motivated responses to decision biases of readers. A well-known and widely studied “cascade” experiment is used to illustrate principles that provide links to standard economic models. News is modeled as an aggregation of a simple, fixed chain of decentralized observations and reports about an underlying, unknown state of nature. The personal value of an individual’s decision depends on both the decision and the underlying state of nature. The information about the state used in the decision can reflect private observations or the “news” about the decisions of others. The experiments demonstrate that aggregated information is dependent on accumulated trust in news sources and has value as a special form of public goods.
Improving Outcome Accountability of Block Grants: Lessons Learned From the Preventive Health and Health Services Block Grant Evaluation
Authors: Lamia Tamara L. , Lowry Garry F. , McLees Anita W. , Frazier Cassandra M. , Young Andrea C.
Published: October 2020

The flexibility federal block grants provide recipients poses challenges for evaluation. These challenges include aggregating data on wide-ranging activities grant recipients implement and the outcomes they achieve. In 2014, we began designing an evaluation to address the challenges of assessing outcomes and to improve outcome accountability for the Preventive Health and Health Services Block Grant. Through the use of evaluability assessment methodology, review of existing data and the literature, and key informant interviews, we developed a measurement framework to assess outcomes resulting from recipients’ ability to use grant funds to meet their locally prioritized needs. We argue our evaluation approach demonstrates that block grants, and other similarly flexible programs, can be evaluated through appropriately designed measures. Our efforts challenge the idea that flexibility presents an insurmountable barrier to evaluation and outcome accountability for federal block grants.
Conducting Evaluations Using Multiple Trials
Authors: Barnow Burt S. , Greenberg David H.
Published: October 2020

This paper reviews the use of multiple trials, defined as multiple sites or multiple arms in a single evaluation and replications, in evaluating social programs. After defining key terms, the paper discusses the rationales for conducting multiple trials, which include increasing sample size to increase statistical power; identifying the most effective program design; increasing external validity; and learning how various factors affect program impact. The paper discusses reasons why program design varies across sites, including adaptations to local environment and participant characteristics and a lack of fidelity to the program design. The paper discusses why programs vary across sites and when it is desirable to maintain consistency. Distinctions are drawn between evaluations of pilots and demonstrations versus ongoing programs, as well as programs where variation is permitted or encouraged versus when a fixed design is desired. The paper includes illustrations drawn from evaluations of demonstrations and ongoing programs.
Artificial neural network and multi-criterion decision making approach of designing a blend of biodegradable lubricants and investigating its tribological properties
Authors: Bhaumik Shubrajit , Kamaraj M
Published: October 2020

Various blends containing glycerol, castor oil (NCO) and cashew nut shell liquid (CNSL) were made following soft computational techniques and the blend consisting 60% glycerol and 40% NCO was proposed, which exhibited 37% less coefficient of friction (CoF) than NCO and CNSL and 50% less CoF and comparable extreme pressure properties to non-biodegradable commercial mineral oil (CMO). Accelerated wear was indicated by particle quantifier index for CMO, NCO and CNSL samples while normal wear was observed in glycerol and the proposed blend. SEM and 3-D profilometer images exhibited more damaged surfaces in NCO and CNSL than other lubricants. Raman spectra indicated the presence of FeOOH, OH, HOH and fatty acids on the wear tracks of the proposed blend.
‘Posture second’ strategy predicts disability progression in multiple sclerosis
Authors: Castelli Letizia , Quartuccio Maria Esmeralda , Ruggieri Serena , De Giglio Laura , Prosperini Luca
Published: October 2020

We assessed 168 patients with multiple sclerosis (MS) by force platform to obtain the dual-task cost (DTC) of balance, that is, the change in postural sway from quiet standing to dual-task condition (Stroop test). After a median follow-up time of 3.5 years from this assessment, disability progression occurred in 45 (27%) patients. Disability progression was predicted by the adoption of a ‘posture second’ strategy, that is, values of DTC of balance exceeding those obtained from 62 healthy controls, even after controlling by demographic and clinical characteristics. The DTC of balance may potentially represent a novel and easy tool to predict MS progression.
‘We’re touching the topic, but we’re not opening the book:’ A grounded theory study of sibling relationships in young people with perinatally acquired HIV
Authors: Deakin Hannah , Frize Graham , Foster Caroline , Evangeli Michael
Published: October 2020

HIV-related stressors affecting young adults with perinatally acquired HIV (PHIV+) and their siblings include parental and sibling ill-health and death, own ill-health, HIV disclosure, and stigma. Young people with PHIV+ typically share their HIV status with family members. We explored sibling relationships in young people with PHIV+. Ten participants (six females, 17–23 years old) with PHIV+ took part in a semi-structured interview, analysed using Grounded Theory. The data were condensed into three theoretical codes: (1) HIV disclosure in sibling relationship; (2) Patterns of communication about HIV between siblings; and (3) Patterns of coping and support in sibling relationship.
Spiritual experiences and altered states of consciousness – Parallels between BDSM and Christianity
Authors: Carlström Charlotta
Published: October 2020

This article is based on a five-year qualitative ethnographic study of bondage and discipline/dominance and submission/sadism and masochism (BDSM) in Sweden. In-depth interviews were completed with 29 self-defined BDSM practitioners. In the article, I investigate spirituality in two different contexts, namely within BDSM practice and in the charismatic Christianity. With a focus on power dynamics, pain rituals, and altered states of consciousness, I discuss the questions: What meaning is given to the concept of spirituality in a BDSM context, and how does this spirituality resemble spirituality in Christianity? Which common denominators between BDSM practice and Christian belief can be found, and how should we interpret the parallels that the informants emphasize between practicing BDSM and having a Christian affiliation? The article aims to broaden our understanding for spirituality in different contexts, and thus contribute to both the research field of BDSM as well as to religion studies. And as such, I hope this study can bring some clarity to the different spiritual experiences individuals may encounter, whether it happens in a BDSM context or in a religious context.
“My Games are … Unconventional”: Intersections of game and BDSM studies
Authors: Sihvonen Tanja , Tuomas Harviainen J
Published: October 2020

This article examines connections between games and BDSM (consensual bondage and discipline, dominance and submission, and sadism and masochism), theoretically speaking (in their respective research areas) as well as in practice. A common grounding behind these connections is the consideration of play as a foundational component in games and game studies as well as in BDSM practices and the studies of BDSM as a cultural phenomenon. We identify five sets of relevant connections. First, there are direct comparisons between the two types of play. Second, several live-action role-playing games have been made about BDSM, or for BDSM. Third, many other games have borrowed ideas from BDSM, as well, as have some BDSM activities, in turn, from games and play. Fourth, queer game studies frequently discuss subversive and transgressive play practices, which provide a fruitful context for analyzing play elements in BDSM, and BDSM-inspired elements in games. And fifth, both games and BDSM are frequently discussed in the research contexts related to performance, theater, and rituals, which forms a potential bridge between these activities. Through this five-strand exploratory analysis, we show how deeply interconnected these two realms are, even if the connection is only rarely mentioned, and to this date, not fully recognized as a valid research topic.
Intramedullary Nailing of Paediatric Tibial Fractures: Comparison between Flexible and Rigid Nails
Authors: Widbom-Kolhanen S. , Helenius I.
Published: October 2020

Purpose:

To describe patient characteristics and to compare outcomes of children undergoing rigid intramedullary nailing of tibial fractures as compared with those operated on using elastic intramedullary nailing.

Methods:

A retrospective review of 26 children who have undergone flexible intramedullary nailing of tibial fractures and 30 children with rigid nailing at our university hospital between 2008 and 2017. The patient charts and radiographs were evaluated to identify demographic characteristics and several variables were measured preoperatively, as well as 6–12 weeks postoperatively in addition to final follow-up radiographs.

Results:

Twenty-six patients (26/26, 100%) treated with a flexible nail and 14 patients (14/30, 46.7%) treated with a rigid nail had open proximal tibial physis (p < 0.001). An acceptable postoperative alignment was obtained in 20 patients (20/26, 76.9%) in the elastic stable intramedullary nail group and in 29 patients (29/30, 96.7%) in the rigid group (p = 0.026). Some complications occurred in four patients (4/26, 15%) in the elastic stable intramedullary nail population and seven patients (7/30, 23%) in the rigid intramedullary nail population (p = 0.46). Malunion occurred in six patients (6/26, 23%) in the elastic stable intramedullary nail group and in none of the patients treated with a rigid intramedullary nail (p = 0.005).

Conclusion:

Younger children with tibial fractures who weight 50 kg or less and with proximal tibial growth plates wide open can be treated with elastic stable intramedullary nail while more mature adolescents benefit from rigid intramedullary nailing.
The chase for legal timber: Developments in the commercial trade of timber in Ghana
Authors: Akapame Clement Kojo
Published: October 2020

The quest for timber and timber resources and its corollary effects on forest degradation has in the last decade contributed to a series of concerted local and international interventions aimed at addressing the situation. These interventions have taken the character of domestic policies, international agreements and pacts and to some extent, domestic legislative reforms. The plethora of interventions have created a horde of laws and agreements with varying scopes and applications, multiple institutions with interlocked and overlapping responsibilities and uncoordinated and often undocumented practice in the commercial trade of timber. The focus of this article is to prod through the domestic and international legal and institutional architecture on the regulation of the trade of timber and timber resources. The article hopes to unearth the challenges in complying with these obligations and propose recommendations on the way forward.