bluuebunny/crossref_metadata_2025 huggingface dataset:
Motives of Knife-Carrying among the Youth in Azerbaijan: In-Depth Interviews Among 27 Experts and 5 Knife-Carriers
Authors: Shahbazov Inqilab , Maharramov Goshgar , Farajli Orkhan , Rustamova Efsane
Published: October 2021

Drawing on in-depth interviews with psychologists, criminologists, and sociologists ( n = 27), as well as five adolescents (aged between 15 and 17 years) with a history of knife-carrying in Azerbaijan, this study attempts to explore the motives for knife-carrying among the male youth. Using a phenomenological approach, the interviews found a set of mixed and interrelated factors as the key motivators of carrying a knife among male youth. The answers provided by members of both samples generally overlap, but each provides some unique insights as well. Experts argue that young men tend to suffer from poor socialization and fail academically, which forces them to seek companionship, status, and identity elsewhere. In such circumstances, adolescents become likely to fall under the influence of their peers, as well as the criminal world whose figures are widely popular in the country. Since knife-carrying provides a sense of power and self-esteem, as well as constitutes a core attribute of notorious criminal figures, it becomes attractive to the youth. Male interviewees with a history of knife-carrying, all with irregular class attendance and part of “circles” (deviant peer groups), were attracted to sharp objects (a) by their ability to project power to others around them, such as so-called “predators” and (b) rule of the circles. The desire to exercise informal control over an area (school or neighborhood) and emulate thieves-in-law was particularly critical in shaping adolescents’ decision to carry knives and five-knuckle. The findings not only largely confirm the results reported by the Western studies, but also advance our understanding of youth's inclination towards knife-carrying in a nonwestern society.
Amusing Ourselves to Loyalty? Entertainment, Propaganda, and Regime Resilience in China
Authors: Xia Shouzhi
Published: October 2021

Is it possible to form “soft autocracy” that manages citizens by taking away their sense of resistance? This paper suggests that the rise of entertainment media in autocracies enables the rulers to maintain their resilience through a soft approach, thereby avoiding costly heavy-handed measures. Such a soft approach can work because entertainment media, like “fictitious pleasure drugs,” undo audiences’ sophistication so that people are susceptible to autocratic propaganda. By analyzing a Chinese data set, via instrumented regressions, this paper shows that a one standard deviation increase in people’s interest in entertainment media is associated with an increase of almost 20% in both their satisfaction with the current regime and their anti-Western hostility. Furthermore, the findings show a positive relationship between people’s entertainment media interest and their acceptation of indoctrination by state media. In short, entertainment media contribute to China’s regime stability through “amusing ordinary citizens to loyalty.”
Cross-validating the Dot Counting Test Among an Adult ADHD Clinical Sample and Analyzing the Effect of ADHD Subtype and Comorbid Psychopathology
Authors: Abramson Dayna A. , White Daniel J. , Rhoads Tasha , Carter Dustin A. , Hansen Nicholas D. , Resch Zachary J. , Jennette Kyle J. , Ovsiew Gabriel P. , Soble Jason R.
Published: October 2021

This study cross-validated the dot counting test (DCT) as a performance validity test (PVT) in an adult attention-deficit/hyperactivity disorder (ADHD) clinical population and examined the effect of ADHD subtype and psychiatric comorbidity on accuracy for detecting invalidity. DCT performance was assessed among 210 consecutive adult ADHD referrals who underwent neuropsychological evaluation and were classified into valid ( n = 175) or invalid ( n = 35) groups based on seven independent criterion PVTs. The invalid group had significantly worse DCT performance than the valid group using both the standard and unrounded scoring procedure ([Formula: see text]). Classification accuracy was excellent, with 54.3% sensitivity/92% specificity at optimal cut-scores of ≥14 (rounded) and ≥13.38 (unrounded). Nonsignificant DCT performance differences emerged based on ADHD subtype or the presence/absence of comorbid psychopathology. The DCT functions well as a nonmemory-based PVT in an ethnoracially diverse ADHD population, supporting its clinical utility for detecting invalid neurocognitive performance during ADHD evaluations.
Measurement to Improve Treatment Delivery: A Commentary on the HiTOP Measure Development Project
Authors: Sauer-Zavala Shannon
Published: October 2021

The focus on this commentary will be on how dimensional models of psychopathology, particularly HiTOP model, have the potential to significantly streamline treatment efforts and increase the likelihood that evidence-based interventions are more widely integrated in clinical practice. The approach to assessment adopted by the HiTOP consortium is likely to have an outsized impact on whether these innovations are adopted in routine clinical practice. Toward that end, I provide suggestions for a measurement strategy that can maximize clinical utility. In particular, the tension between creating items that reflect all phenomena at the sign/symptom level to refine our understanding of relationships among psychopathological constructs and creating a measure that is suitable for clinical practice is explored.
The English Version of the Schema Inventory for Children: Psychometric Evaluation of a Measure of Early Maladaptive Schemas in a Primary School-Aged Sample
Authors: Wong Quincy J. J. , Boulton Kelsie A. , Reyes Natasha , Han Jin , Torok Michelle
Published: October 2021

Early maladaptive schemas (EMSs) are proposed to be maladaptive ways of thinking and feeling that develop from adverse experiences and basic needs not being met in childhood or adolescence. Once developed, EMSs increase vulnerability to psychopathology. Psychometric evaluations of EMS measures in children are scarce. This study aimed to evaluate the psychometric properties of the English version of the Schema Inventory for Children (SIC) in a community sample of youth aged 8 to 13 years. The SIC and measures of positive and negative automatic thoughts, social phobia symptoms, and depressed mood were administered to participants. Although a correlated 11-factor model was expected for the SIC, the optimal factor structure was a correlated six-factor model. EMS subscales corresponding to these six factors had acceptable internal consistency, and they had positive associations with the measures of negative automatic thoughts, social phobia symptoms, and depressive mood, as well as negative associations with the measure of positive automatic thoughts. These results indicate that EMSs in children may not be as differentiated as they are in adults. The results provide evidence for the reliability and validity of the English version of the SIC, justifying its use in contexts requiring the assessment of EMSs in children.
Effect of Context on Scientists’ Normative Beliefs
Authors: Tiffany Leigh Anne , Hautea Samantha , Besley John C. , Newman Todd P. , Dudo Anthony
Published: October 2021

Past research on the relationship between scientists’ normative beliefs about public engagement in the context of willingness to engage could prove misleading if respondents do not consider the impacts of engagement activities when responding to survey questions. This study asks scientists to report normative beliefs in the context of engagement impacts and explores correlations between these responses and engagement willingness. Results suggest mentioning positive societal impact positively affects normative beliefs, while mentioning lost research time negatively affects normative beliefs. However, changing the measurement context does not affect the non-relationship between normative beliefs and engagement willingness.
Dynamic stiffness formulation for a micro beam using Timoshenko–Ehrenfest and modified couple stress theories with applications
Authors: Banerjee J Ranjan , Papkov Stanislav O , Vo Thuc P , Elishakoff Isaac
Published: October 2021

Several models within the framework of continuum mechanics have been proposed over the years to solve the free vibration problem of micro beams. Foremost amongst these are those based on non-local elasticity, classical couple stress, gradient elasticity and modified couple stress theories. Many of these models retain the basic features of the Bernoulli–Euler or Timoshenko–Ehrenfest theories, but they introduce one or more material scale length parameters to tackle the problem. The work described in this paper deals with the free vibration problems of micro beams based on the dynamic stiffness method, through the implementation of the modified couple stress theory in conjunction with the Timoshenko–Ehrenfest theory. The main advantage of the modified couple stress theory is that unlike other models, it uses only one material length scale parameter to account for the smallness of the structure. The current research is accomplished first by solving the governing differential equations of motion of a Timoshenko–Ehrenfest micro beam in free vibration in closed analytical form. The dynamic stiffness matrix of the beam is then formulated by relating the amplitudes of the forces to those of the corresponding displacements at the ends of the beam. The theory is applied using the Wittrick–Williams algorithm as solution technique to investigate the free vibration characteristics of Timoshenko–Ehrenfest micro beams. Natural frequencies and mode shapes of several examples are presented, and the effects of the length scale parameter on the free vibration characteristics of Timoshenko–Ehrenfest micro beams are demonstrated.
Lymph Node Ratio after Neoadjuvant Chemotherapy for Stage II/III Breast Cancer: Prognostic Value Measured with Gini’s Mean Difference of Restricted Mean Survival Times
Authors: Keam Bhumsuk , Gorobets Olena , Vinh-Hung Vincent , Im Seock-Ah
Published: October 2021

Restricted mean survival time (RMST), recommended for reporting survival, lacks a tool to evaluate multilevel factors. The potential of the Gini’s mean difference of RMSTs (Δ) is explored in a comparison of a lymph node ratio-based classification (LNRc) versus a number-based classification (ypN) applied to stage II/III breast cancer patients who received neoadjuvant chemotherapy and underwent axillary dissection. Number of positive nodes ( npos) classified patients into ypN0, npos = 0, ypN1, npos = [1,3], ypN2, npos = [4,9], and ypN3, npos ⩾ 10. Ratio npos/( number of nodes examined) of 0, (0,0.20], (0.20,0.65], and >0.65, classified patients into Lnr0 to Lnr3, respectively. Unadjusted and Cox-adjusted RMSTs were computed for the ypN and LNRc’s. At a follow-up time horizon of 72 months for 114 node-negative and 254 node-positive patients, unadjusted ypN0-ypN3 RMSTs were 62.4-41.4 months, Δ = 11.9 months (95%CI: 7.4-16.9), and Lnr0-Lnr3 62.4 to 36.3 months, Δ = 14.0 months (95%CI: 10.1-18.1). Cox models’ ypN1-ypN3 hazard ratios were 1.81-3.30, and Lnr1-Lnr3 1.52-4.39. Δ from Cox-fitted survival were ypN 8.1 months (95%CI: 5.9-10.5), LNRc 10.5 months (95%CI: 8.4-12.8). In conclusion, Gini’s mean difference is applicable to well established data in keeping with the literature on LNRc. It provides an alternative view on the improvement gained with a lymph node ratio-classification over using a number-classification.
Teaching Innovation Experience for COVID-19 Times: A Case Study on Blended Learning of Television Journalism Courses with Moodle
Authors: Mayo-Cubero Marcos
Published: October 2021

The effective implementation of information and communications technologies (ICTs) in higher education is not guaranteed without serious and rigorous pedagogical reflection. It is essential to maintain an ongoing debate on the effectiveness of the learning process. A debate accelerated by the impact of the COVID-19 crisis and the growing role of virtual and remote learning in universities worldwide. This research aims to overcome the quantitative approach of previous work with qualitative evidence to contribute to the field knowledge. The designed case study is based on a Moodle teaching experience in communication studies at a Spanish university. This innovative methodology is developed within a hybrid teaching ecosystem (blended learning) with the support of a virtual platform (Aula Virtual). The sample analysed is composed of 77 students enrolled in the subject ‘Television Journalism’. The design of an original and novel data collection instrument has supplied various quantitative and qualitative data. The triangulation of four data collection techniques has provided a demographic profile, an activity report, a grading report and a satisfaction report. The findings suggest a high degree of student satisfaction, with the experience and a significant improvement in students’ television writing skills, thanks to the implementation of Moodle.
The video years: Stuart Cunningham and screen industry research
Authors: Lobato Ramon
Published: October 2021

This essay explores Stuart Cunningham's foundational contributions to screen industry research. Cunningham's work is grounded in the understanding that industrial and expressive processes are co-constitutive. More than a gestural attempt to articulate opposing fields (industry and culture), it is instead a career-long thinking-through of their mutual constitution. This manifests in Cunningham's close attention to the everyday work of screen industries: distribution; exhibition; promotion; professional training and education; institutional representation and lobbying; regulation. The essay explores Cunningham's thirty years of work on these topics, including his recent studies of online video production and distribution. It also reflects on his intellectual trajectories and his legacies for the field.
The remoteness of democratic representation
Authors: Michener Gregory , Amorim Neto Octavio , Civitarese Jamil
Published: October 2021

Democratic representation is increasingly remote from citizens. Many institutions exacerbate this remoteness, but the shrinking ratio of legislative representatives to citizens is perhaps the most obvious. Around the world, the number of representatives has not kept pace with growing populations. To what extent does this distance, between citizens and their elected politicians, explain our current democratic malaise? Relying on both quantitative and historical evidence, this article maps the remoteness of democratic representation and considers its causes, consequences, and potential remedies. Strongly associated with economic inequality and rural elites, the remoteness of representation has far-flung implications, ranging from deficits of diversity and accountability in political representation to the weakened capacity of citizens to engage in political collective action.
Radicalization to Violence: A View from Cultural Psychiatry
Authors: Rousseau Cécile , Aggarwal Neil K. , Kirmayer Laurence J.
Published: October 2021

This article introduces a thematic issue of Transcultural Psychiatry with selected papers from the McGill Advanced Study Institute in Cultural Psychiatry on “Pluralism and Polarization: Cultural Contexts and Dynamics of Radicalization,” which took place June 20–22, 2017. The ASI brought together an interdisciplinary group scholars to consider the role of social dynamics, cultural contexts and psychopathology in radicalization to violent extremism. Papers addressed four broad topics: (1) current meanings and uses of the term radicalization; (2) personal and social determinants of violent radicalization, including individual psychology, interpersonal dynamics, and wider social-historical, community and network processes; (3) social and cultural contexts and trajectories of radicalization including the impact of structural and historical forces associated with colonization and globalization as well as contemporary political, economic and security issues faced by youth and disaffected groups; and (4) approaches to community prevention and clinical intervention to reduce the risk of violent radicalization. In this introductory essay, we revisit these themes, define key terms, and outline some of the theoretical and empirical insights in the contributions to this issue. Efforts to prevent violent radicalization face challenges because social media and the Internet allow the rapid spread of polarizing images and ideas. The escalation of security measures and policies also serves to confirm the worldview of conspiracy theory adherents. In addition to addressing the structural inequities that fuel feelings of anger and resentment, we need to promote solidarity among diverse communities by building a pluralistic civil society that offers a meaningful alternative to the violent rhetorics of us and them.
Experimental investigation and optimization of quality characteristics during friction stir welding of Al- and Zn-based magnesium alloy using artificial intelligence
Authors: Yadav Pradeep K , Khurana Manoj K
Published: October 2021

Friction stir welding is successfully used to weld different wrought magnesium alloys. This work investigated the mechanical and microstructural behavior of the friction stir-welded AZ31B magnesium alloy. The experiments were conducted as per experimental runs designed by response surface methodology. An artificial neural network model was developed to produce a relationship between process variables (tool rotational speed, welding speed, and tool shoulder diameter) and characteristics of the friction stir-welded joints (tensile strength, percentage elongation, impact strength, microhardness, and grain size). The acceptable range of statistical parameters validated the adequacy of the model. The multi-objective optimization technique, genetic algorithm was used to obtain a set of Pareto optimal solutions. The best-compromised optimum solution for maximum tensile strength (164.2 MPa), percentage elongation (8%) impact strength (3.5 J), microhardness (85 Hv), and minimum grain size (13.1 μm) was validated by confirmation test with <3 percent absolute error percentage. The fractographical analysis has been performed and dimples and torn edges observed in fracture zones.
Finite element simulations and experimental verifications for forming limit curve determination of two-layer aluminum/brass sheets considering the incremental forming process
Authors: Jalali A. , Hashemi R. , Rajabi M. , Tayebi P.
Published: October 2021

In this paper, forming limit diagram (FLD) of aluminum/brass two-layer sheets through an incremental forming process (ISF) was studied numerically and experimentally. At first, the two-layer aluminum 1050/brass (65% copper) sheets were fabricated using the roll bonding process. Also, the finite element simulations of the incremental forming process with ABAQUS software were utilized to predict the FLD. For this purpose, the criterion of the second derivative of the equivalent plastic strain was used to predict fracture. Finally, the numerical simulation results were compared with the experimental results. For instance, comparing experimental and numerical FLD0 values for the formed samples with forming angle 62.5-degree showed a 7% difference. However, the difference was negligible, and numerical simulation results could be used with an appropriate reliability coefficient. The effect of sheet arrangement towards tools was then investigated. It finds out from the experimental results that the formability of the Brass/Al (brass was up layer and aluminum was bottom layer) was more than the Al/Brass (aluminum is up layer and brass is bottom layer). In the following, the ISF parameters such as forming limit angle, step-down, and thickness distribution were investigated.
Investigation on pulsed electrolytically polished AlSi10Mg alloy processed via selective laser melting technique
Authors: Anand Kumar S. , Sudarshan Reddy Anigani , Mathias Snehith , Shrivastava Abhishek , Raghupatruni Prasad
Published: October 2021

Currently, the surface integrity-related issues of additively manufactured parts are limiting the potential high-end applications. The present work investigates the effectiveness of the pulsed-electropolishing technique to improve the surface integrity of aluminium alloys fabricated using the selective laser melting (SLM) technique. Due to its low density, high corrosion resistance, the aluminium alloys considerably enhance the performance of lightweight critical parts for different industrial applications. In this study, selective laser melted AlSi10Mg samples were subjected to microstructural examinations using optical microscopy, scanning electron microscopy, energy-dispersive X-ray spectroscopy and X-ray diffraction technique. The microhardness and tensile properties were determined using a microhardness tester and a universal testing machine, respectively. The pulsed-electropolishing process was employed for the surface finishing of the SLM-processed AlSi10Mg samples. The effect of current density on the electropolishing of selective laser melted AlSi10Mg alloy were also investigated. The microstructures of printed samples revealed a density of greater than 99.9% and weld beads along the build direction (longitudinal) and laser scan paths perpendicular to the build direction (transverse). The microhardness, yield and tensile strength properties were similar in both as-printed conditions. The pulsed electropolishing results showed a beneficial effect of higher current density values, resulting in decreased surface roughness of the SLM-processed AlSi10Mg samples. Compared to as-printed conditions, a significant decrease in surface roughness of about ∼73.35% under optimized electropolishing conditions was noted. The material ratio curve shows that the surface topography becomes more uniform with increased current density and has lesser surface undulations for as-printed samples. The 2D line profilogram and 3D surface topography of electropolished SLM-processed samples reveal the surface finish quality characteristics. The material ratio curve aids as an effective method to assess and qualify the surface topography of electropolished samples.
The young child’s journey of ‘the will’: A synthesis of child-centered and inclusive principles in international Waldorf early childhood education
Authors: Attfield Kate
Published: October 2021

Within the education academic arena, there is almost no established research on the alternative Waldorf (or Steiner) education movement in the US or UK. This primary research investigates Rudolf Steiner’s philosophy of early childhood Waldorf education, and its child-centered and inclusive core. Ten kindergarten teachers in the US and UK educating children ages three through seven were interviewed on their values and practices, and on intrinsic notions of inclusion, which are scrutinized according to Lani Florian's inclusive pedagogy. Contrasting interpretation among practitioners on educating diverse learners emerge. US and UK Waldorf education appear situationally different, and yet the underlying educational ethos fundamentally remains the same. An anthroposophical understanding of the human being, and ‘the will’ of the kindergarten child who learns through imitation and play, underlies this far-sighted, holistic basis. Recommendation is for Waldorf early childhood studies to enhance transnational networks among themselves, and to make connections with broader academic educational clusters, in particular those on inclusion.
Survey of Occupational Therapy Driver Assessors’ Rehabilitation Interventions With Older Drivers
Authors: Unsworth Carolyn Anne , Baker Anne , Morton-Kehle Dana , Darzins Susan
Published: October 2021

The rehabilitation strategies used by occupational therapy driver assessors with older drivers with age-related decline or health conditions are not well understood. The objective of the study was to describe driver rehabilitation interventions used by Australian driver assessors, identify factors that guide rehabilitation choices, and identify barriers and facilitators encountered. An online survey was emailed to 300 driver assessors. Descriptive statistics were used to summarize and to rank order participant responses. A total of 148 respondents selected from a combined total of 655 interventions. The four most common rehabilitation methods were (a) graded driving (18%, n = 118), (b) practicing specific maneuvers (17.7%, n = 116), (c) using a modified vehicle (16.9%, n = 111), and (d) graded driving in local areas only (15.1%, n = 99). The most common barrier limiting driver rehabilitation was cost ( M = 2.92, SD = 1.24). The most frequently used driver rehabilitation method was on-road training. Practice can be enhanced by collating and evaluating resources, and ensuring effective interventions are more accessible.
Giant Bochdalek Hernia: A Minimally Invasive Transabdominal Approach
Authors: Nitz Jonathan , Kharazi Alexandra , Iannettoni Mark , Speicher James
Published: October 2021

A Bochdalek hernia is the most common congenital diaphragmatic hernia (CDH). It can rarely evade prenatal detection and persist into adulthood with minimal symptoms. Large CDH repair has often required an open approach in the past. In this article, we present a case of a patient with large CDH who was asymptomatic until later in her adult life who subsequently developed symptoms and sought a surgical evaluation. A minimally invasive transabdominal approach was used to effectively reduce and repair this rare giant hernia. The patient has remained free of recurrence and has had resolution of her symptoms after 18 months of follow-up. This case illustrates that even the largest of these can be handled in a minimally invasive fashion and achieve durable results.
“Terrified of a System I Didn’t Understand”: Reporting Staff Sexual Misconduct Against Women on Parole
Authors: Darcy Kathleen , Fedock Gina , Kubiak Sheryl Pimlott
Published: October 2021

Incarcerated women experience staff-perpetrated sexual victimization at high rates, yet limited research exists regarding women’s experiences of this victimization while on probation and parole, particularly regarding their formal reporting decisions. This qualitative study explored the formal reporting decisions for 10 women who experienced staff-perpetrated sexual victimization while on parole. Women who formally reported their victimization experiences qualitatively differed from non-reporting women in terms of the dynamics and their identification of victimization (e.g., viewing as support vs. fear) and in the types of structural barriers (e.g., vulnerability and cautionary tales) they encountered. These findings highlight policy, practice, theory, and research directions.
Association Between Regorafenib Dose and Efficacy Against Metastatic Colorectal Cancer in a Real-World Setting
Authors: Hatori Masahiro , Kawakami Kazuyoshi , Wakatsuki Takeru , Shinozaki Eiji , Kobayashi Kazuo , Aoyama Takeshi , Nakano Yasuhiro , Suzuki Kenichi , Yamaguchi Kensei , Hama Toshihiro
Published: October 2021

The association between regorafenib dosage in the treatment of metastatic colorectal cancer (mCRC) and efficacy is currently not well established. It was previously reported that the regorafenib dose as prescribed is associated with efficacy, but doses in actual clinical settings have not been analyzed. We retrospectively analyzed patients with mCRC who had received regorafenib as third-line or later chemotherapy between May 2013 and June 2018. Patients who were not treated in the Pharmaceutical Outpatient Clinic for compliance assessment were excluded. Overall survival was calculated using the Kaplan–Meier method. Prognostic factors, including baseline demographics and adverse events, were evaluated using Cox proportional hazard models. A total of 176 patients were enrolled. By multivariate analysis, total dose until the second cycle < 3180 mg (HR = 1.71, 95% CI, 1.20–2.44, P = .003) was one of independent negative predictors of overall survival. Median survival times of the lower-dose group (< 3180 mg) and higher-dose group (≥ 3180 mg) were 5.8 and 7.6 months, respectively ( P = .045). The cumulative dose of regorafenib until the second cycle in patients with mCRC was associated with survival. It is important to individualize regorafenib dose in mCRC patients.
“I Know Which Devil I Write for”: Two Types of Autonomy Among Czech Journalists Remaining in and Leaving the Prime Minister's Newspapers
Authors: Kotisova Johana , Císařová Lenka W.
Published: October 2021

This paper examines two different understandings of professional autonomy among journalists currently and formerly working at Mafra, a Czech media house acquired in 2013 by Andrej Babiš, who in 2017 became the Czech Prime Minister. We build on existing research of local trends in media ownership and journalistic autonomy to ask the following questions: What differentiated the experience of journalists who exited the organization after the ownership change from that of those who stayed put? How did the two groups understand professional journalistic autonomy? Based on the thematic analysis of twenty semistructured interviews with ten journalists who stayed in the media house after Babiš's acquisition and ten journalists who left, we argue that in the journalists’ narratives, the two decisions reflect two different notions of autonomy: autonomy-as-a-practice and autonomy-as-a-value. While our findings add to the scarce empirical research on journalists’ lived experiences of the region's mediascape marked by growing comingling and concentration of political, economic and media power, we also suggest that the autonomy-as-a-practice and journalists’ agency should be further studied as a possible way how to perform and promote journalistic autonomy even in illiberalizing contexts—in Central and Eastern Europe and beyond.
Three-Dimensional-Printed External Scaffolds Mitigate Loss of Volume and Topography in Engineered Elastic Cartilage Constructs
Authors: Dong Xue , Premaratne Ishani D. , Bernstein Jaime L. , Samadi Arash , Lin Alexandra J. , Toyoda Yoshiko , Kim Jongkil , Bonassar Lawrence J. , Spector Jason A.
Published: October 2021

Objective

A major obstacle in the clinical translation of engineered auricular scaffolds is the significant contraction and loss of topography that occur during maturation of the soft collagen-chondrocyte matrix into elastic cartilage. We hypothesized that 3-dimensional-printed, biocompatible scaffolds would “protect” maturing hydrogel constructs from contraction and loss of topography.

Design

External disc-shaped and “ridged” scaffolds were designed and 3D-printed using polylactic acid (PLA). Acellular type I collagen constructs were cultured in vitro for up to 3 months. Collagen constructs seeded with bovine auricular chondrocytes (BAuCs) were prepared in 3 groups and implanted subcutaneously in vivo for 3 months: preformed discs with (“Scaffolded/S”) or without (“Naked/N”) an external scaffold and discs that were formed within an external scaffold via injection molding (“Injection Molded/SInj”).

Results

The presence of an external scaffold or use of injection molding methodology did not affect the acellular construct volume or base area loss. In vivo, the presence of an external scaffold significantly improved preservation of volume and base area at 3 months compared to the naked group ( P < 0.05). Construct contraction was mitigated even further in the injection molded group, and topography of the ridged constructs was maintained with greater fidelity ( P < 0.05). Histology verified the development of mature auricular cartilage in the constructs within external scaffolds after 3 months.

Conclusion

Custom-designed, 3D-printed, biocompatible external scaffolds significantly mitigate BAuC-seeded construct contraction and maintain complex topography. Further refinement and scaling of this approach in conjunction with construct fabrication utilizing injection molding may aid in the development of full-scale auricular scaffolds.
Clinical Outcomes of the Traditional Latarjet Versus the Congruent Arc Modification for the Treatment of Recurrent Anterior Shoulder Instability: A Meta-analysis
Authors: Mengers Sunita R.P. , Knapik Derrick M. , Kaufman Matthew W. , Edwards Gary , Voos James E. , Gillespie Robert J. , Karns Michael R.
Published: October 2021

Background:

Few studies have compared clinical outcomes between the traditional Latarjet procedure for anterior shoulder instability and the congruent arc modification to the Latarjet procedure.

Purpose:

To systematically evaluate the literature for the incidence of recurrent instability, clinical outcomes, radiographic findings, and complications for the traditional Latarjet procedure and the congruent arc modification and to compare results of each search.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic review and meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We included studies published between January 1990 and October 2020 that described clinical outcomes of the traditional Latarjet and the congruent arc modification with a follow-up range of 2 to 10 years. The difference in surgical technique was analyzed using a chi-square test for categorical variables, while continuous variables were evaluated using a Student t test.

Results:

In total, 26 studies met the inclusion criteria: 20 studies describing the traditional Latarjet procedure in 1412 shoulders, and 6 studies describing the congruent arc modification in 289 shoulders. No difference between procedures was found regarding patient age at surgery, follow-up time, Rowe or postoperative visual analog scores, early or late complications, return-to-sport timing, or incidence of improper graft placement or graft fracture. A significantly greater proportion of male patients underwent glenoid augmentation using the congruent arc modification versus traditional Latarjet ( P < .001). When comparing outcomes, the traditional Latarjet procedure demonstrated a lower incidence of fibrous union or nonunion ( P = .047) and broken, loose, or improperly placed screws ( P < .001), and the congruent arc modification demonstrated improved outcomes with regard to overall return to sport ( P < .001), return to sport at the same level ( P < .001), incidence of subluxation ( P = .003) or positive apprehension ( P = .002), and revision surgery for recurrent instability ( P = .027).

Conclusion:

Outcomes after the congruent arc modification proved at least equivalent to the traditional Latarjet procedure in terms of recurrent instability and return to sport, although early and late complications were equivalent. The congruent arc procedure may be an acceptable alternative to traditional Latarjet for the treatment of anterior shoulder instability with glenoid bone loss; however, long-term outcomes of this procedure are needed.
Risk Factors for Supraspinatus Tears: A Meta-analysis of Observational Studies
Authors: Zhao Jinlong , Luo Minghui , Liang Guihong , Wu Ming , Pan Jianke , Zeng Ling-feng , Yang Weiyi , Liu Jun
Published: October 2021

Background:

The pathogenesis of rotator cuff tears remains unclear, and there is a lack of high-quality evidence-based research on the risk factors for supraspinatus tears.

Purpose:

To explore 10 potential risk factors for supraspinatus muscle tears.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

This review was conducted according to the MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines. PubMed, Embase, and Web of Science were searched for cohort, case-control and cross-sectional studies published before January 2021 on supraspinatus tears. The following potential risk factors were analyzed: age, body mass index, male sex, female sex, arm dominance, diabetes mellitus, smoking, hypertension, thyroid disease, and the critical shoulder angle (CSA). Risk ratios (RRs) or weighted mean differences (WMDs) of related risk were calculated. The Egger test was used to evaluate publication bias.

Results:

A total of 9 articles from 8 countries were included; among the 3240 patients, 687 were included in the supraspinatus tear group, and 2553 were included in the nonsupraspinatus tear group. The meta-analysis showed that older age (WMD, 3.36 [95% confidence interval (CI), 0.53-6.20]; P = .02), male sex (RR, 0.87 [95% CI, 0.78-0.97]; P = .01), smoking (RR, 2.21 [95% CI, 1.56-3.14]; P < .00001), diabetes (RR, 1.67 [95% CI, 1.03-2.70]; P = .04), hypertension (RR, 1.51 [95% CI, 1.16-1.97]; P = .002), and the CSA (WMD, 2.25 [95% CI, 1.39-3.12]; P < .00001) were risk factors for supraspinatus tears.

Conclusion:

Older age, male sex, smoking, diabetes, hypertension, and a higher CSA were found to be risk factors for supraspinatus tears in this meta-analysis review. Identifying risk factors for supraspinatus tears early can help clinicians identify these high-risk patients and choose appropriate treatments.
Current Perceptions of Diversity Among Head Team Physicians and Head Athletic Trainers: Results Across US Professional Sports Leagues
Authors: Wiggins Anthony J. , Agha Obiajulu , Diaz Agustin , Jones Kristofer J. , Feeley Brian T. , Pandya Nirav K.
Published: October 2021

Background:

Discrepancies in race, ethnicity, and sex among health care providers and their patients have been shown to affect the patient-provider relationship as well as the quality of care. Currently, minority and female representation among orthopaedic surgeons remains low. Given the large proportion of minority athletes and their degree of public visibility, professional sports serves as an important arena within which to analyze the diversity of health care providers.

Purpose:

To describe and evaluate the current level of diversity of head team physicians (HTPs) and head athletic trainers (ATCs), primarily in terms of race and sex, within men’s professional sports leagues in the United States.

Study Design:

Cross-sectional study.

Methods:

Five major US professional sports leagues were evaluated: National Basketball Association, National Football League, National Hockey League, Major League Soccer, and Major League Baseball. Publicly available data were collected to identify the HTPs and head ATCs for each team within these leagues. Two independent observers analyzed photographs and names of these individuals to determine his or her perceived race and sex, with disagreements being resolved by a third independent observer. Other physician data collected included graduate degree(s), specialty, and number of years in practice. Kappa coefficients (κ) were employed to evaluate interobserver reliability. Chi-square, Fisher exact, and t tests were used for statistical comparisons across leagues.

Results:

The κ values for perceived race were 0.85 for HTPs and 0.89 for head ATCs, representing near-perfect interobserver agreement. Minorities comprised 15.5% of HTPs and 20.7% of ATCs ( P = .24). Women comprised 3.9% of HTPs and 1.3% of head ATCs ( P = .017). The majority of HTPs were orthopaedic surgeons with medical doctorates. Female HTPs had significantly fewer years in practice compared with male HTPs (15.0 ± 4.9 vs 23.1 ± 9.6; P = .04).

Conclusion:

The lead physicians and athletic training providers for men’s professional sports teams demonstrated low rates of minority and female representation, denoting a highly visible area for discussing the role of increased diversity in health care.
A Haveli at the Agra Riverfront: Link to a Lost Heritage
Authors: Bansal Richa , Upadhyay Abhishek
Published: October 2021

Agra was the capital of the Mughal Empire at its zenith, and the splendour of the city during this period can only be imagined. There is an abundance of royal buildings which are protected by the Government of India. There were other significant buildings too, housing the high nobility, away from both the royal quarters as well as the ordinary peoples’ houses. These have largely vanished, being large enough to attract builders as well as developers. The article describes and establishes the significance of one such rare traditional townhouse or mansion called ‘haveli’ located on the river Yamuna, Agra, in relation to a larger historical and cultural landscape. It also discusses the possibilities of conservation and management for protecting and enhancing the significance of the premises and planning for its sustainable development in future.

The current edifice appears to be a coalescence of British and Mughal architecture with some local features. The building stands where similar-sized havelis stood during the Mughal period, housing high nobility. The architects of these buildings efficiently used the features of the river. With most such havelis having disappeared from the riverfront, this large residence-like edifice provides an interesting glimpse of the lost heritage. Fragments of information obtained from old maps and paintings, site surveys and some few research works have been joined together to reconstruct the origin and transformation vis-a-vis the present condition.
Psychosexual Problem in Remitted Psychiatric Patients
Authors: Shakya Dhana Ratna , Dhali Tapan Kumar , Bhattarai Sabeena , Sapkota Nidesh , Pandey Arun Kumar
Published: October 2021

Background:

Many patients and health literature, in general, allege that psychotropic agents cause sexual side effects.

Objective:

We intended to investigate this issue in a Nepalese clinical setting by estimating the prevalence of psychosexual problems among remitted psychiatric outpatients (on psychotropic medication) and by comparing it with that of a nonpsychiatric patient group (on nonpsychotropic medication).

Methodology:

In this hospital-based cross-sectional comparison study with purposive sampling, we collected the responses to a self-response questionnaire called “Arizona Sexual Experience Scale” from a total of 400 subjects: 100 male and 100 female consecutive consenting remitted psychiatric and dermatological outpatients, each with sex and marital status matching. We recorded pertinent information in the proforma and screened psychosexual problems with the Arizona Sexual Experience Scale after informed written consent. The problems in psychiatric and dermatological groups were compared.

Results:

We have more subjects of reproductive ages in both the psychiatric and dermatological groups. Depression, anxiety, and bipolar affective disorder were the most common diagnoses in the psychiatric patients, whereas eczema, fungal, immunologic, and allergic skin lesions/diseases were common in the dermatological patients. Both groups had comparable sexual dysfunction rates, both by overall and the criteria of ≥3 items with scores ≥4, whereas dermatological patients had more problems with criteria of ≥1 item with a score ≥5.

Conclusions:

Psychosexual dysfunction was more or less similar in frequency among both the psychiatric patients on psychotropic medication and dermatological patients on topical agents.
Ground motion models for shallow crustal and deep earthquakes in Hawaii and analyses of the 2018 M 6.9 Kalapana sequence
Authors: Wong Ivan , Darragh Robert , Smith Sarah , Wu Qimin , Silva Walter , Kishida Tadahiro
Published: October 2021

The damaging 4 May 2018 M 6.9 Kalapana earthquake and its aftershocks have provided the largest suite of strong motion records ever produced for an earthquake sequence in Hawaii exceeding the number of records obtained in the deep 2006 M 6.7 Kiholo Bay earthquake. These records provided the best opportunity to understand the processes of strong ground shaking in Hawaii from shallow crustal (< 20 km) earthquakes. There were four foreshocks and more than 100 aftershocks of M 4.0 and greater recorded by the seismic stations. The mainshock produced only a modest horizontal peak ground acceleration (PGA) of 0.24 g at an epicentral distance of 21.5 km. In this study, we evaluated the 2018 strong motion data as well as previously recorded shallow crustal earthquakes on the Big Island. There are still insufficient strong motion data to develop an empirical ground motion model (GMM) and so we developed a GMM using the stochastic numerical modeling approach similar to what we had done for deep Hawaiian (>20 km) earthquakes. To provide inputs into the stochastic model, we performed an inversion to estimate kappa, stress drops, Ro, and Q(f) using the shallow crustal earthquake database. The GMM is valid from M 4.0 to 8.0 and at Joyner–Boore (RJB) distances up to 400 km. Models were developed for eight VS30 (time-averaged shear-wave velocity in the top 30 m) values corresponding to the National Earthquake Hazards Reduction Program (NEHRP) site bins: A (1500 m/s), B (1080 m/s), B/C (760 m/s), C (530 m/s), C/D (365 m/s), D (260 m/s), D/E (185 m/s), and E (150 m/s). The GMM is for PGA, peak horizontal ground velocity (PGV), and 5%-damped pseudo-spectral acceleration (SA) at 26 periods from 0.01 to 10 s. In addition, we updated our GMM for deep earthquakes (>20 km) to include the same NEHRP site bins using the same approach for the crustal earthquake GMM.
Black Phosphorus Nanoparticles Promote Osteogenic Differentiation of EMSCs Through Upregulated TG2 Expression
Authors: Lu Naiyan , Wang Xinhe , Shi Wentao , Bian Lu , Zhang Xuan , Yang Guofeng , Tang Xue , Wang Jun , Zou Yin , Weng Yuyan
Published: October 2021

At bio-safe concentrations, black phosphorus nanoparticles activated TG2, and promote the expression of ECM, which further promoted osteogenic differentiation of EMSCs. From these results, we can conclude that black phosphorus nanoparticles are suitable as biological factors in bone tissue engineering. Black phosphorus nanoparticles (BPs) present excellent biocompatibility and good biodegradability, which have been rigorously studied and proven. However, its utilization in bone tissue engineering fields is still in its infancy. Thus, the main purpose of the present study was to investigate the effects of BPs on osteogenic differentiation of ectodermal mesenchymal stem cell (EMSC) in vitro. Biocompatible BPs with high yield were prepared with a simple and efficient ultrasonication technique. EMSCs were isolated from adult rat nasal respiratory mucosa. Then, we treated EMSCs with BPs at different concentrations in vitro and examined the effect of BPs on osteogenic differentiation of EMSCs. In addition, inhibitor of transglutaminase 2 (TG2) and western blot were used to clarify the mechanism of the promoting effect of BPs on osteogenesis. Our results indicated that BPs could significantly enhance osteogenic differentiation of EMSCs in vitro. Nevertheless, BPs had no effect on EMSCs proliferation. Mechanistically, BPs promoted osteogenesis differentiation of EMSCs through upregulating TG2 expression. These results highlight the advantage of using chemical materials for novel engineering strategies of these highly promising small molecules for bone-tissue regeneration.