bluuebunny/crossref_metadata_2025 huggingface dataset:
Detecting Articular Cartilage and Meniscus Deformation Effects Using Magnetization Transfer Ultrashort Echo Time (MT-UTE) Modeling during Mechanical Load Application: Ex Vivo Feasibility Study
Authors: Jerban Saeed , Kasibhatla Akhil , Ma Yajun , Wu Mei , Chen Yanjun , Guo Tan , Wan Lidi , Szeverenyi Nikolaus , Chang Eric Y. , Du Jiang
Published: December 2020

Objective

Ultrashort echo time (UTE) magnetic resonance imaging (MRI) sequences have improved imaging of short T2 musculoskeletal (MSK) tissues. UTE-MRI combined with magnetization transfer modeling (UTE-MT) has demonstrated robust assessment of MSK tissues. This study aimed to investigate the variation of UTE-MT measures under mechanical loading in tibiofemoral cartilage and meniscus of cadaveric knee joints.

Design

Fourteen knee joints from young ( n = 8, 42 ± 12 years old) and elderly ( n = 6, 89 ± 4 years old) donors were scanned on a 3-T scanner under 3 loading conditions: load = 300 N (Load1), load = 500 N (Load2), and load = 0 N (Unload). UTE-MT sequences were performed at each loading condition. Macromolecular proton fraction (MMF) was calculated from UTE-MT modeling. Wilcoxon rank sum test was used to examine the MRI data differences between loading conditions.

Results

For young donors, MMF increased in all grouped regions of interest (meniscus [M], femoral articular cartilage [FAC], tibial articular cartilage [TAC], articular cartilage regions covered by meniscus [AC-MC], and articular cartilage regions uncovered by meniscus [AC-UC]) when the load increased from 300 to 500 N. The increases in MMF were significant for M (13.3%, P < 0.01) and AC-MC (9.2%, P = 0.04). MMF decreased in all studied regions after unloading, which was significant only for AC-MC (−8.9%, P = 0.01). For elderly donors, MRI parameters did not show significant changes by loading or unloading.

Conclusion

This study highlights the potential of the UTE-MT modeling combined with knee loading in differentiating between normal and abnormal knees. Average tissue deformation effects were likely higher and more uniformly distributed in the joints of young donors compared with elderly donors.
Value of high-density sign on CT images after mechanical thrombectomy for large vessel occlusion in predicting hemorrhage and unfavorable outcome
Authors: Portela de Oliveira Eduardo , Chakraborty Santanu , Patel Mihilkumar , Finitsis Stefanos , Iancu Daniela
Published: December 2020

Purpose

Cerebral hyperdensities can appear on head computed tomography (CT) images performed early after endovascular treatment (EVT) in patients with acute ischemic stroke and may be secondary to contrast staining or hemorrhagic transformation. The aim of this study was to determine how the high-density sign on CT affects mortality and clinical outcome and whether CT parameters predict hemorrhagic conversion or unfavorable outcome.

Methods

We retrospectively reviewed a database of patients who underwent EVT with mechanical thrombectomy for acute ischemic stroke over 7 years. Included were acute stroke patients with a CT examination within 24 h post-EVT with mechanical thrombectomy, demonstrating areas of hyperdensity. We evaluated morphologic characteristics of these lesions, location, CT Hounsfield units and largest area, as well as patient demographics, EVT methods and patient outcome.

Results

A total of 29 patients met the strict inclusion criteria. Complete recanalization was achieved in 58.6% (17/29). Seventeen (58.6%) cases of post-intervention cerebral hyperdensities were related to contrast staining and 12 (41.4%) cases to contrast staining and hemorrhage. Patient mortality was significantly higher in the hemorrhagic group (50.0% versus 5.9%, p = 0.003). The increased density on CT was associated with higher hemorrhagic risk (odds ratio 1.05, p = 0.036).

Conclusion

Patients with the high-density sign on CT images after mechanical thrombectomy for acute ischemic stroke demonstrated increased mortality and worse clinical outcome, primarily when these hyperdensities were related to hemorrhage. CT imaging parameters as higher density areas can help in the differentiation of hemorrhage from contrast staining.
The EU Whistleblower Directive and its Transposition: Part 2
Authors: Gerdemann Simon , Colneric Ninon
Published: December 2020

The Whistleblower Directive of 2019 is by far the European Union’s most important piece of whistleblowing legislation to date, covering a remarkably broad range of regulatory fields and subjects. After Part 1 of this two-part article series, which mostly focused on the Directive’s scope and general conditions for whistleblower protection, Part 2 will analyse its provisions on public disclosures and the various measures for protection and support that Member States are required to implement. Following this discussion, the article will then turn to some of the most pressing legislative questions each Member State will have to answer before the deadline for transposition passes on 17 December 2021.
CMV retinitis in a stem cell transplant recipient treated with foscarnet intravitreal injection and CMV specific immunoglobulins
Authors: Vassallo Francesco , Nuzzi Raffaele , Cattani Ilaria , Dellacasa Chiara , Giaccone Luisa , De Rosa Francesco Giuseppe , Cavallo Rossana , Iovino Giorgia , Brunello Lucia , Bruno Benedetto , Busca Alessandro
Published: December 2020

Cytomegalovirus (CMV) retinitis (CMVR) has been reported rarely in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). In addition, little is known about strategies for ophthalmic surveillance and adequate antiviral treatment of CMVR. A case of CMVR in an allogeneic HSCT recipient is described, including clinical signs and therapy. An adult patient received HSCT from a matched unrelated donor for treatment of a Burkitt lymphoma. Donor and recipients were both CMV positive. Starting on day +40, the patient presented multiple CMV reactivation, treated with valganciclovir, foscarnet and a combination of both. On day +160, the patient started complaining of conjunctival hyperaemia and a decrease in visual acuity. Fundoscopy revealed retinal lesions consistent with CMVR, although whole blood CMV DNAemia was negative. Aqueous humor biopsy showed the presence of CMV infection (CMV DNA 230400 UI/ml). CMVR was treated with foscarnet (180 mg i.v. and 1.2 mg intravitreal injection) combined with anti CMV immunoglobulin at 0.5 ml/kg every 2 weeks. After 4 weeks of systemic therapy, 20 weekly doses of intravitreal foscarnet and six cycles of immunoglobulins, a significant improvement of visual acuity was observed. The treatment was well tolerated with no side effect. In conclusion, our case suggests that systemic and local antiviral treatment combined with CMV-specific-IVIG, may reduce CMV load in the eye of patients with CMVR, leading to a consistent improvement of visual acuity. Systematic ophthalmologic examination should be recommended in HSCT recipients with multiple CMV reactivations and high peak CMV DNA levels.
Evidence-based clinical practice guidelines on the management of pain in older people – a summary report
Authors: Schofield Patricia , Dunham Margaret , Martin Denis , Bellamy Gary , Francis Sally-Anne , Sookhoo Dave , Bonacaro Antonio , Hamid Eshtar , Chandler Rebecca , Abdulla Aza , Cumberbatch Mike , Knaggs Roger
Published: December 2020

Objective:

The objective of this study is to develop an update of the evidence-based guidelines for the management of pain in older people.

Design:

Review of evidence since 2010 using a systematic and consensus approach is performed.

Results:

Recognition of the type of pain and routine assessment of pain should inform the use of specific environmental, behavioural and pharmacological interventions. Individualised care plans and analgesic protocols for specific clinical situations, patients and health care settings can be developed from these guidelines.

Conclusion:

Management of pain must be considered as an important component of the health care provided to all people, regardless of their chronological age or severity of illness. By clearly outlining areas where evidence is not available, these guidelines may also stimulate further research. To use the recommended therapeutic approaches, clinicians must be familiar with adverse effects of treatment and the potential for drug interactions.
An adolescent with herpes simplex encephalitis, presenting with mild symptoms and rapid deterioration: A case report
Authors: Stepien Natalia , Weseslindtner Lukas , Seidl Rainer , Geldner Julia , Golej Johann , Schmook Maria-Theresa , Peyrl Andreas
Published: December 2020

Headaches in children are a common, but unspecific symptom that can have many underlying causes, ranging from unspecific tension headache through migraine and up to encephalitis and intracranial hypertension. We present the case of a 14-year-old boy who presented to our emergency department with headache, nausea as well as vomiting and developed seizures later on. The initial diagnosis was complicated by a magnetic resonance imaging which did not show any signs of inflammation, but was of limited informative value due to orthodontic appliances. Despite the unremarkable imaging, prophylactic antiviral and antibiotic treatment was started after lumbar puncture. Herpes simplex virus as well as human herpes virus 7 were confirmed in the cerebrospinal fluid. Although both viruses are ubiquitous, severe infections are a rare complication. Immunodeficiency syndromes are predisposing factors for serious complications and genetic analysis of UNC93B and TLR-3 might be helpful for decision-making. No genetic or immunologic predisposition was found in our patient. The patient’s condition deteriorated rapidly, so he had to be admitted to the pediatric intensive care unit, where he was intubated and his antiviral treatment with acyclovir was extended by foscarnet. After prolonged mechanical ventilation, he slowly improved. With intensive neurorehabilitation, he could finally return to his daily life activities 3 months after diagnosis. Despite headaches being an unspecific symptom, the possibility of a herpes simplex virus encephalitis should always kept in mind, especially in patients presenting with additional symptoms such as vomiting, altered mental status and/or focal neurological deficits. An initial magnetic resonance imaging might be misleading if orthodontic appliances are in place. Initiation of treatment without delay is crucial for neurologic outcome of herpes simplex virus encephalitis.
A rare case of osteoblastoma in the femoral head combined with cam-type femoroacetabular impingement: A case report
Authors: Morita Akira , Kobayashi Naomi , Choe Hyonmin , Tezuka Taro , Kawabata Yusuke , Hayashida Kenta , Higashihira Shota , Kato Ikuma , Inaba Yutaka
Published: December 2020

Osteoblastoma is a relatively rare benign bone-forming tumor accounting for less than 1% of all bone tumors. This report describes a patient with an osteoblastoma in the femoral head complicated by coexistence of femoroacetabular impingement. A 25-year-old male rugby football player complained of severe right hip pain after an injury during rugby practice. The pain became progressively worse despite resting from sports activity and rehabilitation for 4 months. The image inspection revealed bone tumor complicated by cam-type femoroacetabular impingement and a labral injury. Hip arthroscopic surgery was planned using a navigation system and a three-dimensional model for both complete debridement and cam resection. The tumor was resected by open surgery using a posterior approach. The bone tumor was diagnosed histopathologically as an osteoblastoma. The patient’s symptoms improved markedly after surgery, with no evidence of local tumor recurrence or hip arthritis 1 year later.
Linear cutaneous lupus erythematosus in children—report of two cases and review of the literature: A case report
Authors: Lim Darosa , Hatami Afshin , Kokta Victor , Piram Maryam
Published: December 2020

Linear cutaneous lupus erythematosus is an unusual presentation of cutaneous lupus following Blaschko’s lines. It is described mostly in children and young adults and is usually not associated with systemic involvement. We report two cases of linear cutaneous lupus erythematosus in children who significantly improved after treatment with hydroxychloroquine in combination with topical corticosteroids and tacrolimus. These rare cases underline the importance of including linear cutaneous lupus erythematosus in the differential diagnosis of blaschkoid inflammatory lesions.
Urology trainee perceptions of curriculum checkpoints and challenges to achieving a Certificate of Completion of Training: Results of a national survey
Authors: Harvey NJ , Ross DG
Published: December 2020

Objective:

To determine the views of urology trainees regarding training checkpoints/waypoints, and challenges to achieving a Certificate of Completion of Training (CCT).

Methods:

A novel survey was devised and distributed to evaluate urology trainee perceptions of the challenges in achieving the current CCT requirements as well as their views on the ST4 waypoint, indicative numbers (INs), workplace-based assessments (WBAs) and critical condition case-based discussions.

Results:

Of 347 trainees, 59 (17.0%) returned completed surveys from 13 of 19 training regions. The most significant challenges in achieving CCT as perceived by all trainees were, from highest to lowest: publication requirements, paediatric urology experience, achieving FRCS (Urol), INs and WBAs. All questions relating to ST4 waypoints were answered positively by a majority of respondents.

Conclusions:

The findings of this survey suggest that trainees will approve of the forthcoming changes in training assessment and outcomes embedded within the 2021 curriculum. The ST5 checkpoint, in particular, is an opportunity to better match trainees and placements and will underpin successful ‘phasing’ of training. A future study will inform the success of ‘embedding’ the 2021 curriculum and subsequently play a crucial part in the continuous improvement of urological training.

Level of evidence:

Not applicable for this multicentre audit.
Adaptive capacity of midwives participating in pregnancy termination procedures: Polish experience
Authors: Banasiewicz Jolanta , Zaręba Kornelia , Rozenek Hanna , Ciebiera Michał , Jakiel Grzegorz , Chylińska Joanna , Owczarek Krzysztof
Published: December 2020

A cross-sectional study was conducted in 181 midwives working in hospitals in Poland. The midwives completed professional psychological tests (CISS questionnaire, EPQ-R questionnaire, OLBI questionnaire) and a questionnaire developed for this study. Midwives participating in pregnancy termination procedures most commonly used the task-oriented coping style. The emotion-oriented coping style was positively related to burnout in the group which performed pregnancy terminations. The analysis showed that the higher the indices of neuroticism, the greater the severity of burnout in both groups. The results indicate the need to conduct an initial assessment of personality resources when employing midwives to the wards.
Understanding patient-provider discordance in adolescents with lupus: The role of pain and antidepressant medication use
Authors: Kenney-Riley Kathleen , Berkowitz Shari Salzhauer , Rapoza Kimberly
Published: December 2020

The current study examines depression and pain as potential contributors to patient-provider discordance in the assessment of lupus disease activity. The study conducted a secondary analysis of data obtained from the Childhood Arthritis and Rheumatology Research Alliance registry, with N = 859 adolescent participants. Assessments of pain, disease activity, and antidepressant medication use were collected from the patient and provider. Results indicated that depression might be underdiagnosed in pediatric lupus patients. While psychotropic medication and pain scores were independently related to greater patient-provider discordance regarding health status, pain mediated this relationship. Implications for treatment outcomes are discussed.
Protocol for randomized controlled trial of electric stimulation with high-volt twin peak versus placebo for facial functional recovery from acute Bell’s palsy in patients with poor prognostic factors
Authors: Loyo Myriam , McReynold Margaret , Mace Jess C , Cameron Michelle
Published: December 2020

Background

Electric stimulation (ES) can prevent muscle atrophy and promote tissue healing and therefore may help prevent sequelae of Bell’s palsy but due to lack of high-quality studies, the effectiveness of ES in Bell’s palsy remains controversial. Here we describe a protocol to evaluate the effects of monophasic high volt ES in patients with Bell’s palsy and poor prognosis for recovery.

Results

This is a protocol for a prospective, double-blinded, randomized, placebo-controlled study. Participants include adults with acute Bell’s palsy with poor prognosis for full recovery due to complete paralysis or being over age 60. ES will be a monophasic, high-volt pulsed waveform, 100μsec pulse duration, 35 hertz, motor-level intensity. Follow up will be at months 1, 2, 3 and 6. The primary outcome will be the proportion of patients with complete recovery using the eFACES tool. Secondary outcomes include patient reported quality of life measured by FaCE and the synkinesis assessment questionnaires, objective photographs, time to complete recovery, adverse effects, and tolerability.

Conclusion

This protocol has the potential to provide high quality evidence regarding the effects, up to 6 months after onset, of pulsed monophasic high-volt ES for patients with acute Bell’s palsy and poor prognosis for complete recovery.
Severe anaphylactic shock after anesthesia induction: An unusual initial manifestation of Churg-Strauss syndrome
Authors: Melemeni Aikaterini , Tympa Grigoriadou Aliki , Karachanidi Stavroula , Tsaroucha Athanasia
Published: December 2020

Churg-Strauss syndrome or eosinophilic granulomatosis with polyangiitits (EGPA) is a rare multisystem disorder. A case of anaphylactic shock after induction of anesthesia, as the initial clinical presentation of Churg-Strauss syndrome in a 15-year-old girl is reported. It is extremely rare to see pediatric patients with previous perioperative anaphylaxis receiving future anesthesia; a multidisciplinary approach including allergist, rheumatologist, anesthesiologist, and surgeon is necessary in order to provide a better future anesthetic plan.
An Interdisciplinary Conducting Curriculum: Selected Theater Games From Viola Spolin’s “Improvisation for the Theater”
Authors: Otto Devin
Published: December 2020

This article presents a series of theater games with clear connections to conducting and rehearsing music ensembles, explaining both how to play them and how young conductors will benefit from the experience. These games are published in Viola Spolin’s seminal text Improvisation for the Theater, which presents a series of exercises that foster communication, creativity, immediacy, and spontaneity. Many games also focus on creating and communicating character through physical movement and posture, awareness of the body in space, and manipulation of “space objects,” which are imaginary props made real in the mind of the observer through understanding of shared human experiences. Theater games are effectively experienced in short periods of time, intended for players of all ability and experience levels, and encourage immediate emotive communication, making them highly effective for young conductors and easily incorporated into undergraduate and graduate conducting classes.
Civic Participation Profiles and Predictors Among French-Canadian Youths Transitioning Into Adulthood: A Person-Centered Study
Authors: Vézina Marie-Pier , Poulin François
Published: December 2020

How do young adults get involved in community and political life and what distinguishes those who are engaged from those who are not? In an attempt to answer these questions, the current study examines civic participation (CP) profiles, and their predictors, among 311 French-Canadian youths transitioning into adulthood. Latent Class Analysis (LCA) and multinomial logistic regressions were performed. Four CP profiles were identified: unengaged ( N = 198; 64%), political specialists ( N = 47; 15%), community service specialists ( N = 31; 10%) and dual activists ( N = 35; 11%). Higher civic attitudes, altruistic orientation, political attentiveness and educational aspirations predicted active CP profile membership. Implications for future research are discussed.
Relevance of Methodology of M. N. Srinivas Today: Some Issues
Authors: Chaudhury Sukant Kumar
Published: December 2020

This article aims at analysing the methods and techniques used by M. N. Srinivas, the pioneer of Indian sociology and social anthropology. Srinivas was the founder of sociology department at two universities in India: Baroda and Delhi, where his focus was to pursue lengthy fieldwork with participant observation technique by the researcher. He was influenced by Radcliffe-Brown’s structural-functional approach and pursued it in village studies in India. His village studies in Rampura produced many ideas and concepts par excellence: Sanskritisation, Westernisation, Secularisation and Dominant Caste including the concept of vote bank. Further, this article discusses the interface between sociology and social anthropology as advocated by him.
An Innovative Meta-Systematic Review into the Landscape of Literature and the Concluding Evidence on the Quality of Life of Patients Using Two Implant Supported Mandibular Complete Denture Prosthesis
Authors: Rajaraman Vaishnavi , Nallaswamy Deepak , Ganapathy Dhanraj M. , Ashok V.
Published: December 2020

Aim:

The aim of this systematic review is to analyze the existing evidence on the quality of life of patients completely edentulous in the mandible.

Materials and Methods:

A search questionnaire was formulated using population intervention comparison outcome (PICO) analysis, and a comprehensive search was initiated in PubMed Central, Medline, Cochrane, and Google Scholar databases for the related topics. Manuscripts published till December 2019 were included in this review. Out of the 63 articles obtained from searching all databases, 27 studies were excluded based on the title and abstract. Out of the remaining 36 studies, 12 were excluded based on the inclusion and exclusion criteria of our interest and 24 were included on the basis of core data.

Results:

One review author identified randomized trials meeting inclusion criteria for this review. Two review authors extracted data and assessed study quality. The oral health-related quality of life in completely edentulous mandibular patients wearing implant-supported overdentures was better when compared to conventional tissue-supported complete denture, and a minimum two implant-supported mandibular complete denture has sufficient improvement in oral health-related quality of life.

Conclusion:

There are about more than 170 reviews and clinical trials that have been published in support of the same for the past two decades. Thus, the clinicians may not be tempted in placing additional implants in well-formed mandibular edentulous ridges. To enhance the understanding of mandibular implant overdenture treatment, clinicians must scrutinize the existing evidence and formulate a protocol by striking a balance between efficient and evidence based treatment.
Book review: Amit Ahuja, Mobilizing the Marginalized: Ethnic Parties without Ethnic Movements
Authors: Wankhede Harish S.
Published: December 2020

Amit Ahuja, Mobilizing the Marginalized: Ethnic Parties without Ethnic Movements. Delhi: Oxford University Press. 2019. 238 pp. ₹550. ISBN: 9780190916435
Association of Serum Vitamin D Levels and Stress Fractures in Collegiate Athletes
Authors: Millward David , Root Allison D. , Dubois Jeremy , Cohen Randall P. , Valdivia Luis , Helming Bruce , Kokoskie Justin , Waterbrook Anna L. , Paul Stephen
Published: December 2020

Background:

Low vitamin D levels along with high-intensity athletic training may put an athlete at increased risk for a stress fracture.

Purpose:

To assess whether supplementation with vitamin D is associated with a reduced risk of stress fractures in college athletes. We also assessed differences in vitamin D levels among athletes participating in outdoor versus indoor sports.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

The study participants included 802 National Collegiate Athletic Association Division I intercollegiate athletes (497 men and 305 women) on a sports team for at least 1 semester from 2012 to 2018. All athletes who had a baseline vitamin D level in their medical record were included. Athletes with vitamin D levels <40 ng/mL were given vitamin D supplements. We assessed differences in the rate of stress fracture among those who maintained or improved vitamin D levels to ≥40 ng/mL and those who did not, as well as differences in average baseline vitamin D levels by sport type (indoor vs outdoor).

Results:

The rate of stress fracture was 12% higher (95% CI, 6-19; P < .001) for those who remained low in vitamin D compared with those who were low at baseline but improved their vitamin D status to ≥40 ng/mL. The rate of stress fracture was also 12% higher (95% CI, 5-18; P < .001) for those who had low vitamin D levels compared with those who maintained normal levels. The mean baseline vitamin D values were significantly higher for men participating in outdoor sports versus indoor sports. For men, the mean vitamin D level was 5.7 ng/mL higher (95% CI, 0.9-10.5; P = .01) in outdoor athletes. For women, the mean vitamin D level was 3.7 ng/mL higher (95% CI, –0.58 to 8.03; P < .04) for outdoor versus indoor sports.

Conclusion:

Study results indicated that correcting low serum vitamin D levels reduces the risk of stress fracture. This study also presented evidence that athletes who participate in indoor sports may be at greater risk for vitamin D deficiency than those who compete in outdoor sports.
Minimal Damage to the Supinator Muscle After the Double-Incision Technique for Distal Biceps Tendon Repair
Authors: Blonna Davide , Olivero Alberto , Galletta Claudia , Greco Valentina , Castoldi Filippo , Fracassi Matteo , Davico Marco , Rossi Roberto
Published: December 2020

Background:

The effect of the double-incision technique on the supinator muscle is unclear.

Purpose:

The aim of this study was to quantify fatty atrophy of the supinator muscle and map the area of muscle damage.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 19 male patients (median age, 43 years) who underwent distal biceps tendon repair were included in the analysis. Patients with a minimum of 12 months of follow-up were included. The following variables were analyzed: range of motion; shortened version of Disabilities of the Arm, Shoulder and Hand (QuickDASH) score; Summary Outcome Determination (SOD) score; and isokinetic peak force and endurance in supination. Quantitative analysis and mapping of fatty infiltration of the supinator muscle were based on the calculation of proton density fat fraction on magnetic resonance imaging scans of both elbows using the IDEAL (Iterative Decomposition of Echoes of Asymmetrical Length) sequence.

Results:

At an average follow-up of 24 months (range, 12-64 months), the median SOD score was 9.0 (95% CI, 7.8-9.4), and the mean QuickDASH score was 6.7 (95% CI, 0.0-14.1). A difference of 17% in peak torque was measured between repaired and nonrepaired elbows (repaired elbow: 9.7 N·m; nonrepaired elbow: 11.7 N·m; P = .11). Endurance was better in the repaired elbow than the nonrepaired elbow (8.4% vs 14.9% work fatigue, respectively; P = .02). The average fat fraction of the supinator muscle was 19% (95% CI, 16%-21%) in repaired elbows and 14% (95% CI, 13%-16%) in contralateral elbows ( P = .04). The increase in fat fraction was located in a limited area between the radius and ulna at the level of the bicipital tuberosity.

Conclusion:

The assessment of the supinator muscle showed a limited increase in fat fraction between the radius and ulna at the level of the bicipital tuberosity. No significant effect on supination strength was highlighted.
Effects of Mound Versus Flat-Ground Pitching and Distance on Arm Mechanics and Elbow Torque in High School Pitchers
Authors: Dowling Brittany , McElheny Kathryn D. , Camp Christopher L. , Ling Daphne I. , Dines Joshua S.
Published: December 2020

Background:

Although the monitoring of a pitcher’s throwing arm workload has become a hot topic in both research and the pitching world, the impact of mound height and distance still remains unclear.

Purpose:

To compare the kinetics and kinematics between pitches from a mound and flat ground at 2 different distances.

Study Design:

Descriptive laboratory study.

Methods:

A total of 21 healthy high school varsity baseball pitchers (age, 16.2 ± 1.3 years; weight, 73.6 ± 11.0 kg; height, 181.3 ± 6.4 cm) participated in this study. Players were fitted with a motusBASEBALL sensor and sleeve. Each pitcher was instructed to pitch 5 fastballs under 4 conditions: mound at 60.5 ft (regulation distance), flat ground at 60.5 ft, mound at 50.5 ft, and flat ground at 50.5 ft. Linear mixed-effects models were used to account for both intra- and interplayer variability. A multivariable model was used to evaluate the association of mound pitching, flat-ground pitching, and their distances (50.5 ft and 60.5 ft), and their interaction to arm speed, arm slot, arm rotation, elbow varus torque, and ball velocity.

Results:

There were no statistically significant effects of mound, flat-ground, or distance variation on arm speed or shoulder rotation. Arm slot was significantly higher (+3.0°; P = .02) on pitches from the mound at 60.5 ft compared with 50.5 ft. Elbow varus torque was lower (–1.5 N·m; P = .02) on mound pitches at 60.5 ft compared with 50.5 ft. Pitches thrown from the mound displayed significantly faster ball velocity compared with flat-ground pitches at both distances ( P < .01 for both), with pitches at 60.5 ft having higher velocity (+0.7 m/s; P < .01).

Conclusion:

Contrary to long-standing notions, the study results suggest that pitching from the mound does not significantly increase stress on the elbow compared with flat-ground pitching. Lower elbow varus torque and faster ball velocity at the regulation distance compared with the reduced distance indicate that elbow stress and ball velocity may not correlate perfectly, and radar guns may not be an appropriate surrogate measure of elbow varus torque.

Clinical Relevance:

A better understanding of the kinetic and kinematic implications of various throwing programs will allow for the designing of programs that are driven by objective data with aims directed toward injury prevention and rehabilitation in baseball pitchers.
Making Change Happen: Exploring the Change Discourse of Managers in a CSR Context
Authors: Haas Aurore , De Rozario Pascale
Published: December 2020

Diversity managers bear the responsibility of developing and implementing diversity policies. Despite advances in the legislation to fight discrimination, they often encounter resistance and need to generate change and to influence behaviors in the firm. Hence, they develop strategies to implement diversity within the organization. Based on the structuration approach developed by Giddens, and Barley and Tolbert, this research examines the discourse of diversity managers to generate change and institutionalize diversity. Based on a series of 37 in-depth interviews with diversity managers and experts in France, we identified eight scripts for diversity management in organizations. Whereas some scripts have the potential to generate change, others foster a “business as usual” vision of diversity and are in fact non-diversity scripts. This research sheds light on the role of discourse in promoting diversity in firms. To disrupt organizational practices, discourse needs to unveil hidden prejudice, and to be embedded in legislation, time, and space.
Revisiting the Role of Physicians in Assisted Living and Residential Care Settings
Authors: Dys Sarah , Smith Lindsey , Tunalilar Ozcan , Carder Paula
Published: December 2020

As the United States population ages, a higher share of adults is likely to use long-term services and supports. This change increases physicians’ need for information about assisted living and residential care (AL/RC) settings, which provide supportive care and housing to older adults. Unlike skilled nursing facilities, states regulate AL/RC settings through varying licensure requirements enforced by state agencies, resulting in differences in the availability of medical and nursing services. Where some settings provide limited skilled nursing care, in others, residents rely on resident care coordinators, or their own physicians to oversee chronic conditions, medications, and treatments. The following narrative review describes key processes of care where physicians may interact with AL/RC operators, staff, and residents, including care planning, managing Alzheimer’s disease and related conditions, medication management, and end-of-life planning. Communication and collaboration between physicians and AL/RC operators are a crucial component of care management.
Linked Lives and Childhood Experience of Family Death on Educational Attainment
Authors: Patterson Sarah E. , Verdery Ashton M. , Daw Jonathan
Published: December 2020

Sociological theory and research suggest that experiencing family members’ deaths during childhood and adolescence is an important event subject to significant disparities. Previous research links immediate family members’ deaths to poor life outcomes, but it considers a limited set of family members and has not tested the association of family member death with educational attainment. In this study the authors estimate the rates and educational impacts of experiencing the deaths of immediate (siblings, parents) and extended (aunts and uncles, cousins, and grandparents) family members during childhood and adolescence for black and white Americans. The authors find that family death is associated with educational attainment, but the associations differ by family member type and gender and child’s race. Experiences of family death are unequally distributed by race and demonstrate complex associations with educational attainment. This research broadens life-course and family-systems theory by incorporating childhood family experiences of death on adult educational attainment and stratification.
Amalgam Phase-Down Part 1: UK-Based Posterior Restorative Material and Technique Use
Authors: Bailey O. , Vernazza C.R. , Stone S. , Ternent L. , Roche A.-G. , Lynch C.
Published: December 2020

Introduction:

A European Union amalgam phase-down has recently been implemented. Publicly funded health care predominates in the United Kingdom with the system favoring amalgam use. The current use of amalgam and its alternatives has not been fully investigated in the United Kingdom.

Objectives:

The study aimed to identify direct posterior restorative techniques, material use, and reported postoperative complication incidence experienced by primary care clinicians and differences between clinician groups.

Methods:

A cross-sectional survey was distributed to primary care clinicians through British dentist and therapist associations (11,092 invitations). The questionnaire sought information on current provision of direct posterior restorations and perceived issues with the different materials. Descriptive statistical and hypothesis testing was performed.

Results:

Dentists’ response rate was 14% and therapists’ estimated minimum response rate was 6% (total N = 1,513). The most commonly used restorative material was amalgam in molar teeth and composite in premolars. When placing a direct posterior mesio-occluso-distal restoration, clinicians booked on average 45% more time and charged 45% more when placing composite compared to amalgam ( P < 0.0001). The reported incidences of food packing and sensitivity following the placement of direct restorations were much higher with composite than amalgam ( P < 0.0001). Widely recommended techniques, such as sectional metal matrix use for posterior composites, were associated with reduced food packing ( P < 0.0001) but increased time booked ( P = 0.002).

Conclusion:

Amalgam use is currently high in the publicly funded sector of UK primary care. Composite is the most used alternative, but it takes longer to place and is more costly. Composite also has a higher reported incidence of postoperative complications than amalgam, but time-consuming techniques, such as sectional matrix use, can mitigate against food packing, but their use is low. Therefore, major changes in health service structure and funding and posterior composite education are required in the United Kingdom and other countries where amalgam use is prevalent, as the amalgam phase-down continues.

Knowledge Transfer Statement:

This study presents data on the current provision of amalgam for posterior tooth restoration and its directly placed alternatives by primary care clinicians in the United Kingdom, where publicly funded health care with copayment provision predominates. The information is important to manage and plan the UK phase-down and proposed phase-out of amalgam and will be of interest to other, primarily developing countries where amalgam provision predominates in understanding some of the challenges faced.
How multi-optional experts maintain and enhance their employability
Authors: Ruiner Caroline , Liebhart Ursula
Published: December 2020

How do freelancers and workers with frequently changing employment relationships top up their know-how and make themselves more employable? Highly skilled experts with multiple employment options must stay ahead of the game as they move from one job to market themselves for the next one. This article analyses how multi-optional experts improve their employability. It is based on a qualitative study of 17 multi-optional experts in knowledge-intensive industries such as information technology (IT), the media and consultancy as flexible employment is increasing and employability is critical in these highly dynamic fields. The study shows that multi-optional experts maintain and enhance their employability with various, mainly informal and self-organised learning methods. It identifies four types of worker – Flexible Adapter, Flexible Independent, Permalancer and Independent Freelancer – whose vocational development includes reactive, organisation-focused, active and self-focused strategies. In order to contribute to a better understanding of multi-optional experts’ employability this article focuses on their strategies, particularly on how they select and combine learning methods, and examines their motives to enhance their further development.
“You are not my boss!”: Managing inter-organizational collaboration in German ground handling operations
Authors: Ziehe Dominique , Helfen Markus
Published: December 2020

While inter-organizational coordination among firms in networks has become a widespread phenomenon and the governance of inter-organizational networks has garnered considerable attention in the management literature, the repercussions of the network form for managing and organizing work remain a considerable gap in the literature. Building on Gittell’s concept of relational coordination, we explore the inter-organizational work collaboration in four German airports’ ground handling operations. By zooming-in on ramp agents’ boundary spanning work role, our comparative study illustrates whether and how a collaboration in inter-organizational work processes is brought about in practice. Our findings reveal the various practices ramp agents deploy in order to handle the tensions emerging from divergent organizational jurisdictions and the requirements for collaboration. We also illuminate how the field-level context influences inter-organizational collaboration by setting conditions such as workload and time restrictions in distributed service delivery.
Intraoperative Sentinel Events in the Era of Surgical Safety Checklists: Results of a National Survey
Authors: Cramer John D. , Balakrishnan Karthik , Roy Soham , David Chang C. W. , Boss Emily F. , Brereton Jean M. , Monjur Taskin M. , Nussenbaum Brian , Brenner Michael J.
Published: December 2020

Objective

Despite the implementation of advanced health care safety systems including checklists, preventable perioperative sentinel events continue to occur and cause patient harm, disability, and death. We report on findings relating to otolaryngology practices with surgical safety checklists, the scope of intraoperative sentinel events, and institutional and personal response to these events.

Study Design

Survey study.

Setting

Anonymous online survey of otolaryngologists.

Methods

Members of the American Academy of Otolaryngology–Head and Neck Surgery were asked about intraoperative sentinel events, surgical safety checklist practices, fire safety, and the response to patient safety events.

Results

In total, 543 otolaryngologists responded to the survey (response rate 4.9% = 543/11,188). The use of surgical safety checklists was reported by 511 (98.6%) respondents. At least 1 patient safety event in the past 10 years was reported by 131 (25.2%) respondents; medication errors were the most commonly reported (66 [12.7%] respondents). Wrong site/patient/procedure events were reported by 38 (7.3%) respondents, retained surgical items by 33 (6.4%), and operating room fire by 18 (3.5%). Although 414 (79.9%) respondents felt that time‐outs before the case have been the single most impactful checklist component to prevent serious patient safety events, several respondents also voiced frustrations with the administrative burden.

Conclusion

Surgical safety checklists are widely used in otolaryngology and are generally acknowledged as the most effective intervention to reduce patient safety events; nonetheless, intraoperative sentinel events do continue to occur. Understanding the scope, causes, and response to these events may help to prioritize resources to guide quality improvement initiatives in surgical safety practices.
The Role of Students, Educators, and Educational Institutes in Entrepreneurship Education: A Systematic Literature Review and Directions for Future Research
Authors: Schuhmacher Monika C. , Thieu Hieu T.
Published: December 2020

Based on previous reviews, we have a synthesized understanding of the how and what to teach in entrepreneurship education (EE). In contrast, we find fragmented and differing insights on the who in EE (i.e., the triad of internal stakeholders of students, educators and educational institutes hosting EE). Inspired by stakeholder theory, our study presents a systematic literature review on the role of stakeholder-related factors for effective EE. Specifically, based on 59 empirical articles published between 1995 and 2019, we provide an overview on the current state of literature on the role of stakeholder-related factors in EE research, synthesize findings, identify research gaps and develop a future research agenda as well as derive implications for the design and implementation of EE. In doing so, we provide a theoretical perspective to stimulate future research on stakeholder-related factors for EE to be effective.
Modified manual small incision cataract surgery technique for phacoemulsification-trained surgeons
Authors: Ting Darren S. J. , Chua Daniel , May Khin Oo , Aung Mya , Kumar Ashish , Farook Mohamed , Htoon Hla M. , C. A. Sng Chelvin , Ang Marcus
Published: December 2020

Purpose:

To present the technique and outcomes of a modified manual small incision cataract surgery designed for the phacoemulsification surgeons who are learning to perform manual small incision cataract surgery.

Methods:

This was a retrospective, single-centred, comparative study. We included all the patients who underwent the modified manual small incision cataract surgery for visually significant cataract at Singapore National Eye Centre. All surgeries were performed by either a senior phaco-trained surgeon (M.A.) who had performed more than 500 manual small incision cataract surgery or a junior phaco-trained surgeon (D.C.) who had performed around 500 phacoemulsification but never performed any manual small incision cataract surgery. The main modification of this technique lies in the creation of an additional phaco-like main wound at 90° to the scleral tunnel wound, with most surgical steps performed through this additional wound. The outcomes were analysed and compared between the senior and junior surgeons. The main outcome measures were visual outcome and major intraoperative complications such as posterior capsular rupture and zonular dialysis.

Results:

A total of 132 cases were included; 102 (77.3%) and 30 (22.7%) cases were performed by the senior and junior surgeons, respectively. Pre-operatively, 85.6% eyes had best-corrected visual acuity of counting fingers or worse. Postoperatively, the visual outcome at 1 month was similar between the senior and junior surgeons, with 68.7% eyes achieving a best-corrected visual acuity of ⩾6/12 ( p = 0.17). No posterior capsular rupture, zonular dialysis or endophthalmitis was observed during the study period.

Conclusions:

This modified technique may serve as a useful transition technique for the phaco-trained surgeons to develop skills in manual small incision cataract surgery, with demonstrable good visual outcome and safety.
Utilization of Time Series Tools in Life-sciences and Neuroscience
Authors: Gujral Harshit , Kushwaha Ajay Kumar , Khurana Sukant
Published: December 2020

Time series tools are part and parcel of modern day research. Their usage in the biomedical field; specifically, in neuroscience, has not been previously quantified. A quantification of trends can tell about lacunae in the current uses and point towards future uses. We evaluated the principles and applications of few classical time series tools, such as Principal Component Analysis, Neural Networks, common Auto-regression Models, Markov Models, Hidden Markov Models, Fourier Analysis, Spectral Analysis, in addition to diverse work, generically lumped under time series category. We quantified the usage from two perspectives, one, information technology professionals’, other, researchers utilizing these tools for biomedical and neuroscience research. For understanding trends from the information technology perspective, we evaluated two of the largest open source question and answer databases of Stack Overflow and Cross Validated. We quantified the trends in their application in the biomedical domain, and specifically neuroscience, by searching literature and application usage on PubMed. While the use of all the time series tools continues to gain popularity in general biomedical and life science research, and also neuroscience, and so have been the total number of questions asked on Stack overflow and Cross Validated, the total views to questions on these are on a decrease in recent years, indicating well established texts, algorithms, and libraries, resulting in engineers not looking for what used to be common questions a few years back. The use of these tools in neuroscience clearly leaves room for improvement.