bluuebunny/crossref_metadata_2025 huggingface dataset:
Running safety evaluation of high-speed train subject to the impact of floating ice collision on bridge piers
Authors: Li Penghao , Li Zhonglong , Han Zhaoling , Zhu Shengyang , Zhai Wanming , Lou Huibin
Published: April 2021

In Northeast China and the areas along Sichuan-Tibet railway, collision between floating ice and piers of railway bridges seriously threatens the train operation safety. The safety of high-speed train running on the bridge subject to the impact of floating ice collision is rarely assessed considering the spatial interaction of the train-track-bridge-ice system. To evaluate the running safety and ride comfort of trains and the structural stability of railway bridges under the collision between floating ices and piers, a train-track-bridge (TTB) dynamic interaction model considering the impact of floating ice is established. Using the refined finite element model, the collision process of floating ice on bridge pier is simulated, and the impact loads are employed as the excitation input of the TTB dynamics model. Taking a 5 × 32 m simply-supported bridges as a case study, the influence of bridge structural parameters on the floating ice collision system is investigated, and then the dynamic responses of the TTB system induced by the floating ice impact loads are analyzed in detail. Finally, the effect of the ice impact loads on the running safety of the high-speed train is revealed. Results show that under the floating ice impact loads, the angle of the pier sharp-nose (APSN) and lateral stiffness of foundations are the key parameters that influence the dynamic responses of the bridge, and an improperly small lateral stiffness of foundation would lead to an instability of bridge structure. The influence of ice impact loads on the dynamic responses of the train is remarkable. The lateral vibration acceleration, derailment factor and lateral wheel rail force caused by the ice impact loads are all greater than those caused by the track irregularity, while the wheel unloading rate is slightly smaller. In addition, the running speed of train is also closely related to the running safety and ride comfort when the collision occurs. When the train speed exceeds 400 km/h, the train passing through the bridge would have the possibility of derailment.
A simple multiple linear regression model in near infrared spectroscopy for soluble solids content of pomegranate arils based on stability competitive adaptive re-weighted sampling
Authors: Jiang Zhaoqiong , Du Yiping , Cheng Fangping , Zhang Feiyu , Yang Wuye , Xiong Yinran
Published: April 2021

The objective of this study was to develop a multiple linear regression (MLR) model using near infrared (NIR) spectroscopy combined with chemometric techniques for soluble solids content (SSC) in pomegranate samples at different storage periods. A total of 135 NIR diffuse reflectance spectra with the wavelength range of 950-1650 nm were acquired from pomegranate arils. Based upon sampling error profile analysis, outlier diagnosis was conducted to improve the stability of the model, and four outliers were removed. Several pretreatment and variable selection methods were compared using partial least squares (PLS) regression models. The overall results demonstrated that the pretreatment using the first derivative (1D) was very effective and the variable selection method of stability competitive adaptive re-weighted sampling (SCARS) was powerful for extracting feature variables. The equilibrium performance of 1D-SCARS-PLS regression model over ten repeats was similar to 1D-PLS regression model, so that the advantage of wavelength selection was inconspicuous in PLS regression model. However, the number of variables selected by 1D-SCARS was less than 9, which was enough to establish a simple MLR model. The performance of MLR model for SSC of pomegranate arils based on 1D-SCARS achieved a root-mean-square error of calibration of 0.29% and prediction of 0.31%. This strategy combining variable selection method with MLR may have a broad prospect in the application of NIR spectroscopy due to its simplicity and robustness.
On-line identification of silkworm pupae gender by short-wavelength near infrared spectroscopy and pattern recognition technology
Authors: Ma Yue , Xu Yichao , Yan Hui , Zhang Guozheng
Published: April 2021

The gender identification of silkworm pupae is a critical step in the sericulture industry's breeding process. In this study, a low cost, short-wavelength (815-1075 nm) near infrared (NIR) spectrometer combined with multivariate spectra evaluation methods was used to establish calibration models for the on-line identification of female and male pupae of eight silkworm varieties. The diffuse reflection short-wavelength spectra were recorded, and then principal component analysis (PCA), linear discriminant analysis (LDA), and partial least squares discriminant analysis (PLSDA) were tested for calibration model development. The PCA and LDA results showed, that spectral differences between the female and male silkworm pupae existed, however, the two evaluation techniques could not separate the female and male silkworm pupae with the required accuracy. The PLSDA calibration models, on the other hand, could separate the pupae according to their gender with the necessary prediction accuracy of >98%. Thus, it has been proved, that a low-cost, short-wavelength range NIR spectrometer in combination with a PLSDA calibration routine can be successfully applied for the reliable on-line identification of female and male silkworm pupae.
Private Health Insurance in Malaysia: Who Is Left Behind?
Authors: Balqis-Ali Nur Zahirah , Anis-Syakira Jailani , Fun Weng Hong , Sararaks Sondi
Published: April 2021

Despite various efforts introduced, private health insurance coverage is still low in Malaysia. The objective of this article is to find the factors associated with not having a private health insurance in Malaysia. We analyze data involving 19 959 respondents from the 2015 National Health Morbidity Survey. In this article, we describe the prevalence of not having health insurance and conducted binary logistic regression to identify determinants of uninsured status. A total of 56.6% of the study population was uninsured. After adjusting for other variables, the likelihood of being uninsured was higher among those aged 50 years and above, females, Malay/other Bumiputra ethnicities, rural, government/semigovernment, self-employed, unpaid workers and retirees, unemployed, lower education level, without home ownership and single/widowed/divorced, daily smoker, underweight body mass index, and current drinker. The likelihood of being uninsured also increased with increasing household size while the inversed trend was seen for household income. A substantial proportion of population in Malaysia did not have private health insurance, and these subgroups have limited preferential choices for provider, facility, and care.
Historicizing the ideology of ‘the market’
Authors: Eagleton-Pierce Matthew
Published: April 2021

The concept of the market is a linchpin notion in the analysis of contemporary capitalism. This article seeks to question how the term has tended to oscillate between two problematic types of use: either underspecifying the history and politics tied to the concept or, conversely, overloading the notion with a proliferation of too many meanings and applications. As a way to chart an alternative approach which can objectify and critique some of these patterns, this paper re-excavates the notion of ‘the market’ through a historicization of its ideological production and consumption. In particular, the argument brings political economy scholarship into a conversation with theoretical advances in the analysis of ideology, notably Michael Freeden’s so-called ‘morphological approach’. The article illuminates not only past usage patterns but also how the potency of the expression has been refreshed within recent decades associated with neoliberalism. In this way, through a dissection of this master category, the article also aims to contribute to identifying more precisely what is new in the neoliberal ideological ecosystem.
The Value of Additional Gravity Stress Radiographs for Decision Making in the Treatment of Isolated Type B Distal Fibular Fractures
Authors: van Leeuwen Claar A. T. , van Dorst Roderick W. J. J. , Krijnen Pieta , Schipper Inger B. , Hoogendoorn Jochem M.
Published: April 2021

Background:

Prior to treatment decisions concerning isolated Weber type B ankle fractures, assessment of the stability of the ankle joint is mandatory. The gravity stress (GS) radiograph is a radiographic tool to determine stability. We hypothesized that this additional GS radiograph would lead to fewer operative treatments by applying the criterion of operative treatment when medial clear space (MCS) > superior clear space (SCS) + 2 mm on the GS radiograph, compared with the nonstressed mortise view criteria of advising operative treatment in case of MCS > SCS + 1 mm.

Methods:

This retrospective comparative cohort study analyzed 343 patients aged between 18 and 70 years with an isolated Weber type B ankle fracture diagnosed at the emergency department between January 2014 and December 2019. The cohort was divided into 2 groups based on whether an additional GS radiograph was performed. Group I consisted of 151 patients in whom a regular mortise and lateral radiograph were performed. Group II comprised 192 patients, with an additional GS radiograph. Primary outcome was type of treatment (conservative vs operative). Secondary outcomes were patient-reported functional outcomes and pain.

Results:

Baseline characteristics of both groups did not differ. In group I, surgery was performed in 60 patients (39.7%) compared with 108 patients (56.3%) in group II ( P = .002). In the operatively treated patients, the mean MCS on regular mortise view was significantly smaller in patients in whom an additional GS radiograph was performed compared to patients without an additional GS radiograph (4.1 mm vs 5.2 mm, P < .001). Mean Olerud-Molander Ankle Score and mean visual analog scale (VAS) for pain did not differ significantly between groups I and II.

Conclusions:

Contrary to what was hypothesized, the introduction of an additional gravity stress radiograph, by which operative treatment was indicated if the MCS was wider than the SCS + 2 mm, did not result in reduced operative treatment of Weber type B ankle fractures when operative treatment was indicated for MCS > SCS + 1 mm on non-gravity stress radiographs.

Level of Evidence:

Level III: retrospective comparative study.
How Effective Are Concrete and Abstract Climate Change Images? The Moderating Role of Construal Level in Climate Change Visual Communication
Authors: Duan Ran , Takahashi Bruno , Zwickle Adam
Published: April 2021

Relying on construal-level theory, we experimentally test how the level of concreteness and abstraction of climate change imagery affects climate change responses among a diverse sample of U.S. adults ( N = 448). Results show that concrete visual messaging practices cannot directly lead to increased level of concern or behavioral intentions. Instead, they may backfire for conservatives, less-efficacious people, and people who are low in proenvironmental values. Our findings contribute to the effective climate change visual communication literature by incorporating a construal-level perspective, while also offering practical implications regarding how to use visuals more effectively to engage the public with climate change.
Enabling Cocreation With Transformative Interventions: An Interdisciplinary Conceptualization of Consumer Boosting
Authors: Bieler Martin , Maas Peter , Fischer Lukas , Rietmann Nele
Published: April 2021

Service research emphasizes the relevance of consumers’ participation in the cocreation of transformative outcomes like health and well-being. However, in complex services, consumers’ limited operant resources and lacking resource integration efficiency hinder transformative value cocreation. Service research on mechanisms that facilitate well-being through efficient resource integration is sparse, but several disciplines elaborate cognitive interventions with that target. These interventions have been validated in various contexts. Nevertheless, concerns persist that they can hurt, rather than help, individual consumers. Overcoming such limitations requires an interdisciplinary effort. The present article outlines the new research area “transformative consumer interventions” (TCI) by integrating interventions theory, consumer psychology, and transformative service research in a health context. TCI provide theory-driven principles for the selection and design of interventions that facilitate operant resource integration in complex services. Additionally, we conceptualize consumer boosting, the first TCI-based intervention construct. Consumer boosts are efficient, context-specific, and personalized interventions that enhance individuals’ operant resources. Consumer boosting provides a pathway to transformative cocreation and alleviates the risk of unintended consequences and value co-destruction. This research illustrates that the transformative service domain stands to benefit substantially from getting involved in the discussion on consumer interventions and offers a unique perspective for further conceptual elaboration.
Thermal and multiphase flow simulations of polytetrafluoroethylene-based grease flow in restricted geometry
Authors: Raj Aashna , Sarkar Chiranjit , Pathak Manabendra
Published: April 2021

This work presents a numerical model for predicting flow behaviour and temperature distribution of polytetrafluoroethylene thickened grease in a roller bearing configuration of obstructed flow. A finite-element code with a laminar flow multiphase mixture model is used to predict the flow patterns and volume fraction distribution of a thickener in a rectangular channel with two cylindrical rollers rotating at constant angular speeds ranging from 50  to 200 r/min. A heat transfer analysis has been done to study the temperature variation near the rollers. Simulations are carried out for 5%, 10% and 20% concentrations of the thickener. Rheological characterisation of the proposed grease samples is done. An experimentally developed rheological model is incorporated in the numerical model. The rheological characteristics of the samples follow the Herschel–Bulkley model. The velocity profiles obtained from the present numerical model are compared with the nearest available experimental microparticle image velocimetry profiles for lithium complex grease to find qualitative similarity. The variation of volume fraction distribution and temperature at different times and locations of the channel is predicted. The rotation of rollers affects the local distribution of a thickener as well as the rate of homogenisation with the oil. As polytetrafluoroethylene grease is able to maintain its rheology even at elevated temperatures, most of the channel portion is thermally unaffected due to heat dissipation up to 5 W.
The circular economy of food waste: Transforming waste to energy through ‘make-up’ work
Authors: Holmberg Tora , Ideland Malin
Published: April 2021

This article unpacks the neat straightforwardness of the ‘waste regime’ of the circular economy of food waste and its main idea: ‘waste as resource’. It explores the making of circularity by paying detailed attention to what is conceptualized as ‘make-up’ work, i.e. how interruptions and leaks along waste flows are handled in practice. Make-up work capitalizes on its double meaning. First, it highlights the covering of cracks needed in order to transform waste to energy. Second, make-up work pinpoints that the neatness of circularity is far from a straightforward technical system, but is continuously made. Through an interview-based study in Sweden, the article illuminates three steps of transformation of food waste into the commodity of biogas, analysing the material and cultural transformations, showing that the micro-management of preventing such interruptions is crucial. Problems such as lack of or misfit material, difficulties in sorting the substrate effectively, over/underproduction of gas and the political decisions steering the conditions for supply and demand are equally crucial and pose the threat that the production will be viewed as inefficient. Based on these results, the article emphasizes the need to problematize the paradigm of the circular economy and the zero-waste regime, on the one hand, and to recognize the work involved in striving for a sustainable society, on the other.
Toward ‘Cultures of Engagement’? An exploratory comparison of engagement patterns on Facebook news posts
Authors: Ferrer-Conill Raul , Karlsson Michael , Haim Mario , Kammer Aske , Elgesem Dag , Sjøvaag Helle
Published: April 2021

Information production, dissemination, and consumption are contingent upon cultural and financial dimensions. This study attempts to find cultures of engagement that reflect how audiences engage with news posts made by either commercial or state-owned news outlets on Facebook. To do so, we collected over a million news posts ( n = 1,173,159) produced by 482 news outlets in three Scandinavian countries (Denmark, Norway, and Sweden) and analyzed over 69 million interactions across three metrics of engagement (i.e. comments, likes, and shares). More concretely, we investigate whether the patterns of engagement follow distinct patterns across national boundaries and type of outlet ownership. While we are skeptical of metrics of engagement as markers of specific cultures of engagement, our results show that there are clear differences in how readers engage with news posts depending on the country of origin and whether they are fully state-owned or private-owned outlets.
The growing field of interdisciplinary research on user comments: A computational scoping review
Authors: Schindler Max , Domahidi Emese
Published: April 2021

Online user comments (UCs) as the most popular type of online audience participation nowadays form a popular and important field of research. The widespread examination of UCs across different disciplines leads to a variety of terms and constructs and thus a missing clarity about the discussed topics. With this computational scoping review, we uncovered six relevant, overarching topics and their development in the field. Due to the combination of an automatic text analysis via structural topic modeling and a qualitative evaluation, we were able to describe the current state of UC research and found an inherently interdisciplinary body of literature. We observed an inter- and intradisciplinary fragmentation and call for a systematization of the used terms, constructs, and examined topics.
Investigation on the anisotropy behavior of copper strips processed by a combination of FSP and ECAP
Authors: Keshtiban PM , Behnagh R Abdi , Bashirzadeh F , Javadzadeh Rasol , Mohsenzadeh Abolfazl
Published: April 2021

In this study, friction stir processed (FSP) pure copper sheet was equal channel angular pressed (ECAP). The purpose was to investigate the influence of ECAP on the microstructure and mechanical properties of the FSP-treated copper sheet. The dynamically recrystallized grained structure with the average grain size of ∼13 µm was found in the stir zone of the FSP. It was also revealed that FSP caused the enhancement of ultimate tensile strength compared to that of the base metal. Also, it was observed that ECAP led to further grain refinement and a tighter distribution of grains. A refined microstructure with an average grain size of ∼ 2 µm was achieved in copper sheets through FSP, followed by ECAP. The tensile strengths of the ECAP specimens were significantly increased to about 61 and 50% compared to the strengths of base metal and FSP, respectively. An overview of the results of this study showed that combined FSP/ECAP is an effective method for the mechanical improvement of the pure copper sheets.
The Ability of Patients to Provide Standardized, Patient-Taken Photographs for the Remote Assessment of Dupuytren Disease
Authors: Irvine Esmee , Sayed Leela , Johnson Nick , Dias Joseph
Published: April 2021

Background

Clinical goniometry for the assessment of contracture in Dupuytren disease is time-consuming and costly, and there is no universal method for evaluating the severity of the disease. This study aims to evaluate the feasibility of patient-taken photography for the remote assessment of Dupuytren disease.

Methods

Patients at our unit were provided with instructions on how to take standardized photographs of their diseased hand(s), which were subsequently analyzed by computer software to obtain formal measurements of the severity of disease. Compliance with photography instructions and ability to provide a photo of sufficient quality for analysis were measured.

Results

In all, 222 patients supplied photos for analysis; 158 patients (71.2%) were able to take the photographs as instructed. The remaining 28.8% took 1 or more of the images incorrectly or of insufficient quality. There were no statistically significant differences between those able to take the photos as directly versus those who took the photos incorrectly when compared by sex, age, or severity of disease.

Conclusions

Patient-taken photography used to estimate disease severity in Dupuytren disease is an achievable, efficient, and reliable method of remotely assessing and monitoring patients and may be increasingly useful given the current health care climate and preference for remote consultations.
Optimisation for clamping force of aircraft composite structure assembly considering form defects and part deformations
Authors: Zhang Wei , An Luling , Chen Yuan , Xiong Yeping , Liao Yabing
Published: April 2021

Given the existence of manufacturing defects and the accumulation of assembly errors, non-compliant assembly appears between components, especially for composite structure assembly. In the engineering application, the clamping force (CF) is often used to eliminate the clearance between mating components, but the improper CF may result in unwanted structure failure. Thus, on the premise of ensuring the safety of composite parts, this study proposes a procedure to systematically optimise the assembly CF. Firstly, the components mating surfaces were obtained by laser scanner, and the matching of actual surfaces was transformed and simplified based on ‘equivalent surface’ concept. Then, a mathematical optimisation model was established. The CF layout and magnitude were taken as variables, and the clearance elimination rate and the overall assembly force value were employed as objective functions. Finally, the improved genetic algorithm (GA) was used to solve this problem. A parametric finite element analysis (FEA) model was built, and model accuracy was verified by physical experiments. The finite element calculation and post-processing were carried out by Python script in ABAQUS®. Compared to the engineer’s traditional approach, the influence of form defects and part deformations were considered, which can help control the assembly stress well and ensure product performance.
Predictors of engaging in voluntary work during the COVID-19 pandemic: analyses of data from 31,890 adults in the UK
Authors: Mak HW , Fancourt D
Published: April 2021

Aims:

As the COVID-19 pandemic has grown internationally, there has been an increased need for volunteers. This study aimed to identify the predictors of volunteering including demographic backgrounds, socio-economic characteristics, personality, and psychosocial factors.

Methods:

Data were analysed from 31,890 adults in the UK COVID-19 Social Study run by the University College London – a longitudinal study focusing on the psychological and social experiences of adults living in the UK during the COVID-19 pandemic. Tetrachoric factor analysis was applied to identify latent categories of voluntary work. Multivariate logistic regression was used to identity predictors for volunteering and change in volunteering behaviours since before the COVID-19 pandemic.

Results:

Three types of volunteering during the pandemic were identified as follows: formal volunteering, social action volunteering, and neighbourhood volunteering. Regression analysis showed that the pattern of voluntary work was structured by demographic backgrounds, socio-economic factors, personality, and psychosocial factors.

Conclusion:

The predictors of volunteering during the pandemic may be slightly different from other non-emergency period.
School Nurse Poverty Education: Why It Is Important to Your Practice
Authors: Fliesher Susan , Neumann Linda , Curtis Mary P.
Published: April 2021

School nurses are seeing increased numbers of children who are living in poverty. The Missouri Community Action Program Poverty Simulation was presented to school nurses to increase their awareness of what it might be like to live in poverty and the related healthcare barriers. Participants shared their reactions and knowledge gained in the simulation in a postparticipation survey with the simulation facilitators. Some participants shared practice changes that they made as a result of their participation in the simulation, which included use of additional referral resources, being less judgmental, and increased empathy.
Networking infrastructure decision at Well-Known Institute of Management
Authors: Dhurkari Ram Kumar
Published: April 2021

Well-Known Institute of Management is situated in New Delhi, India, and offers a 2-year fully residential post-graduate program in Management (MBA) and a doctoral-level program. While the permanent and fully residential campus of the institute with state-of-the-art facilities is under construction (expected to be completed by June 2024), the institute is currently functioning from a rented transit campus. With the increase in intake in July 2020 and subsequently in 2021, the total number of students in the campus is going to increase from 240 to 400. Two buildings are hired on rent which is 1 km away from the transit campus. The IT team of the institute is asked to conduct a survey, analyze, and propose a solution to provide networking and Internet facilities for 150 students who are going to reside in the newly hired hostel buildings. Because of the Covid-19 pandemic, the networking requirement has changed. Dr Vivek Gupta, Assistant Professor in the area of IT and systems at Well-Known Institute of Management, is heading the IT team of the institute. Puzzled between various options of buying network infrastructure on premise or buying it as a service (infrastructure as a service), Dr Gupta needs to do a thorough analysis before recommending a feasible and plausible solution.
Millennials as Dictionary Users: A Study of Dictionary Use Habits of Serbian EFL Students
Authors: Knežević Ljiljana , Halupka-Rešetar Sabina , Miškeljin Ivana , Milić Mira
Published: April 2021

The article addresses the use of dictionaries among the new millennium generation of English as a foreign language (EFL) undergraduates. Applying the mixed-method approach (a questionnaire and interviews), the study examines the frequency of dictionary use, the types of dictionaries used, activities initiating dictionary consultation, information searched for, and problems faced in using dictionaries. The findings suggest that the participants are most fond of bilingual online dictionaries and use them mostly for looking up the meaning of unknown words. They also show that despite being high consumers of technology, participants do not benefit much from online dictionaries, as they neglect most of the entry information. The qualitative data reveal that the participants perceive various digital tools of questionable quality as online dictionaries. Overall, the study sheds light on the characteristic behavior of the new generation of EFL learners regarding their dictionary use and points to the necessity of developing their digital competence in the realm of dictionary use.
COVID-19: Intensifying the Existential Threat to the Caribbean
Authors: Witter Michael
Published: April 2021

The Caribbean has experienced an overlapping and interconnected series of challenges, including economic, social, and environmental, which pose an existential threat to the region. This article focuses on the nature of this threat as it evolved before and during the pandemic crisis. Under neoliberal globalization, Caribbean economies transformed themselves rapidly into service providers, most having resorted to developing a tourism sector, while some moved into oil production. In all cases, traditional agricultural exports declined with the loss of protected markets where they earned preferential prices. The COVID-19 pandemic has intensified the Caribbean’s existential crisis and revealed the inextricable links among the environment, economy, and public health. This article focuses on these links and suggests a way forward for public policy in the short, medium, and long term.
Decision Making for Treatment After ACL Injury From an Orthopaedic Surgeon and Patient Perspective: Results From the NACOX Study
Authors: Grevnerts Hanna Tigerstrand , Sonesson Sofi , Gauffin Håkan , Ardern Clare L. , Stålman Anders , Kvist Joanna
Published: April 2021

Background:

In the treatment of anterior cruciate ligament (ACL) injuries, there is little evidence of when and why a decision for ACL reconstruction (ACLR) or nonoperative treatment (non-ACLR) is made.

Purpose:

To (1) describe the key characteristics of ACL injury treatment decisions and (2) compare patient-reported knee instability, function, and preinjury activity level between patients with non-ACLR and ACLR treatment decisions.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 216 patients with acute ACL injury were evaluated during the first year after injury. The treatment decision was non-ACLR in 73 patients and ACLR in 143. Reasons guiding treatment decision were obtained from medical charts and questionnaires to patients and orthopaedic surgeons. Patient-reported instability and function were obtained via questionnaires and compared between patients with non-ACLR and ACLR treatment decisions. The ACLR treatment group was classified retrospectively by decision phase: acute phase (decision made between injury day and 31 days after injury), subacute phase (decision made between 32 days and up to 5 months after injury), and late phase (decision made 5-12 months after injury). Data were evaluated using descriptive statistics, and group comparisons were made using parametric or nonparametric tests as appropriate.

Results:

The main reasons for a non-ACLR treatment decision were no knee instability and no problems with knee function. The main reasons for an ACLR treatment decision were high activity demands and knee instability. Patients in the non-ACLR group were significantly older ( P = .031) and had a lower preinjury activity level than did those in the acute-phase ( P < .01) and subacute-phase ( P = .006) ACLR decision groups. There were no differences in patient-reported instability and function between treatment decision groups at baseline, 4 weeks after injury, or 3 months after injury.

Conclusion:

Activity demands, not patient-reported knee instability, may be the most important factor in the decision-making process for treatment after ACL injury. We suggest a decision-making algorithm for patients with ACL injuries and no high activity demands; waiting for >3 months can help distinguish those who need surgical intervention from those who can undergo nonoperative management.

Registration:

NCT02931084 ( ClinicalTrials.gov identifier).
Failure Rates After Revision Arthroscopic Stabilization for Recurrent Anterior Shoulder Instability Based on Anterior Capsulolabral Complex Conditions
Authors: Park In , Lee Jae-Hyung , Park Jin-Young , Shin Sang-Jin
Published: April 2021

Background:

A labral retear is an important contributing factor to surgical failure after arthroscopic soft tissue stabilization for recurrent anterior shoulder instability. However, surgeons frequently encounter poor tissue conditions in the anterior capsule, such as capsular tears, during revision surgery.

Purpose:

To analyze the clinical outcomes and failure rates of revision arthroscopic stabilization after failed Bankart repair based on the tissue conditions of the anterior capsule and the labrum. Outcomes were compared for revision after failed Bankart repair because of a labral retear versus a healed labrum but with capsular tears.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 55 patients who underwent revision arthroscopic stabilization after failed Bankart repair were included. Revision surgery was indicated if patients had a history of recurrent instability with positive apprehension test results, regardless of magnetic resonance imaging (MRI) findings of a labral retear. Patients were allocated into 2 groups based on arthroscopic findings at the time of revision surgery: group 1 consisted of patients who had a healed labrum with definite anterior capsular tears, and group 2 comprised patients who had labral retears without capsular tears. Clinical outcomes were assessed using the American Shoulder and Elbow Surgeons score, Rowe score, and surgical failure rate.

Results:

Overall, 10 patients were included in group 1, and 45 patients were included in group 2. No capsular tears were detected on preoperative MRI or magnetic resonance arthrography scans in either group, whereas all patients in group 2 had evidence of anterior labral retears on imaging scans. After revision surgery, 9 patients (16.4%) showed surgical failure by 25.6 months postoperatively. Patients in group 1 had a significantly higher surgical failure rate than did those in group 2 (4 patients [40.0%] vs 5 patients [11.1%], respectively; P = .04). The incidence of capsular tears was significantly higher in patients with surgical failure versus those without surgical failure (44.4% vs 13.0%, respectively; P = .04).

Conclusion:

A capsular tear of the anterior capsulolabral complex was an important indicator for surgical failure after revision arthroscopic stabilization. If patients demonstrate symptomatic instability after arthroscopic soft tissue stabilization without evidence of labral retears on imaging scans, an anterior capsular tear should be considered as a possible factor for recurrence.
COVID-19 as External Enabler of entrepreneurship practice and research
Authors: Davidsson Per , Recker Jan , von Briel Frederik
Published: April 2021

For decades, entrepreneurship and strategy research has been dominated by agent-centric and inward-looking theoretical perspectives. The ongoing COVID-19 pandemic demonstrates the limits of this stance, as its influence on business has been both enormous and palpable. For the most part, the effects of the pandemic are no doubt negative. Business research—and presumably business practice—typically address such influence in terms of failure, resilience, and crisis management among existing businesses. Contrasting this prevalent discourse, we focus instead on positive influence of the pandemic for some emerging and new ventures. We analyze the many possible positive effects on entrepreneurship practice and highlight also positive effects on entrepreneurship research. We illustrate both positives by applying the External Enabler framework.

JEL CLASSIFICATION: L26, M13, O3, R11
In Our Own Words: Baccalaureate Nursing Students Describe Academic Service Learning Experiences
Authors: Beebe Lora Humphrey , Elliott Lizanne M. , Whitaker Helen , Gladson Colby
Published: April 2021

Introduction

Service learning integrates community service, didactic and student self-reflection while at the same time striving to identify and meet needs of the community partnership agencies involved. Project Descriptions. In this manuscript, two baccalaureate nursing students describe their service learning experiences while embedded in an integrated primary care community partner site for two years. In project one, students designed and conducted an educational group for mental health clients in a rural day treatment program. In project two, the student revised a diabetic clinic educational form to reduce client burden. Project management and outcomes: Projects were designed in collaboration with community partners and faculty. Project one resulted in increased knowledge of coping mechanisms in a majority of group participants. Three months after implementation of the revised form designed in project two, a majority of diabetic clients served in the clinic had A1c reductions.

Discussion

Lessons learned by students during the experiences include communication skills such as developing rapport with specific client groups, steps of change management, professional team interactions and increased civic engagement.

Conclusion

To our knowledge, this is the first manuscript wherein baccalaureate nursing students add their voice to the literature describing the benefits of academic service learning. Our next step is an online follow up 9 months post-graduation, to examine whether benefits and skills are maintained.
Mental Hygiene: What It Is, Implications, and Future Directions
Authors: Tremblay Guillaume , Rodrigues Nicole C. , Gulati Sanjiv
Published: April 2021

Every day, people struggle with mental health challenges; one in five people will experience a mental illness in their lifetime. Innovative approaches to strengthen the public mental health strategy warrant careful deliberation. This article reintroduces and explores the conceptual framework of mental hygiene. The concept of mental hygiene was originally introduced in the early 20th century, with the aim of preventing and treating mental illness and milder mental disorders. The movement lost its momentum shortly thereafter and the concept went largely ignored since then. Mental hygiene is a form of preventive maintenance that can be likened to other hygienic practices. Through the plasticity of the brain, mental training activities can foster healthy cognitive patterns that are conducive to well-being. The article offers a brief overview of some of the mental hygiene practices one can engage in, on a daily basis, to support well-being and assist in preventing mental health issues. Such mental training behaviors may potentially reduce ubiquitous human tendencies to ruminate and mind-wander without awareness, which when in excess correlate with increased activity of the default mode network and susceptibility to the pathogenesis of mental illness, along with impeding human flourishing. The article advocates for the routine engagement in healthy mental hygiene to become a global recommendation.
RNA sequencing describes both population structure and plasticity-selection dynamics in a non-model fish
Authors: Thorstensen Matt J. , Baerwald Melinda R. , Jeffries Ken M.
Published: April 2021

Background

Messenger RNA sequencing is becoming more common in studies of non-model species and is most often used for gene expression-based investigations. However, the method holds potential for numerous other applications as well—including analyses of alternative splicing, population structure, and signatures of selection. To maximize the utility of mRNA data sets, distinct analyses may be combined such as by exploring dynamics between gene expression with signatures of selection in the context of population structure. Here, we compare two published data sets describing two populations of a minnow species endemic to the San Francisco Estuary (Sacramento splittail, Pogonichthys macrolepidotus): a microsatellite data set showing population structure, and an mRNA whole transcriptome data set obtained after the two populations were exposed to a salinity challenge. We compared measures of population structure and genetic variation using single nucleotide polymorphisms (SNPs) called from mRNA from the whole transcriptome sequencing study with those patterns determined from microsatellites. For investigating plasticity and evolution, intra- and inter-population transcriptome plasticity was investigated with differential gene expression, differential exon usage, and gene expression variation. Outlier SNP analysis was also performed on the mRNA data set and signatures of selection and phenotypic plasticity were investigated on an individual-gene basis.

Results

We found that mRNA sequencing revealed patterns of population structure consistent with those found with microsatellites, but with lower magnitudes of genetic variation and population differentiation consistent with widespread purifying selection expected when using mRNA. In addition, within individual genes, phenotypic plasticity or signatures of selection were found in almost mutual exclusion (except heatr6, nfu1, slc22a6, sya, and mmp13).

Conclusions

These results show that an mRNA sequencing data set may have multiple uses, including describing population structure and for investigating the mechanistic interplay of evolution and plasticity in adaptation. MRNA sequencing thus complements traditional sequencing methods used for population genetics, in addition to its utility for describing phenotypic plasticity.
Comparative physiological and full-length transcriptome analyses reveal the molecular mechanism of melatonin-mediated salt tolerance in okra (Abelmoschus esculentus L.)
Authors: Zhan Yihua , Wu Tingting , Zhao Xuan , Wang Zhanqi , Chen Yue
Published: April 2021

Background

Melatonin, a multifunctional signal molecule, has been reported to play crucial roles in growth and development and stress responses in various plant species. Okra (Abelmoschus esculentus L.) is a food crop with extremely high values of nutrition and healthcare. Recent reports have revealed the protective role of melatonin in alleviating salt stress. However, little is known about its regulatory mechanisms in response to salt stress in okra.

Results

In this study, we explored whether exogenous melatonin pretreatment could alleviate salt stress (300 mM NaCl) of okra plants. Results showed that exogenous application of melatonin (50 μM) significantly enhanced plant tolerance to salt stress, as demonstrated by the plant resistant phenotype, as well as by the higher levels of the net photosynthetic rate, chlorophyll fluorescence and chlorophyll content in comparison with nontreated salt-stressed plants. Additionally, melatonin pretreatment remarkably decreased the levels of lipid peroxidation and H2O2 content and scavenged O2•- in melatonin-pretreated plants, which may be attributed to the higher levels of enzyme activities including POD and GR. Moreover, a combination of third- (PacBio) and second-generation (Illumina) sequencing technologies was applied to sequence full-length transcriptomes of okra. A total of 121,360 unigenes was obtained, and the size of transcript lengths ranged from 500 to 6000 bp. Illumina RNA-seq analysis showed that: Comparing with control, 1776, 1063 and 1074 differential expression genes (DEGs) were identified from the three treatments (NaCl, MT50 and MT + NaCl, respectively). These genes were enriched in more than 10 GO terms and 34 KEGG pathways. Nitrogen metabolism, sulfur metabolism, and alanine, aspartate and glutamate metabolism were significantly enriched in all three treatments. Many transcription factors including MYB, WRKY, NAC etc., were also identified as DEGs.

Conclusions

Our preliminary results suggested that melatonin pretreatment enhanced salt tolerance of okra plants for the first time. These data provide the first set of full-length isoforms in okra and more comprehensive insights into the molecular mechanism of melatonin responses to salt stress.
A review of the use of controlled multiple imputation in randomised controlled trials with missing outcome data
Authors: Tan Ping-Tee , Cro Suzie , Van Vogt Eleanor , Szigeti Matyas , Cornelius Victoria R.
Published: April 2021

Background

Missing data are common in randomised controlled trials (RCTs) and can bias results if not handled appropriately. A statistically valid analysis under the primary missing-data assumptions should be conducted, followed by sensitivity analysis under alternative justified assumptions to assess the robustness of results. Controlled Multiple Imputation (MI) procedures, including delta-based and reference-based approaches, have been developed for analysis under missing-not-at-random assumptions. However, it is unclear how often these methods are used, how they are reported, and what their impact is on trial results. This review evaluates the current use and reporting of MI and controlled MI in RCTs.

Methods

A targeted review of phase II-IV RCTs (non-cluster randomised) published in two leading general medical journals (The Lancet and New England Journal of Medicine) between January 2014 and December 2019 using MI. Data was extracted on imputation methods, analysis status, and reporting of results. Results of primary and sensitivity analyses for trials using controlled MI analyses were compared.

Results

A total of 118 RCTs (9% of published RCTs) used some form of MI. MI under missing-at-random was used in 110 trials; this was for primary analysis in 43/118 (36%), and in sensitivity analysis for 70/118 (59%) (3 used in both). Sixteen studies performed controlled MI (1.3% of published RCTs), either with a delta-based (n = 9) or reference-based approach (n = 7). Controlled MI was mostly used in sensitivity analysis (n = 14/16). Two trials used controlled MI for primary analysis, including one reporting no sensitivity analysis whilst the other reported similar results without imputation. Of the 14 trials using controlled MI in sensitivity analysis, 12 yielded comparable results to the primary analysis whereas 2 demonstrated contradicting results. Only 5/110 (5%) trials using missing-at-random MI and 5/16 (31%) trials using controlled MI reported complete details on MI methods.

Conclusions

Controlled MI enabled the impact of accessible contextually relevant missing data assumptions to be examined on trial results. The use of controlled MI is increasing but is still infrequent and poorly reported where used. There is a need for improved reporting on the implementation of MI analyses and choice of controlled MI parameters.
Treating epistaxis – who cares for a bleeding nose? A secondary data analysis of primary and secondary care
Authors: Althaus Annina E. , Lüske Jonas , Arendt Ulrike , Dörks Michael , Freitag Michael H. , Hoffmann Falk , Jobski Kathrin
Published: April 2021

Background

The primary objective was to describe outpatient treatment of epistaxis among different physicians based on a large patient population over a period of 10 years. The secondary objective was to evaluate the value of the practice fee as an instrument of allocation in patients with epistaxis.

Methods

Anonymized statutory health insurance data (AOK Lower Saxony) of patients with a diagnosis of epistaxis treated between 2007 and 2016 were examined. Demographic data, accompanying diagnoses, medication and involved medical groups (general practitioners (GP), pediatricians, ear, nose and throat (ENT) specialists or other) were analyzed. Furthermore, we assessed whether the use of specialist groups changed after abolition of the practice fee in 2013.

Results

Epistaxis was responsible for 302,782 cases (160,963 patients). The distribution of cases was slightly in favor of ENT specialists vs. GP (119,170 vs. 110,352). The cases seen by GP and ENT specialists were comparable with regard to age and sex distribution. Hypertension, atrial fibrillation/flutter and an antithrombotic therapy were slightly more common among cases consulting a GP. The GP recorded more co-diagnoses than the ENT. The use of outpatient care and the proportions of the involved physicians scarcely fluctuated during the study period. Overall, 23,118 patients (14.4%) were diagnosed by both, GP and ENT during a relatively short time period. The practice fee remuneration had no impact on the consultation of the physician groups.

Conclusion

The outpatient treatment of epistaxis constitutes a considerable medical and economic burden in Germany. Strengthening the primary medical sector (GP-centered care) is necessary to reach the goal of initially directing patients to primary care, providing specialists more time for severe cases and reducing the impact on public health balance sheets.