bluuebunny/crossref_metadata_2025 huggingface dataset:
The dancefloor is now open: A dispositional analysis of the glocalization and sportification of Chinese DanceSport
Authors: Dai Shushan , Newman Joshua I , Xue Hanhan , Du James
Published: October 2021

In recent decades, the political, economic, and social environment in the Peoples’ Republic of China has opened up to inflows of commerce and culture from around the world. Consequently, the physical cultural practices within China have undergone a double-dialectical shift—whereby performing bodies now influence, and are influenced by, a shifting body politic (e.g. sport and physical activity practices opening up to global markets and brands, transnational trade, and post-socialist political alignments, etc.) and also where the body politic has mutated as a result of, and to constitute, inflows and outflows of global capital, culture, and polity (e.g. cosmopolitan consumer culture, Westernization, etc.). In this article, we examine this double dialectic as a form of government within the performances, aesthetics, choreographies, and administration of Chinese DanceSport. DanceSport, a competitive and structured—arguably “sportified”—form of international dance, has in recent years supplanted traditional Chinese dance as the most popular form of dance in the Peoples’ Republic. Using Foucauldian Discourse Analysis, we examine the operational and administrative discourses within the sport to explicate how organizational and governing bodies have constructed regimes of conduct through which dancers and dance performances might conform to, and negotiate, prevailing glocalized cultural physicalities. The results invite further analysis into how Chinese DanceSport has become increasingly, and perhaps paradoxically, more regulated and codified with respect to how “the West” is performed on the dance floors of China.
Building Partnerships and Trust: Research With Vulnerable Immigrant Communities
Authors: Huslage Melody , Rai Abha , Held Mary Lehman
Published: October 2021

Stress and distress among immigrant communities in the United States have escalated under the recent sociopolitical climate (e.g., exclusionary federal policies, COVID-19), underscoring the urgent need for additional data to better understand immigrant experiences. Yet, the very stressors that generate this need for data also create fear and trust-related barriers that might impede research success. Barriers, including a lack of trust, power differentials, language differences, and varying cultural norms, negatively impact the collection of valid data. Recommendations to address these barriers are provided, and integration of such strategies is an essential step toward growing the knowledge base of the profession, delivery of evidence-based interventions with immigrant clients, and better-informed discussions of culturally responsive approaches in social work education and practice.
Family Caregiver Experience of Resistance to Care: Occurrence Patterns, Context, and Impact on Caregiver
Authors: Shirai Yumi , Koerner Susan Silverberg , Xu Shuo
Published: October 2021

Although the extant literature identifies resistance to care (RTC) as one of the most frequently reported and impactful caregiver (CG) stressors, typical studies that rely on quantitative measures of RTC do not fully explain how and why RTC negatively influences CGs’ well-being. As such, it is difficult to develop specific intervention strategies to support CGs in dealing with RTC. Informed by existing literature and tenets from Stress Theory, the current study includes semi-structured interviews with 19 family CGs of community-dependent (non-institutionalized) elders, regarding their RTC experiences. Through a directed qualitative content analysis, we explored occurrence patterns, contextual factors of when and how RTC occurs, how CGs respond to RTC, and its potential impact on CGs’ subjective stress. The results revealed distinguishable characteristics of four types of RTC: Frequent-Pervasive, Frequent-Delimited, Transition-Activated, and Shock-to-Unfamiliar/Unexpected. We discuss how recognition of those types of RTC can be integrated into CG support intervention strategies.
Hemodynamic Effects of Ketamine Compared With Propofol or Dexmedetomidine as Continuous ICU Sedation
Authors: Atchley Evan , Tesoro Eljim , Meyer Robert , Bauer Alexia , Pulver Mark , Benken Scott
Published: October 2021

Background

Ketamine has seen increased use for sedation in the intensive care unit. In contrast to propofol or dexmedetomidine, ketamine may provide a positive effect on hemodynamics.

Objective

The objective of this study was to compare the development of clinically significant hypotension or bradycardia (ie, negative hemodynamic event) between critically ill adults receiving sedation with ketamine and either propofol or dexmedetomidine.

Methods

This was a retrospective cohort study of adults admitted to an intensive care unit at an academic medical center between January 2016 and January 2021.

Results

Patients in the ketamine group (n = 78) had significantly less clinically significant hypotension or bradycardia compared with those receiving propofol or dexmedetomidine (n = 156) (34.6% vs 63.5%; P < 0.001). Patients receiving ketamine also experienced smaller degree of hypotension observed by percent decrease in mean arterial pressure (25.3% [17.4] vs 33.8% [14.5]; P < 0.001) and absolute reduction in systolic blood pressure (26.5 [23.8] vs 42.0 [37.8] mm Hg; P < 0.001) and bradycardia (15.5 [24.3] vs 32.0 [23.0] reduction in beats per minute; P < 0.001). In multivariate logistic regression modeling, receipt of propofol or dexmedetomidine was the only independent predictor of a negative hemodynamic event (odds ratio [OR]: 3.3, 95% confidence interval [CI], 1.7 to 6.1; P < 0.001).

Conclusion and Relevance

Ketamine was associated with less clinically relevant hypotension or bradycardia when compared with propofol or dexmedetomidine, in addition to a smaller absolute decrease in hemodynamic parameters. The clinical significance of these findings requires further investigation.
Family Resilience and Parental Stress in Families of Children with Autism
Authors: Cheatham Kelly L. , Fernando Delini M.
Published: October 2021

In this quantitative study, we examined relationships among family resilience, gender, and parental stress in a sample of 71 parents of young children with autism. Although findings from multiple regression and correlational analyses indicated significantly higher parental stress levels in parents of children with autism, mothers demonstrated higher levels of stress than fathers. Five family resiliency factors, including family communication and problem solving, utilizing social and economic resources, family connectedness, family spirituality, and ability to make meaning of adversity were shown to contribute significantly to parental stress. We provide explanations of these findings and present clinical and research implications.
Waste Pickers and Their Practices of Insurgency and Environmental Stewardship
Authors: Gutberlet Jutta , Sorroche Santiago , Martins Baeder Angela , Zapata Patrik , Zapata Campos María José
Published: October 2021

Informed by different grassroots learning and educational practices engaged in waste management, and drawing from the concepts of insurgent citizenship and environmental stewardship, we examine the role of waste picker organizations and movements in creating new pathways towards more sustainable environmental waste governance. Two case studies (Argentina and Brazil) demonstrate how waste pickers inform and educate the general public and raise the awareness of socio-environmental questions related to waste management. Different educational practices are used as strategies to confront citizens with their waste: to see waste as a consumption problem, resource, and income source. Our paper draws on grassroots learning (social movement learning and insurgent learning) and education (stewardship) aimed at the transformation of waste practices. We argue that waste pickers play an important role in knowledge production promoting recycling, in landfilling less and recovering more resources. We conclude that waste pickers act as insurgent citizens and also are environmental stewards.
Age Under 30 Years As a Predictor of Poor Survival in a Cohort of Mexican Women With Breast Cancer
Authors: Alvarez-Bañuelos María T. , Segura-Jaramillo Kevin A. , Gómez-Rivera Elba del C. , Alarcón-Rojas Carlos A. , Morales-Romero Jaime , Sampieri Clara L. , Guzmán-García Raúl E.
Published: October 2021

Introduction

Young women under 30 years with breast cancer (BC) are an emerging challenge. The purpose is to identify prognostic factors for survival in young women under 30 years of age with BC.

Material and methods

A retrospective cohort study was conducted among women younger than or equal to 40 years with BC and who were treated at the State Cancer Center during the period 2012–2017. Overall survival was assessed using the Kaplan–Meier method and the log-rank test. Univariate and multivariate analysis assessed survival predictors using Cox proportional hazards regression model.

Results

282 young women were included. The >30-year-old subgroup showed a significant association with excess weight ( P = .002) compared to the <30-year-old group. The <30-year-old subgroup showed a poor overall survival (56.7%), as well as highly significant values in advanced clinical stages, metastatic nodules, metastasis, and neoadjuvant therapy ( P < .001). In Model 3 of the multivariate analysis, age <30 years (HR = 3.0; 95% CI 1.1 to 8.6), triple negative subtype (HR = 2.6; 95% CI 1.1 to 6.0), tumor size >5 cm HR = 2.3; 95% CI 1.03 to 5.1), and advanced clinical stages (HR = 6.6 95% CI 1.3 to 35.5) persisted as predictors.

Conclusions

Being very young (<30 years) is a predictor for limited survival compared to the age of 30–40 years, as well as the tumor covariates for a worse prognosis: triple negative subtype, advanced stages, positive lymph nodes, and distant metastases in liver.
Removal of Cadmium, Copper, and Lead From Water Using Bio-Sorbent From Treated Olive Mill Solid Residue
Authors: Mahmoud Enas N , Fayed Fidaa’ Y , Ibrahim Khalil M , Jaafreh Sawsan
Published: October 2021

Olive Mill Solid Residue (OMSR) can be utilized as a bio-sorbent in wastewater treatment. Even though several studies on OMSR as a bio-sorbent were carried out, there is still a need to investigate a simple and relatively inexpensive OMSR treatment that increases pollutant removal. In this study; OMSR is used in batch experiments to remove toxic heavy metals from aqueous solutions including Cd2+, Cu2+, and Pb2+ ions. The effect of OMSR treatment (untreated; OMSR-U, treated with n-hexane; OMSR-H, and treated with water; OMSR-W) was investigated by chemical oxygen demand and cation exchange capacity. It was confirmed by both tests that OMSR-W was the best treatment. The same result was re-confirmed by batch uptake experiments of the heavy metal ions. Using OMSR-W as a bio-sorbent; the effect of several parameters such as pH, contact time, bio-sorbent concentration, metal ions concentration, and the presence of other metal species were studied to figure their influence on the metal ions uptake. The optimum conditions for single metal systems were found to occur at pH 5.5, an initial metal concentration of 50 mg/L, a shaking time of 60 minutes, a bio-sorbent concentration of 20 g/L. In binary metal ions solutions; Cd2+ uptake was increased in presence of Cu2+ or Pb2+. However, the uptake of Cu2+ and Pb2+ was decreased in presence of other metals. The equilibrium sorption data for single metal systems were described by the Langmuir isotherm model. The highest value of maximum uptake was found for Pb2+ (4.587 mg/g) followed by Cd2+ (4.525 mg/g) and Cu2+ (4.367 mg/g). These results show that OMSR-W, which has a very low economical value, could be used for the treatment of wastewater contaminated with heavy metals.
Maternal Satisfaction With Delivery Services and its Associated Factors Among Mothers Who Gave Birth at Public Health Centers in Yeka Sub City, Addis Ababa, Ethiopia
Authors: Eziawdres Daniel , Worku Walelegn , Taye Molla
Published: October 2021

This study aimed to assess maternal satisfaction and associated factors with delivery care services uptake among mothers who gave birth at public health centers. An institution-based cross-sectional study was conducted in the Yeka Sub-City in Addis Ababa, Ethiopia. A systematic sampling technique was used to select mothers. Bivariable and multivariable analysis was done to identify associated variables. The overall mothers’ satisfaction with delivery care services uptake was 63%. The median age of the participants was 28 years. In multivariable analysis privacy measures taken at delivery care services uptake, mothers’ education level, occupational status of mothers, and family income level of mothers were associated with mothers’ satisfaction in delivery care services. Mother’s income levels of 1501 to 5000 birr were satisfied with the service (AOR = 2.49; 95% CI: 1.3, 4.76). However, mothers whose income below1500 birr were dissatisfied. In conclusion, a mother’s educational level, occupational status, and family income affect mothers’ satisfaction with delivery care services uptake in public health centers, in the Yeka Sub-City. Evaluating health care services uptake from the client’s point of view and targeting to identify problems is very necessary.
Just a Flu? Self-perceived infection mediates the link between conspiracy beliefs and Covid-19 health beliefs and behaviors
Authors: van Prooijen Jan-Willem , Etienne Tom W , Kutiyski Yordan , Krouwel André PM
Published: October 2021

The Covid-19 pandemic has inspired many conspiracy theories, which are associated with detrimental health beliefs and behaviors (e.g. reduced physical distancing; decreased vaccination intentions). We propose a previously unrecognized mediator of these relationships: A self-perceived likelihood to already have experienced a Covid-19 infection. Results from a large sample ( N = 9033) revealed that self-perceived infections mediated the link between conspiracy beliefs and health beliefs and behaviors. These findings emerged independently of institutional distrust, and actual infections as indicated by a positive medical test. These findings suggest that conspiracy beliefs shape people’s interpretation of the physical signals of their own body.
Simulation and experiment analysis of relationship between voids and permeability of composites
Authors: Guan Chenglong , Zhan Lihua , Shi Hanqiao , Dai Guangming , Xiao Yu
Published: October 2021

Due to the significant weight reduction advantage, aerospace composite tanks have become the focus of international competition of spacecraft. However, the permeation of small molecules at low temperature caused by the internal voids of composites is one of the key technical problems which restrict the engineering application of composite tanks. In this study, a combination of theoretical research and experimental research was adopted. By changing the curing pressures of the composites’ autoclave process, laminates with different porosities were prepared and tested for low-temperature permeability. Based on the grayscale processing and median filtering methods, a permeability prediction model with the true voids morphology of composite materials was established. Based on the random medium theory, the random voids model of composites was built to study the effect of void size and shape on the permeability of laminates. The results showed that the finite element analysis of composites, permeability based on the real voids morphology model was in good agreement with the experimental results, which proved the feasibility of this method. The permeation rate of laminates increased with the raised of porosity, and the internal porosity of the laminates could be diminished by improving the curing pressure so as to reduce the permeation of the composite components. Under the condition of a certain porosity, the laminates with small, stripe voids had a higher permeation rate than the laminates with large, circular voids.
Digitally shaped ethnographic relationships during a global pandemic and beyond
Authors: Kim Jaymelee J , Williams Sierra , Eldridge Erin R , Reinke Amanda J
Published: October 2021

Social distancing and public safety measures enacted in response to COVID-19 created a surge in methodological “advice” for researchers facing disruption to fieldwork. Resources and publications frequently encouraged changes vis-a-vis digitally enhanced methods or employment of digital ethnography. For ethnographers, the establishment and maintenance of ethnographic relationships in pandemic contexts restricted to virtual interactions has not been thoroughly explored, leaving those trained in recruitment, rapport-building, and field engagement with fewer resources to navigate this integral topic. Here, we provide insights into how ethnographic relationships may be developed when there is limited access to the field and traditional relationship building is not possible. We argue that as ethnographic methods change and adapt, so too must perspectives on ethnographic relationship development. By closely examining ethnographic relationships confined to digital spaces in the context of the Tennessee tornado recovery amid the COVID-19 pandemic, this project sheds light on how to overcome this challenge.
A Model of an Integrative Approach to Breast Cancer Patients
Authors: Rossi Cristina , Maggiore Claudia , Rossi Maria Maddalena , Filippone Alessio , Guarino Donatella , Di Micco Annalisa , Forcina Luana , Magno Stefano
Published: October 2021

Background:

Breast cancer (BC) survivors have physical and psychological needs that require convincing responses by health care providers. The quality of life issue and clinical unmet needs are among the main reasons pushing a number of patients toward “natural” therapies that are often misleading and alternative to mainstream cancer care. Integrative Oncology (IO) tries to respond to many of those needs, by combining lifestyle counseling, body-mind activities, and complementary evidence-informed therapies with anticancer standard treatments.

Methods:

In our model at Fondazione Policlinico Gemelli (FPG), every woman diagnosed with a BC waiting for surgery or candidate to neoadjuvant chemotherapy undergoes a preliminary psycho-oncological distress evaluation and a brief lifestyle interview. Anthropometric measurements, body composition analysis, and individual levels of physical activity are recorded. Patients are given evidence based recommendations about the advisable diet and physical activity in a prehabilitation setting. A physician provides patients with information about integrative care plans to treat symptoms related to the disease or its treatments. Therapeutic approaches include acupuncture, mindfulness-based protocols, qigong, massage therapy, and classes of music/art therapy.

Results:

Between September 2018 and February 2020, the Center for Integrative Oncology at FPG has carried out 1249 lifestyle counseling sessions, 1780 acupuncture treatments, 1340 physiotherapy sessions, 3261 psycho-oncological consultations, 218 herbal medicine counseling sessions. Moreover, 90 BC patients completed the mindfulness based stress reduction (MBSR) protocol and 970 patients participated in qigong, art therapy, and music therapy classes.

Conclusions:

Our integrative approach aims to achieve a person-centered medicine by improving symptoms management, adherence to oncological protocols, and eventually overall quality of life.
Traditional Herbal Medicine, Sipjeondaebo-Tang, for Cancer-Related Fatigue: A Randomized, Placebo-Controlled, Preliminary Study
Authors: Lee Jee Young , Kim Eun Hye , Yoon Jee-Hyun , Eo Wankyu , Yoon Seong Woo
Published: October 2021

Purpose:

Sipjeondaebo-tang (SDT) is a widely used traditional herbal medicine for relieving fatigue. This randomized, placebo-controlled, preliminary study evaluated SDT for cancer-related fatigue, which is the most common symptom experienced by patients with cancer.

Patients and Methods:

Patients with a Brief Fatigue Inventory (BFI) score of at least 4 were randomly assigned in a double-blinded manner to receive SDT (3 g 3 times daily) or placebo orally for 3 weeks. The BFI was the primary outcome measure and secondary outcome measures included the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC QLQ-C30), immunoregulatory tests, and safety.

Results:

A total of 50 participants were randomly assigned and 48 patients completed the trial. Based on intention-to-treat analysis, fatigue, which was the primary outcome, was improved in both arms compared with the baseline, and was significantly better in the SDT group than in the placebo group at week 3 (3.56 ± 1.18 vs 4.63 ± 1.83, P = .019). Secondary outcomes, including anxiety, depression, and immunoregulatory tests, did not improve significantly in either group. However, quality of life measured using the EORTC QLQ-C30 improved in both arms compared with the baseline, and the global health subscale was significantly better in the SDT group than in the placebo group ( P = .02). No significant toxicities were observed.

Conclusion:

SDT may improve cancer-related fatigue and quality of life in patients with cancer. A further randomized clinical trial with large sample size is warranted.
Arousal and Consciousness in Focal Seizures
Authors: Blumenfeld Hal
Published: October 2021

Impaired consciousness during seizures severely affects quality of life for people with epilepsy but the mechanisms are just beginning to be understood. Consciousness is thought to involve large-scale brain networks, so it is puzzling that focal seizures often impair consciousness. Recent work investigating focal temporal lobe or limbic seizures in human patients and experimental animal models suggests that impaired consciousness is caused by active inhibition of subcortical arousal mechanisms. Focal limbic seizures exhibit decreased neuronal firing in brainstem, basal forebrain, and thalamic arousal networks, and cortical arousal can be restored when subcortical arousal circuits are stimulated during seizures. These findings open the possibility of restoring arousal and consciousness therapeutically during and following seizures by thalamic neurostimulation. When seizures cannot be stopped by existing treatments, targeted subcortical stimulation may improve arousal and consciousness, leading to improved safety and better psychosocial function for people with epilepsy.
Transforming Conflict Narratives
Authors: Fisher-Yoshida Beth , Lopez Joan C.
Published: October 2021

Narratives, both personal and social, guide how we live and how we are acculturated into our social worlds. As we make changes in our lives, our personal stories change and, in turn, have the potential to influence the social narratives of which we are a part. Likewise, when there are changes in the culture and social worlds around us, that social narrative changes, thereby affecting our personal narratives. In other words, personal and social narratives are strongly linked and mutually influence each other. We may feel and know these transformations take place and understand the ways in which our lives are affected. However, we often struggle to document these shifts. This article suggests using the practical theory, Coordinated Management of Meaning (CMM) (Pearce, 2007), for narrative analysis to identify and surface personal and social narrative transformations.
Religious Experience and Clinical-EEG Aspects in Adult People with Epilepsy
Authors: Tedrus Gloria M. A. S. , Vargas Letícia M. , Rodrigues Karen G.
Published: October 2021

Spirituality and religiosity are complex cognitive phenomena; however, the relationship between spiritual experiences and epilepsy continues to be debated. Methods. Data from the daily spiritual experience scale (DSES) were related to EEG data and clinical variables of 100 adult people with epilepsy (PWEs). DSES scores were compared to 51 normal individuals (control group [CG]), with a significance level of P < .05. Results. The total score in the DSES was 36.1 ± 14 and 37.6 ± 13.2, respectively, in the PWEs and in the CG. In the PWEs, there was a correlation between DSES and age (Pearson's correlation; −0.22; P = .027) and educational level (0.207; P = .039). PWEs with ≥one seizure/month have a lower frequency of daily spiritual experiences than those with better controlled seizures ( T-test; 39.2 ± 16.2 vs 31.7 ± 7.6; P = .038). EEG epileptiform activity (EA) in the right hemisphere was associated with a higher frequency of spiritual experiences than those with left-hemisphere EA (29.8 ± 9.0 vs 38.5 ± 17.5; P = .010). Conclusion. Demographic aspects, EA in the right hemisphere, and lower seizure frequency are associated with daily spiritual experiences in epilepsy, suggesting an association between aspects of spirituality, epilepsy, and neurobiological correlates.
Personal effects of the SARS-CoV-2 pandemic in Japan: The toughest triage
Authors: Tanaka Michihiro
Published: October 2021

The Japan healthcare system is considered as one of the world's finest. However, medical facilities across Japan are struggling to cope with the recent surge in novel coronavirus infections, leaving the medical care system in many areas on the brink of collapse. Physician burnout was already a growing problem, and the coronavirus disease 2019 pandemic has only made it worse. The personal impact of coronavirus disease 2019 in Japan is reported.
How ageing and blindness affect egocentric and allocentric spatial memory
Authors: Ruggiero Gennaro , Ruotolo Francesco , Iachini Tina
Published: October 2021

Egocentric (subject-to-object) and allocentric (object-to-object) spatial reference frames are fundamental for representing the position of objects or places around us. The literature on spatial cognition in blind people has shown that lack of vision may limit the ability to represent spatial information in an allocentric rather than egocentric way. Furthermore, much research with sighted individuals has reported that ageing has a negative impact on spatial memory. However, as far as we know, no study has assessed how ageing may affect the processing of spatial reference frames in individuals with different degrees of visual experience. To fill this gap, here we report data from a cross-sectional study in which a large sample of young and elderly participants (160 participants in total) who were congenitally blind (long-term visual deprivation), adventitiously blind (late onset of blindness), blindfolded sighted (short-term visual deprivation) and sighted (full visual availability) performed a spatial memory task that required egocentric/allocentric distance judgements with regard to memorised stimuli. The results showed that egocentric judgements were better than allocentric ones and above all that the ability to process allocentric information was influenced by both age and visual status. Specifically, the allocentric judgements of congenitally blind elderly participants were worse than those of all other groups. These findings suggest that ageing and congenital blindness can contribute to the worsening of the ability to represent spatial relationships between external, non-body-centred anchor points.
Opponensplasty using the extensor indicis proprius tendon for severe carpal tunnel syndrome in 40 patients
Authors: Matsuki Hiroyuki , Nakatsuchi Yukio , Momose Toshimitsu
Published: October 2021

The aim of this study was to assess the clinical results after extensor indicis proprius opponensplasty in patients with carpal tunnel syndrome and severe thenar muscle atrophy. Forty patients who underwent this procedure during open carpal tunnel releases. The mean follow-up period was 17 months (range 10 to 36). Kapandji scores significantly improved from 5.5 before surgery to 9.6 at final follow-up. Thumb pronation angle also significantly improved from 111° before surgery to 149°. Side and pulp pinch strength significantly improved postoperatively, as well as DASH scores at final follow-up. In conclusion, the extensor indicis proprius tendon transfer technique represents a reliable opponensplasty procedure to achieve consistent results in patients with severe carpal tunnel syndrome.

Level of evidence: IV
Outcomes and recommendations for revision of thumb carpometacarpal resection arthroplasty
Authors: Herren Daniel B. , Fuchs Nina , Schindele Stephan , Marks Miriam
Published: October 2021

This study investigated revision surgery for the thumb after failed trapeziectomy with ligament reconstruction and tendon interposition and defined a revision concept. Twenty-four patients with 25 affected thumbs were examined at a mean of 5.5 years after their last revision operation. Pain during daily activities was 2.7 on a 0–10 numeric rating scale, pain at rest was 1.6 and the brief Michigan Hand Outcomes Questionnaire score was 63. Although 68% of patients indicated that their thumb was better than before primary surgery, the outcome after revision surgery was less favourable than that reported for primary trapeziectomy with ligament reconstruction and tendon interposition. We defined a revision algorithm to use as a guide for patients with residual symptoms after resection arthroplasty. The main reason for revision, symptomatic impingement of the thumb metacarpal, should be treated with resection of the metacarpal base and scaphotrapezoidal joint. An existing interposition should be revised, or a new interposition should be used, preferably with an autologous tendon or alternately with an allograft.

Level of evidence: IV
Troubling the Troublemakers: Three Challenges to Post-Qualitative Inquiry
Authors: Aagaard Jesper
Published: October 2021

In recent years, a number of prominent scholars have criticized the current state of qualitative research and advocated a paradigm of post-qualitative inquiry (PQI). Incorporating insights from new materialism, PQI seeks to trouble what it calls conventional humanist qualitative methodology (CHQM). Although sympathetic to this overall project, the present article identifies and discusses three challenges in current PQI, namely the roles it ascribes to theory, to data, and to writing. It is argued that PQI risks succumbing to 1) theory-centrism, 2) researcher deletion, and 3) meta-reflexivity. By pinpointing these three challenges, the article hopes to nudge PQI one step further in its continuous theoretical “becoming.”
Relationship Between Pitch Volume and Subjective Report of Injury in High School Female Fast-Pitch Softball Pitchers
Authors: Gooch Brittany , Lambert Bradley S. , Goble Haley , McCulloch Patrick C. , Hedt Corbin
Published: October 2021

Background:

The relationship between pitch volume and injury is well-represented within baseball literature. However, the impact of softball pitch volume on injury epidemiology is limited.

Hypothesis:

The purpose was to determine if increased pitch volumes in high school–aged softball pitchers are related to increased rates of subjectively reported pain/injury. We hypothesized that pitchers with increased volumes would have higher pain/injury rates.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 4.

Methods:

A total of 28 female softball pitchers (aged 14-18 years) completed an online survey of questions pertaining to pitching history, pitch volume, and subjective report of pain or injury in the back, shoulder, and elbow. An independent-samples t test was used to (1) compare pitch volumes in those who reported pain in individual body regions (shoulder, elbow, back) compared with those who did not; (2) compare pitch volumes in those who reported pain in 0 or 1 of the regions of interest compared with 2 or 3 regions; and (3) compare the reported percentage of the past year that players reported playing through pain in players who averaged >85 compared with <85 pitches per game. Chi-square analysis was used to compare those who pitched either >85 or <85 pitches per game with regard to frequency of shoulder pain, elbow pain, back pain, seeking of medical attention, and actual injury diagnosis. Type I error was set at α = 0.05.

Results:

Weekly and yearly pitch counts were higher in those reporting pain or injury (YES) than those who did not (NO) in the shoulder (pitches per week: NO = 219 ± 35; YES = 429 ± 101; P = 0.027) (pitches per year: NO = 8876 ± 946; YES = 19,195 ± 4944; P = 0.022) and back (pitches per week: NO = 188 ± 16; YES = 426 ± 90; P = 0.014) (pitches per year: NO = 8334 ± 793; YES = 18,252 ± 4340; P = 0.027). Similar results were observed for those with pain or injury reported in 2 or 3 regions compared with 0 or 1 regions (pitches per week: NO = 220 ± 38; YES = 414 ± 95; P = 0.039) (pitches per year: NO = 8765 ± 1010; YES = 18,661 ± 4623; P = 0.028). Those reporting shoulder pain or injury also reported higher pitch counts per game (NO = 71.4 ± 5.2; YES = 83 ± 4; P = 0.049), and those reporting back pain also reported playing more games per week (NO = 2.7 ± 0.2; YES = 5.2 ± 1.1; P = 0.034). Those with pitch counts of >85/game were more than twice as likely to see a physician regarding pain/injury ( P = 0.027) and reported playing through pain a higher percentage of the year (>85, 49.3% ± 10%; <85, 25.2% ± 6%; P < 0.05).

Conclusion:

High pitching volumes commonly prevalent in high school–aged softball pitchers may be associated with increased pain/injury and appear related to cumulative volume.

Clinical Relevance:

This study provides recommendations for cumulative pitch volume guidelines in softball pitchers.
External Training Load and the Association With Back Pain in Competitive Adolescent Tennis Players: Results From the SMASH Cohort Study
Authors: Johansson Fredrik , Gabbett Tim , Svedmark Per , Skillgate Eva
Published: October 2021

Background:

In young tennis players, high loads on the spine and high training volumes in relation to age are associated with a high lifetime prevalence of back pain. The primary aim of this study was to investigate if accumulated external workload “spikes” in the acute:chronic workload ratio (ACWR) of tennis training, match play, and fitness training, and if high or low workload/age ratio were associated with back pain events in competitive adolescent tennis players. Additional aims were to report the incidence of back pain stratified by sex and level of play and to describe the characteristics of players with back pain.

Hypothesis:

Rapid increases in external workload are associated with the incidence of back pain.

Study Design:

Cohort study of 198 competitive tennis players, 13 to 19 years, with a weekly follow-up for 52 consecutive weeks.

Level of Evidence:

Level 3.

Methods:

Accumulated external workload spikes (uncoupled ACWR >1.3), and the workload/age ratio, were time-varying exposures in Cox regression analyses with the outcome back pain (pain intensity ≥2/10 in the lower back and/or in the upper back/neck with a pain-related disability).

Results:

For each additional workload spike in tennis training/match play, the hazard rate ratio (HRR) was 1.17 (95% CI, 1.06-1.28) for back pain. The corresponding HRR for fitness training was 1.13 (95% CI, 1.05-1.22). Training workload/age ratio was not related to back pain.

Conclusion:

Accumulated external workload spikes of tennis training, match play, and/or fitness training are associated with a higher rate of back pain events in competitive adolescent tennis players.

Clinical Relevance:

Back pain is a troublesome clinical problem that may affect the performance of talented young tennis players. Structuring the training schedule to minimize rapid increases (ie, spikes) of training load on a weekly basis may enhance performance and reduce back pain in adolescent tennis players.
Effect of the amount of correction on posterior tibial slope and patellar height in open-wedge high tibial osteotomy
Authors: Wu Keliang , Zeng Jianchun , Han Linjing , Feng Wenjun , Lin Xiaosheng , Zeng Yirong
Published: October 2021

Objectives: To evaluate the effect of amount of correction on postoperative changes in PTS (posterior tibial slope), PH (patellar height), and clinical outcomes following biplanar OWHTO (open-wedge high tibial osteotomy). Method: This study included 79 knees (32 left and 47 right) of 79 patients (mean age 60.28 ± 4.2 years, 24 males, 55 females) with varus malalignment and symptomatic isolated medial joint osteoarthritis who underwent OWHTO. According to the amount of correction angles, all patients were divided into three groups: LCA (large correction angle) group (>14°), MCA (medium correction angle) group (10°–14°), and SCA (small correction angle) group (<10°). All patients were clinically assessed according to the Lysholm score, HSS (hospital for special surgery knee score), and KSS (knee society score) prior to and after surgery. For radiographic analysis, we measured the PTS, PH [ISI (Insall-Salvati index), and BPI (Blackburne-Peel index)]. The pre-post difference of PTS, ISI, and BPI was calculated by subtracting the post-OWHTO value to the pre-OWHTO value in three groups, respectively. The preoperative, postoperative, and difference of PTS, ISI, and BPI values were analyzed according to the correction angle. The mean follow-up period was 28.5 months (SD, 4.9; range 18–52 months). Results: Radiologically, PTS increased and PH decreased after surgery on the whole ( p < .05). The relationship between amount of correction and slope increase is significant ( p < .001). Furthermore, the pairwise difference between the LCA group and SCA group and MCA group is significant respectively ( p < .05). In terms of PH, the LCA group yielded ISI and BPI that were significantly different from baseline for the SCA group and MCA group. In addition, the pairwise difference between the SCA group and LCA group in ISI and BPI is significant ( p = .031). Clinically, significant improvements were observed in postoperative clinical scores of the Lysholm score, HSS, and KSS ( p < .05). Seventy-four patients (93.67%) reported satisfaction with surgery. However, no correlation was found between changes in PTS and PH with postoperative knee score. No severe adverse complications were observed. Conclusions: The amount of correction angle is a significant factor affecting the PTS and PH in OWHTO. With increased correction angle, the likelihood of increasing the PTS and decreasing the PH increases. Special attention should be paid to keep PTS and PH unchanged in cases where large corrections are required. Otherwise, closing wedge osteotomy or other intraoperative effective measures are supposed to be adopted.
West Lake staging: A new staging system orchestrated by X-ray and MRI on knee osteoarthritis
Authors: Huang Jiaxin , Chen Xi , Xia Mengting , Lv Shuaijie , Tong Peijian
Published: October 2021

Purpose: To investigate the differences on X-ray and MRI among each stage of knee osteoarthritis (KOA) and further propose a new staging system called West Lake (WL) staging. Methods: A cross-sectional study was conducted on patients with KOA. Stage I, II, III, and IV were divided based on stepwise treatment strategy of Knee osteoarthritis (KOA). Joint space widths (JSW) were measured on X-rays, whereas cartilage injuries (CI) and bone marrow lesions (BML) were evaluated on MRI. The differences of them across the groups were calculated by T-test. Receiver operating characteristic (ROC) curves were rendered to obtain the areas under the curves (AUC), Youden index and corresponding cut-off points. Results: Eventually, there were significant differences on JSW, CI, and BML between stage II/III and III/IV, while no significant differences between stage I/II. In stage II/III, the AUC of JSW, CI, BML was 0.99, 0.76, 0.71 and the Youden index was 0.94, 0.38, 0.45, meanwhile the cut-off points were ≤5.1 mm, >1, >2. In stage III/IV, the AUC of JSW, CI, BML was 0.96, 0.79, 0.74 and the Youden index was 0.84, 0.58, 0.38, meanwhile the cut-off points were ≤3.2 mm, >3, >4. Conclusion: The WL staging was described as follows: Stage I, X-ray shows no joint space narrow, normal MRI or MRI shows cartilage degeneration and only 1 or 2 sections are involved in BML. Stage II, X-ray shows joint space narrow, MRI shows cartilage defect but no full-thickness cartilage defect, meanwhile 3 or 4 sections are involved in BML. Stage III, X-ray shows serious joint space narrow even JSW disappeared, MRI shows full-thickness cartilage defect, more than 4 sections are involved in BML.
Acromioclavicular Joint Separation in UEFA Soccer Players: A Matched-Cohort Analysis of Return to Play and Player Performance From 1999 to 2018
Authors: Diaz Connor C. , Forlenza Enrico M. , Lavoie-Gagne Ophelie Z. , Knapik Derrick M. , Korrapati Avinaash , Chahla Jorge , Forsythe Brian
Published: October 2021

Background:

Acromioclavicular joint (ACJ) separation injuries are uncommon in professional soccer players, threatening future performance and team contributions. Data regarding return to play (RTP) in professional soccer players after ACJ separation are limited.

Purpose:

To determine the rate, time to RTP, and player performance after ACJ separation in soccer players from the top 5 professional European leagues when compared with a retrospective, matched cohort of uninjured players.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Professional soccer players suffering ACJ separation injuries between 1999 and 2018 were identified and were matched to uninjured players (2 controls to 1 injured player) by position, height, age, season year, and length of time played. Information on date of injury, timing to RTP, and player performance metrics (minutes played, games played, goals scored, assists made, and points per game) were collected from transfermarkt.co.uk, uefa.com , fifa.com , official team websites, public injury reports, and press releases. Change in performance metrics for the 4 seasons after the season of injury were based on metrics 1 season before injury. Univariate comparisons were performed using independent 2-group t tests and Wilcoxon rank-sum tests when normality of distributions was violated.

Results:

A total 59 soccer players with ACJ separation injuries were identified. Mean age at injury was 24.6 ± 5.3 years. Of these, 81% of the players returned to play, with 69% returning within postinjury season 1. Mean time to RTP was 49.8 ± 24.3 days (5.9 ± 4.1 games). Two players suffered recurrent ACJ separation injuries in their professional soccer careers. There were no significant differences between athletes who sustained ACJ injuries versus control athletes in the number of games played, minutes per game per season, goals scored, assists, or points in the 4 seasons after injury. Defenders played fewer minutes and recorded fewer assists during postinjury season 1 when compared with control athletes.

Conclusion:

Of the 59 elite soccer players who sustained ACJ separation injuries during the study period, 81% returned to elite competition. Performance metrics were similar to preinjury levels and matched, uninjured control players.
Simultaneous or Staged Bilateral Arthroscopic Rotator Cuff Repair: An Observational Study of Intraoperative and Postoperative Outcomes
Authors: Chu Jiabao , Shieh Ju-Sheng , Wu Kailun , Guan Huaqing , Roche Stephen , Held Michael F.G. , Yang Huilin , Guo Jiong Jiong
Published: October 2021

Background:

Bilateral arthroscopic rotator cuff repair (ARCR) is frequently performed in patients with symptomatic bilateral rotator cuff tears.

Purpose:

To compare patient-reported outcomes and mobility between simultaneous and staged bilateral ARCR.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 51 patients who underwent simultaneous (anesthetized once) and 42 patients who underwent staged (anesthetized twice) bilateral ARCR between January 2014 and January 2018; for the staged group, the interval between procedures was at least 12 months. All operations were performed by the same surgeon, and all patients had minimum 24-month follow up in both shoulders. Patient-reported outcomes and range of motion (ROM) were assessed preoperatively and postoperatively and compared between groups. Outcome measures included the Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score as well as measures of psychological status, health-related quality of life, activities of daily living (ADL), and patient satisfaction with the state of one’s shoulders.

Results:

The mean follow-up times for the staged and simultaneous ARCR groups were 44.1 months (range, 36-60 months) and 37.5 months (range, 25-59 months), respectively. There were no significant differences in age, tear size, or fatty degeneration of rotator cuff muscles between the groups. The cumulative length of hospital stay in the staged group was significantly longer than in the simultaneous group ( P < .001). At the final follow-up, both groups showed significant improvement in ROM, CMS, and ASES scores ( P < .05). No significant differences between the groups were observed in terms of ROM, CMS, and ASES scores postoperatively. At 24 months postoperatively, psychological status and health-related quality of life in both groups improved significantly ( P < .05), and there were no significant between-group differences. Patients were able to perform most essential ADL. Both groups had high patient satisfaction, but patient satisfaction for the second shoulder of the staged group was lower than that of the simultaneous group ( P = .039).

Conclusion:

Simultaneous bilateral ARCR was shown to be effective, resulting in similar improvements in clinical outcomes to staged bilateral ARCR at 2-year follow-up. In addition to higher patient satisfaction, simultaneous bilateral ARCR also had a shorter treatment cycle.
Older Adults’ Computer-Mediated Communication (CMC) Engagement Following COVID-19 and Its Impact on Access to Community, Information, and Resource Exchange: A Longitudinal, Qualitative Study
Authors: Mikal Jude P. , Wurtz Rebecca , Grande Stuart W.
Published: October 2021

Following COVID-19, the CDC asked individuals to social distance and state and local authorities nationwide began issuing curfews and recommendations to “shelter-in-place.” Known to be more susceptible to the negative effects of COVID-19 and often coping with higher levels of social isolation, many worried that older adults’ mental health would suffer. While computer-mediated communication (CMC) is on the rise among older adults, whether and how older adults leverage the social benefits of CMC remains underexplored. This study assesses older adults’ CMC use after COVID and the impact of CMC engagement on access to connection, information, and resources. We follow 22 older adults over 6 weeks, using longitudinal qualitative surveys to study CMC use patterns and mental health outcomes. Results revealed that while older adults exhibited purpose-driven CMC engagement, limited integration into larger online communities restricted access to up-to-the-minute information, notably early in the pandemic. Longitudinal findings show progressively less engagement with online news and information, withdrawal from online social engagement, and a progressive relaxing of social distancing. This study sheds light on how best to reach older adults following disaster, and where older adults may be disadvantaged as social media becomes a modern “emergency broadcast system.”