bluuebunny/crossref_metadata_2025 huggingface dataset:
Normative Misperceptions About Cannabis Use in a Sample of Risky Cannabis Users
Authors: Cunningham John A , Schell Christina , Bertholet Nicolas , Wardell Jeffrey D , Quilty Lena C , Godinho Alexandra
Published: April 2023

Introduction:

This study examines normative misperceptions in a sample of participants recruited for a brief intervention trial targeting risky cannabis use.

Methods:

Participants who were concerned about their own risky cannabis use were recruited to help develop and evaluate intervention materials. At baseline, participants reported on their own cannabis use and provided estimates of how often others their gender and age used cannabis in the past 3 months. Comparisons were made between participants estimates of others cannabis use with reports of cannabis use obtained from a general population survey conducted during a similar time period.

Results:

Participants (N = 744, mean age = 35.8, 56.2% identified as female) largely reported daily or almost daily cannabis use (82.4%). Roughly half (55.3%) of participants estimated that others their age and gender used cannabis weekly or more often in the past 3 months, whereas the majority of people in the general population reported not using cannabis at all.

Conclusions:

Normative misperceptions about cannabis use were common in this sample of people with risky cannabis use. Limitations and possible future directions of this research are discussed, as well as the potential for targeting these misperceptions in interventions designed to motivate reductions in cannabis use.

ClinicalTrials.org number:

NCT04060602
Be careful what you wish for: Portfolio allocation, presidential popularity, and electoral payoffs to parties in multiparty presidentialism
Authors: Batista Mariana , Power Timothy J , Zucco Cesar
Published: April 2023

We know little about how coalitional strategy affects the electoral fates of political parties in presidential democracy. The literature on coalitions in parliamentary systems shows a negative impact of entering government, while the coattail effects literature on presidential systems suggests some benefits. Combining elements from both approaches, we argue that there is a conditional electoral effect of joining the cabinet under coalitional presidentialism. Even considering presidentialism’s heightened attribution of responsibility to a unipersonal executive, we find that coalition parties do indeed place a meaningful electoral wager whenever they choose to enter the president’s cabinet as identifiable allies. Leveraging data on Brazilian elections held at national and local levels over 24 years and employing an innovative measure of portfolio salience, we show that the payoff of this wager is contingent on control of the most highly-valued cabinet positions and on the popular approval of the president.
Conformity or differentiation? The effect of competitive strategy on hotel performance
Authors: Iryani Beta Septi , Yudhistira Muhammad Halley , Khoirunurrofik Khoirunurrofik , Hartono Djoni
Published: April 2023

Hotels often stay close to each other to exploit the agglomeration benefit. However, geographical proximity also parallels competition. This study used annual longitudinal hotel data from the 2016–2019 Indonesian Accommodation Survey to examine the relationship between competitive strategy and hotel performance. We constructed a capacity and quality distance index to capture hotel strategies and used the panel fixed effect method to address possible sorting behavior. Our estimates broadly suggest that conformity corresponds to a higher total revenue per available room. We attribute the result to labor pooling and lower consumer searching cost mechanisms. The results show that hotels that implement a conformity strategy in capacity or quality with neighboring hotels tend to have a higher total revenue per available room. It implies that a hotel’s conformity strategy can be a reference for investors and hoteliers in planning a profitable hotel business and creating sustainable and quality tourism.
Uncovering the social determinants of brain injury rehabilitation
Authors: Dunne Stephen , Williams Glenn P , Bradbury Chloe , Keyes Tamsin , Lane Alison R , Yang Keming , Ellison Amanda
Published: April 2023

Social determinants of health (SDH), such as social isolation and loneliness, are often more frequently experienced in brain injury survivors. The paper explores the personal experiences of loneliness among brain injury survivors during lockdown to negate health inequalities and improve rehabilitation for this population in the future. Twenty-four brain injury survivors participated in semi-structured interviews and questionnaires relating to loneliness, resilience and wellbeing. Three themes (the experience of loneliness, loneliness during the pandemic and loneliness after the pandemic) explored survivors’ experiences of loneliness generally post-brain injury, but also chronicle how these feelings developed in lockdown and survivors’ feelings regarding society returning to ‘normal’. Future interventions should focus on reframing survivors’ beliefs regarding societal expectations and minimise the pressure they experience to keep up with their peers physically and emotionally. Additionally, we recommend creating accessible peer support options for all brain injury survivors as an important step for alleviating loneliness.
‘We Did Many Projects Together’: Boundary-Spanning Strategies of Councillors in Rural Ghana
Authors: Sabbi Matthew
Published: April 2023

A thematic gap in decentralization research is how rural councillors with limited political scope assert agency in rural transformation processes. Analysis of councillors’ strategic interfaces with local organisations and international agencies outside the elected councils explores how they construct access to resources for rural development. Drawing on fieldwork in rural Ghana, the article demonstrates how creative boundary-spanning links councillors to different structures of rural governance and development intervention outside the remit of the district council. Clearly emergent from this study is that the cross-boundary collaborations create privileged access to outside resources and support for local political action but with significant political and economic consequences for councillors. These collaborative engagements offer a wider framework to understand councillors’ individual agency for rural transformation beyond conventional analyses of state-led or bottom-up development planning and the dominant critique of external intervention.
Assessment of percent-time-operable of surface combatants with conventional and wave-piercing hulls
Authors: Choi Sungeun , Kim Kiwon , Kim Hoyong , Seo Jeonghwa , Yang Kyung-Kyu , Rhee Shin Hyung
Published: April 2023

The present study concerns assessing and comparing the operability of two surface combatants with conventional and modern wave-piercing hulls. The operability is measured in terms of the percent-time-operable (PTO), based on the capability of missions in the annual operating condition by seakeeping analysis. The seakeeping criteria of the surface combatant in various missions are selected by the literature review applicable to the basic design stage. The numerical seakeeping analysis is performed to obtain ship motion spectra in seaways around the Korean peninsula and North Pacific, after corrected by comparison to the experiments in regular waves. It is found that the wave-piercing hull has higher PTO than the flared hull under a generic operation scenario owing to reduced pitch motion and low resonance frequency of roll motion, the main restraint of seakeeping performance in PTO assessment.
A multiscale inversion algorithm for engineering inspection using GPR data
Authors: Gutiérrez Sergio , Menanno Giovanni , Yáñez Gonzalo
Published: April 2023

A numerical algorithm based on multiscale modeling is presented, to postprocess ground penetrating radar measurements obtained when inspecting a reinforced concrete slab, to characterize the position and shape of rebars. The method is based on minimizing the difference between the measured signal and the signal generated by a guessed location of the inclusion. Results for three specific examples are presented, including synthetic and real data. Comparison between inversion results and causative bodies is encouraging, despite the simplicity of the approach.
Simulating quantum key distribution in fiber-based quantum networks
Authors: Vitullo Dashiell LP , Cook Trevor , Jones Daniel E , Scott Lisa M , Toth Andrew , Kirby Brian T
Published: April 2023

Quantum networks exploit the unique properties of quantum mechanics to enable communication and networking tasks unavailable to existing distributed classical systems. Recently, the research community has focused considerable effort on the simulation of large-scale quantum networks with the ultimate goal of understanding their general properties, developing technical standards, and estimating their expected performance. However, comparatively little effort has been spent considering how quantum networks may impact tactical scenarios of military relevance where both quantum and classical resources may be severely constrained. Here, we develop a custom framework, called QuanTACT, for quantum network simulation explicitly designed for future integration into existing tactical simulation tools. In particular, our framework extends the existing quantum networking tool, SQUANCH, to include channel models required to simulate deployed fiber environments. Furthermore, we implement the additional subroutines needed to simulate entanglement-based quantum key distribution (QKD) and use published results from various field-deployed QKD experiments to benchmark the performance of our framework.
Using Bandura's Self-Efficacy Theory to Explain Individual Differences in the Appraisal of Problem-Focused Coping Potential
Authors: Poluektova Olga , Kappas Arvid , Smith Craig A.
Published: April 2023

Appraisal theory assumes that the individual variability of emotional reactions to the same situation is due to individual differences in appraisal. However, the question of how interindividual differences in appraisal come about has been rarely formally addressed. We focus on one of the central dimensions of appraisal—problem-focused coping potential—and attempt to explain individual differences in appraisals along this dimension using self-efficacy theory. We integrate outcome expectancies, self-efficacy expectations, and problem-focused coping potential into a single framework and outline their personality antecedents. Using generalized self-efficacy beliefs as an example, we then discuss the mechanisms underlying the effects of personality dispositions on appraisal and the conditions that moderate their influence. We conclude with the implications for theory, research, and practice.
The association of alcohol use disorder with revision rates and post-operative complications in total shoulder arthroplasty
Authors: Chiu Anthony K , Cuero Kendrick J , Agarwal Amil R , Fuller Samuel I , Kreulen R Timothy , Best Matthew J , Srikumaran Uma
Published: April 2023

Background

Alcohol use disorder (AUD) is the most prevalent substance use disorder in the United States. However, the current literature on AUD as a preoperative risk factor for Total Shoulder Arthroplasty (TSA) outcomes is limited. The purpose of this study was to identify the association of AUD with revision rates and 90-day postoperative complications in TSA.

Methods

A retrospective study was conducted using the PearlDiver database. Patients diagnosed with AUD were identified. Patients in remission or with underlying cirrhosis were excluded. Outcomes included 2-year revision, 90-day readmission, 90-day emergency, and 90-day post-operative medical complications. Analysis was performed with univariate chi-squared tests followed by multivariable logistic regression.

Results

A total of 59,261 patients who underwent TSA for osteoarthritis were identified, with 1522 patients having a diagnosis of AUD. Multivariable logistic regression showed that patients with AUD were more likely to undergo 2-year all-cause revision (OR = 1.49, p  =  0.007), 2-year aseptic revision (OR = 1.47, p  =  0.014), 90-day hospital readmission (OR = 1.57, p  =  0.015), and 90-day transient mental disorder (OR = 2.13, p  =  0.026).

Conclusions

AUD is associated with increased rates of 2-year revision surgery, as well as 90-day readmission and 90-day transient mental disorder following primary TSA for osteoarthritis. These findings may assist orthopedic surgeons in counseling patients with AUD during the pre-operative course.
Biomechanical Effects of Manipulating Preferred Cadence During Treadmill Walking in Patients With ACL Reconstruction
Authors: Garcia Steven A. , Johnson Alexa K. , Orzame Marissa , Palmieri-Smith Riann M.
Published: April 2023

Background:

Abnormal gait is common after anterior cruciate ligament reconstruction (ACLR) which may influence osteoarthritis risk in this population. Yet few gait retraining options currently exist in ACLR rehabilitation. Cueing cadence changes is a simple, low-cost method that can alter walking mechanics in healthy adults, but few studies have tested its effectiveness in an ACLR population. Here, we evaluated the acute effects of altering cadence on knee mechanics in patients 9 to 12 months post ACLR.

Hypothesis:

Cueing larger steps will facilitate larger knee angles and moments, while cueing smaller steps would induce smaller knee angles and moments.

Study Design:

Randomized cross-sectional design.

Level of Evidence:

Level 3.

Methods:

Twenty-eight patients with unilateral ACLR underwent gait assessments on a treadmill at preferred pace. Preferred walking gait was assessed first to obtain preferred cadence. Participants then completed trials while matching an audible beat set to 90% and 110% of preferred cadence in a randomized order. Three-dimensional sagittal and frontal plane biomechanics were evaluated bilaterally.

Results:

Compared with preferred cadence, cueing larger steps induced larger peak knee flexion moments (KFMs) and knee extension excursions bilaterally ( P < 0.01), whereas cueing smaller steps only reduced knee flexion excursions ( P < 0.01). Knee adduction moments remain unchanged across conditions and were similar between limbs ( P > 0.05). Peak KFMs and excursions were smaller in the injured compared with uninjured limb ( P < 0.01).

Conclusion:

Frontal plane gait outcomes were unchanged across conditions suggesting acute cadence manipulations result in mainly sagittal plane adaptations. Follow-up studies using a longitudinal cadence biofeedback paradigm may be warranted to elucidate the utility of this gait retraining strategy after ACLR.

Clinical Relevance:

Cueing changes in walking cadence can target sagittal plane knee loading and joint range of motion in ACLR participants. This strategy may offer high clinical translatability given it requires relatively minimal equipment (ie, free metronome app) outside of a treadmill.
The role of Europol and Eurojust in countering the threat of FTFs: An evolving mandate
Authors: Weyembergh Anne , Theodorakakou Georgia
Published: April 2023

Foreign Terrorist Fighters (FTFs) can pose a major security threat to EU Member States as after they return to the EU, they may engage in terrorism-related activities. In order to curb this threat, the EU and the Member States have adopted a multidisciplinary strategy. This article discusses the role that Europol and Eurojust play in supporting Member States in their efforts to combat FTFs effectively, including in their relations with third partners. Their role is particularly necessary in the field of the so-called ‘criminal justice response’, which is one of the core pillars of the holistic approach to address FTFs and consists of investigating and prosecuting crimes allegedly committed by FTFs abroad, including terrorism-related crimes and core international crimes. Aside from the respective role that each agency can play in the fight against FTFs, Europol and Eurojust cooperate closely with each other to scale up the chances of a successful response. Although, both agencies have considerably helped Member States tackle the FTF phenomenon, there are still some challenges which lie in their interagency cooperation when it comes to the collection and use of evidence, and in the lack of cooperation agreements with some significant in the field third partners. Finally, the recent revision of both agencies’ mandate is expected to further enhance the Europol and Eurojust’s capacity in supporting Member States’ efforts to combat FTFs; nevertheless, it raises some concerns as regards the fundamental rights of individuals concerned.
One-sixth of women experienced obstructed labor among those delivered at public hospitals in Southern Ethiopia: A multicenter study
Authors: Melesse Yekatit , Assebe Yadeta Tesfaye , Lami Magarsa , Getachew Tamirat , Mohammed Hanan , Berhanu Bekelu , Dheresa Merga
Published: April 2023

Objective:

The study aimed to assess the prevalence of obstructed labor and associated factors among women delivered at public hospitals in Southern Ethiopia.

Methods:

Institution-based cross-sectional study was employed among 704 systematically selected postnatal women. The data were collected by the structured and pre-tested interviewer-administered questionnaire and analyzed by Statistical Package for Social Science version 20. Multivariable logistic regression with a 95% confidence level was used to determine the associated factors. Statistical significance was declared at p < 0.05.

Result:

The prevalence of obstructed labor was 15.8% (95% confidence interval: 13.1–18.5). Age (adjusted odds ratio = 5.23, 95% confidence interval: 2.98–11.12), antenatal care follow-up (adjusted odds ratio = 1.8, 95% confidence interval: 1.10–3.39), duration of labor (adjusted odds ratio = 4.41, 95% confidence interval: 2.56–7.67), and experiencing complications (adjusted odds ratio = 4.21, 95% confidence interval: 2.63–6.98) were significantly associated with obstructed labor.

Conclusion:

The study revealed that one-sixth of women experienced obstructed labor. Regional health sectors and non-governmental organizations need to collaborate with healthcare providers in providing improved maternal health services with special emphasis on teenage women with optimum and proper follow-up throughout the pregnancy, by early identifying complications during labor and delivery to manage the problem early.
Refractory gastric ulcer bleeding responsive to long-term octreotide
Authors: Iqbal Humzah , Maharaj Dashmeet , Chaudhry Hunza , Gulati Alakh , Roytman Marina
Published: April 2023

Upper gastrointestinal tract bleeding is a common condition that can cause hemodynamic instability and death if left untreated. Endoscopic hemostasis is often successful; however, some patients may develop refractory bleeding. Pharmacologic management with octreotide is beneficial in patients with variceal bleeding and has been shown in some studies to be effective in refractory bleeding due to angiodysplasia. There is a paucity of literature regarding the usage of long-term octreotide in refractory bleeding secondary to a peptic ulcer. We present a case of a bleeding gastric ulcer that was refractory to endoscopic management but responsive to long-term octreotide therapy.
The use of chlordiazepoxide for outpatient gamma-butyrolactone (GBL) detoxification: An observational study
Authors: Balston Alfred , Hunjan Kuljit , Kelleher Michael J
Published: April 2023

Background

Various detoxification regimens are used for gamma-hydroxybutyrate (GHB) and gamma-butyrolactone (GBL), including diazepam, barbiturates, baclofen and GHB itself. However, these regimens are primarily derived from inpatient units, and literature on outpatient GBL detoxification is sparse with no previous reports on chlordiazepoxide. We describe the characteristics of outpatient GBL detoxification using chlordiazepoxide.

Methods

Observational study of all patients who attended a community outpatient addiction service in South London between August 2015 and November 2017 seeking detoxification from GBL. The outpatient caseload is predominantly patients with alcohol, opioid and stimulant dependence. Routine clinical data including patient demographics, GBL usage, daily chlordiazepoxide dose and Clinical Institute Withdrawal Assessment for Alcohol-revised (CIWA-Ar) score were recorded.

Results

In the study period there were 17 attendances for GBL detoxification, 14 of which were undertaken in the outpatient setting. Twelve (86%) patients who had an outpatient detoxification were male, all of whom were men who have sex with men. Of 14 outpatient GBL detoxifications managed with chlordiazepoxide, 10 were successfully completed. One of the four patients that did not complete detoxification required inpatient treatment in an acute hospital. The average successful detoxification took 10 ± 3.1 days. For patients who completed a detoxification, the median maximum CIWA-Ar score on day one of the detoxification was 11 (range 2–17), with the mean dose of chlordiazepoxide used on day one being 140 mg (range 80–225 mg).

Conclusions

Chlordiazepoxide can be used for outpatient GBL detoxification in combination with a provision for crisis admission to hospital. CIWA-Ar score can be applied to GBL withdrawal to measure severity and inform a reducing regimen of chlordiazepoxide.
User experiences of older adults navigating an online database of community-based physical activity programs
Authors: Lowndes Ashley M , Connelly Denise M
Published: April 2023

Objectives

This study aimed to (1) explore older adult user experiences navigating an online health database of local physical activity programs; (2) compare navigational feedback with age-friendly website design guidelines; (3) assess online database completeness.

Methods

Focus groups, including guided tasks and a semi-structured interview script, gathered navigational user experiences of fifteen older adults. A review of the literature sought age-friendly best practice website design guidelines and a website search for local physical activity programs was completed.

Results

The design of the online database website was challenging for older adult participants to navigate and was not ‘intuitive’. Based on focus group feedback, there were multiple discrepancies between the evaluated online database and the established guidelines for designing age-friendly websites. A total of 187 physical activity programs were missing from the database.

Conclusions

Findings provide novel insight into user experiences of older adults navigating online health and physical activity program sites. Redesigning the following age-friendly website recommendations would empower older adults in the use of online databases and promote awareness of local physical activity programs. Health care providers need reliable and age-friendly online resources to link their patients with local physical activity programs to promote healthy aging.
The effect of Augmented-Reality media-based health education on healthy lifestyle knowledge, attitude, and healthy lifestyle behaviors among pregnant women during COVID-19 pandemic in Jakarta, Indonesia
Authors: Mulyani Erry Y , Jus’at Idrus , Sumaedi Sik
Published: April 2023

Pregnancy is a critical period. Pregnant women need to perform healthy lifestyle behavior in order to ensure good fetal development. During COVID-19 pandemic, Augmented-Reality (AR) media may be used in pregnant women health education. However, there is a lack of research that investigated the effect of AR media use in pregnant women health education. Therefore, this research aimed to investigate the impact of AR media use on healthy lifestyle knowledge, attitude, and behaviors among pregnant women during COVID-19 pandemic. This cohort-longitudinal study involved 86 pregnant women aged 18–45 years. The subjects who participated in this research received health education interventions using AR media for 5 months. The data collection was performed at the pre–post-intervention through a survey with questionnaire. Changes in subjects' healthy lifestyle knowledge, attitude, and behaviors were analyzed by using t-test. The research results show that the AR media use in health education significantly improved the subjects' scores for healthy lifestyle knowledge (5.0 ± 10.9; p < .05) and behaviors (9.7 ± 17.5; p < .05). However, the subject score for attitude was not significantly improved (0.3 ± 7.1; p ≥ .05). This research results provide evidence of the importance of using AR media in health education for pregnant women during COVID-19 pandemic.
Posterior circulation infarction after bronchial artery embolization
Authors: Yu Lei , Li Xionghui , Lin Feng , Wan Tuer , Cao Zhiwei
Published: April 2023

Bronchial artery embolization is minimally invasive, has a low complication rate, and achieves good hemorrhage control. It is the first-line treatment in hemoptysis patients whom medications are ineffective. Cerebral infarction is a rare complication of bronchial artery embolization, with posterior circulation infarcts being the most common. Possible mechanisms include a neurotoxic reaction to the contrast medium used, bronchial artery-pulmonary shunt, embolus formation, fistula formation between the bronchial artery and the cerebral artery, and so on. To the best of our knowledge, there have been relatively few reports regarding posterior circulation infarcts after BAE, including 14 cases shown in Table 1. 11 patients recovered well after medical treatment, while the other patients did not survive. We report a case of a patient with a large posterior circulation infarct post bronchial artery embolization who developed severe neurological symptoms and died after 3 months of medication. Conclusion: Posterior circulation infarction is a rare but severe complication of bronchial artery embolization, and measures should be taken to prevent its occurrence.
A Decade of Trend in the Employee Turnover Intention Study in India: A Systematic Review and Recommendation
Authors: Gupta Santosh Kumar , Bhatia Nitesh
Published: April 2023

Employee turnover intentions have emerged as a significant research topic in social sciences as well as a challenge for corporates in Indian settings in past decade. This article presents a systematic literature review of employee turnover intention in India, providing an in-depth analysis of 198 empirical research articles on employee turnover intentions in Indian cultural settings published between 2010 to October 2022 in 126 academic journals listed in Scopus and Web of Sciences and proposes a heuristic model of turnover intention. The study reveals: 53 distinctive correlates of turnover intention which have been grouped into nine broad categories; research being conducted on a few antecedents of turnover intention in isolated pieces without taking a comprehensive approach; lack of attention to testing recent turnover models in Indian settings; too much preference on turnover intention as a proxy for actual turnover. The proposed model was tested on 481 respondents belonging to various industries across service sector in India employing Smart PLS software for validating path analysis provided encouraging results. Taking a note of trends and rifts, this article presents an inclusive approach along with suggestions and recommendations for future employee turnover intention research in India.
Social Media Influencers’ Traits and Purchase Intention: A Moderated Mediation Effect of Attitude Towards Brand Credibility and Brand Familiarity
Authors: Kareem Shaply Abdul , Venugopal Pulidindi
Published: April 2023

The prominence of social media influencers (SMI) has dramatically shifted in recent years. SMI enables brands to connect with users through unique and original content, thereby expanding their reach. In response, this study examined the effects of SMI traits on purchase intention by incorporating variables, such as attitude towards brand credibility as a mediator and brand familiarity as a moderator. Specifically, researchers examined the moderated mediation role of brand familiarity on purchase intention. The conceptual model is based on source credibility and the theory of reasoned action. PLS-SEM and Process Macro analyzed the data of 454 Instagram users. Research shows that SMI trustworthiness, expertise and attitude towards brand credibility improve purchase intention. Attitudes toward brand credibility mediate attractiveness, expertise and purchase intention. Brand familiarity moderates the relationship between attitudes towards brand credibility and intention. The moderated mediation effect of brand familiarity improves the relationship between trustworthiness, expertise and purchase intention. This study contributes to the literature on influencer marketing. Furthermore, managers and practitioners can strategically benefit from this research.
Survivorship, Outcomes, and Risk Factors for Conversion to Total Hip Arthroplasty After Revision Hip Arthroscopic Surgery in Obese Patients: Results at a Minimum 5-Year Follow-up
Authors: Maldonado David R. , Lee Michael S. , Kyin Cynthia , Jimenez Andrew E. , Owens Jade S. , Perez-Padilla Paulo A. , Domb Benjamin G.
Published: April 2023

Background:

There is a paucity of literature reporting outcomes after revision hip arthroscopic surgery in obese patients.

Purpose:

To report the minimum 5-year survivorship, patient-reported outcomes (PROs), clinical benefit, and risk factors for conversion to total hip arthroplasty (THA) in obese patients after revision hip arthroscopic surgery.

Study Design:

Case series; Level of evidence, 4.

Methods:

Data were prospectively collected and retrospectively reviewed for patients who underwent revision hip arthroscopic surgery by a single surgeon between April 2010 and August 2016. Inclusion criteria were a body mass index ≥30 and baseline and minimum 5-year postoperative values for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Exclusion criteria were Tönnis grade >1 and hip dysplasia. Survivorship was defined as no conversion to THA. Clinical benefit was measured using the minimal clinically important difference (MCID). Survivors and nonsurvivors underwent further bivariate and regression analyses to determine the predictors of conversion to THA.

Results:

Included were 24 hips in 24 patients. The mean patient age was 39.3 ± 12.7 years, and the mean follow-up was 83.9 ± 26.5 months. The survivorship rate was 75.0%, and patients demonstrated a significant improvement in all PROs ( P < .01). At 5-year follow-up, the MCID for the mHHS, NAHS, HOS-SSS, and VAS was achieved by 70.6%, 94.1%, 92.9%, and 64.7%, respectively, of the patients. Older age, higher grade ligamentum teres tears, and acetabuloplasty were significant on bivariate analysis for conversion to THA, and increased age was identified as a significant variable for conversion to THA on regression analysis (odds ratio, 1.297 [95% CI, 1.045-1.609]; P = .018), with a 29.7% greater risk for every additional year of age at the time of revision.

Conclusion:

In this study, 25.0% of obese patients who underwent revision hip arthroscopic surgery required conversion to THA. The study patients who did not need conversion to THA had a significant improvement in all PROs, with >90% achieving MCID for one or more outcome measures. Older age was identified as a significant predictor of conversion to THA.
Biomechanical Evaluation of the Efficacy of Suture Tape Augmentation for Subscapularis Peel Repair
Authors: Wellington Ian J. , Hewitt Cory R. , Hawthorne Benjamin C. , Mancini Michael R. , Dorsey Caitlin G. , Quintana Julio O. , Talamo Michael , Obopilwe Elifho , Cote Mark P. , Mazzocca Augustus D. , Sethi Paul M.
Published: April 2023

Background:

Failure of a subscapularis repair construct after anatomic total shoulder arthroplasty can result in difficulty with internal rotation and an increased likelihood of dislocation. Although suture tape has been demonstrated to be an efficacious augment for tendonous repairs elsewhere in the body, it has not been investigated as a method for augmenting subscapularis peel repairs.

Purpose:

To determine the biomechanical efficacy of suture tape augmentation for the repair of a subscapularis peel.

Study Design:

Controlled laboratory study.

Methods:

Twelve human cadaveric shoulders underwent a subscapularis peel. Specimens were randomly split into 2 groups: 6 specimens underwent repair using a transosseous bone tunnel technique with 3 high-strength sutures placed with a Mason-Allen configuration (control group), and 6 specimens underwent the control repair using augmentation with 2 suture tapes placed in an inverted mattress fashion and secured to the proximal humerus using a suture anchor (augmentation group). Shoulders underwent biomechanical testing to compare repair displacement with cyclic loading, load at ultimate failure, and construct stiffness.

Results:

There were no significant between-group differences in displacement after cyclic loading at the superior ( P = .87), middle ( P = .47), or inferior ( P = .77) portions of the subscapularis tendon. Load to failure was significantly greater in the augmentation group (585.1 ± 97.4 N) than in the control group (358.5 ± 81.8 N) ( P = .001). Stiffness was also greater in the augmentation group (71.8 ± 13.7 N/mm) when compared with the control group (48.7 ± 5.7 N/mm) ( P = .003).

Conclusion:

Subscapularis peel repair with augmentation via 2 inverted mattress suture tapes secured with an anchor in the proximal humerus conferred significantly greater load at ultimate failure and construct stiffness when compared with a traditional repair using 3 Mason-Allen sutures. There was no difference in repair displacement with cyclic loading between the repair groups.

Clinical Relevance:

Suture tape augmentation of subscapularis peel repairs after shoulder arthroplasty provides an effective segment to the strength of the repair.
“Doesn’t Seem Like a Place to Interact, or Interact Well”: Motivations to Discuss (and Not) Science and Religion on Social Media
Authors: Marler Will , Hargittai Eszter
Published: April 2023

Incivility in online discussions is an ongoing concern in academic and popular circles alike. Although social media offers the possibility for meaningful discussion, research has identified many barriers to this potential including disrespectful interactions, echo chambers, misinformation, and participation gaps. Most such scholarship focuses on just one topic of discussion, however. By comparing two domains of exchange, the authors are able to examine whether and how the subject of conversation may influence online experiences. The authors analyze interviews with 45 adults from across the United States about their experiences discussing science and religion on social media. People approached the two topics differently, which influenced whether they contributed to related conversations. The intrusion of politics into conversations across both topics broadly limited participation. Curiosity, knowledge, and interacting in private groups or with strangers encouraged joining discussions. Understanding participation dynamics across topic domains is fruitful for future research on the social media public sphere.
Mammary Paget’s Disease of Young Females: Case Reports and Comparison With Middle-Aged and Elderly Patients
Authors: Lv Chun-yan , Cheng Xian-kui , Guo Zhong-Yue , Liu Li , Cai Jian , Lei Tao , Tang Yan
Published: April 2023

Purpose:

Mammary Paget’s disease (PD) in young women has seldom been reported. The aim of this study was to improve the knowledge of the clinicopathological characteristics in young patients with PD to provide a basis for the precise treatment of young patients.

Methods:

The medical records and pathological slides of 8 young patients (younger than 40 years old) with PD were reviewed. The data of 20 patients over 40 years old within the same period were used as controls.

Results:

The average age was 32.00 ± 3.96 years for the young patient group, with the youngest aged 27 years. The first symptom, physical examination, Paget cell morphology, and immunohistochemical marks were the same in different age groups. But young patients have varied tumor distribution patterns, fewer interstitial inflammatory cells, and advanced pathological local lymphatic metastasis than older patients in the same period.

Conclusions:

PD in young women has unique histopathological features. These manifestations seem to provide personalized treatment for PD treatment in young patients. More research is needed to clarify the significance of this research.
Using qualitative study designs to understand treatment burden and capacity for self-care among patients with HIV/NCD multimorbidity in South Africa: A methods paper
Authors: van Pinxteren Myrna , Mbokazi Nonzuzo , Murphy Katherine , Mair Frances S , May Carl , Levitt Naomi S
Published: April 2023

Background

Low- and middle-income countries (LMICs), including South Africa, are currently experiencing multiple epidemics: HIV and the rising burden of non-communicable diseases (NCDs), leading to different patterns of multimorbidity (the occurrence of two or more chronic conditions) than experienced in high income settings. These adversely affect health outcomes, increase patients’ perceived burden of treatment, and impact the workload of self-management. This paper outlines the methods used in a qualitative study exploring burden of treatment among people living with HIV/NCD multimorbidity in South Africa.

Methods

We undertook a comparative qualitative study to examine the interaction between individuals’ treatment burden (self-management workload) and their capacity to take on this workload, using the dual lenses of Burden of Treatment Theory (BoTT) and Cumulative Complexity Model (CuCoM) to aid conceptualisation of the data. We interviewed 30 people with multimorbidity and 16 carers in rural Eastern Cape and urban Cape Town between February-April 2021. Data was analysed through framework analysis.

Findings

This paper discusses the methodological procedures considered when conducting qualitative research among people with multimorbidity in low-income settings in South Africa. We highlight the decisions made when developing the research design, recruiting participants, and selecting field-sites. We also explore data analysis processes and reflect on the positionality of the research project and researchers.

Conclusion

This paper illustrates the decision-making processes conducting this qualitative research and may be helpful in informing future research aiming to qualitatively investigate treatment burden among patients in LMICs.
Laparoscopic Toupet Fundoplication Utilizing the Remnant Stomach for Treatment of GERD After Roux-en Y Gastric Bypass: How I Do It
Authors: Zimmermann Christopher J. , Callahan Zachary M. , Amundson Julia R. , Ujiki Michael B.
Published: April 2023

Roux-en Y gastric bypass (RYGB) is an alternative to fundoplication in patients with concurrent obesity and gastroesophageal reflux disease (GERD). However, up to 25% of bypassed patients continue to have GERD. When medical management in this population fails, laparoscopic fundoplasty using the remnant stomach is a viable option. This video describes our approach to this procedure.
Hybrid Percutaneous Management of Acute Midsubstance Achilles Tendon Ruptures
Authors: McMellen Christopher J. , Desai Bijal , Sinkler Margaret A. , Miskovsky Shana
Published: April 2023

Background:

Operative management techniques of Achilles tendon ruptures can be categorized into open repair, mini-open repair, or percutaneous repair.

Indications:

Surgical repair of acute ruptures of the Achilles tendon is indicated in athletic populations, with percutaneous repair being an effective technique with more favorable outcomes.

Technique:

With the patient prone, the Achilles rupture is identified and the Percutaneous Achilles Repair System (PARS) jig is inserted under the proximal paratenon. A series of Keith needles and flat braided SutureTape sutures are passed transversely across the proximal stump of the tendon. The sutures are then shuttled through the distal stump using a SutureLasso through medial and lateral percutaneous incisions on the distal medial and distal lateral borders of Achilles, respectively. Sutures are passed, tensioned, and secured to the posterior tuberosity of the calcaneus with two SwiveLock anchors.

Results:

Percutaneous repair, compared with open repair, results in lower wound complication rates, improved cosmetic appearance and fewer adhesions. Following surgery, patients follow a 5-stage rehabilitation protocol with return to sport when patients demonstrate dynamic neuromuscular control during multiplane activities without pain or swelling. Outcome studies have compared percutaneous repairs to open repairs, with percutaneous repairs demonstrating a quicker return to work or baseline activities (2.8 months versus 5.6 months) and a shorter return to play for athletes (average 18 weeks). Also, a greater number of PARS patients were able to return to baseline activities within 5 months (98%), compared with open repair patients (82%; P = .0001). In a prospective randomized controlled trial of 33 patients, Lim et al reported no postoperative wound infections in the percutaneous group and a 21% infection rate in the open repair group ( P = .01). Finally, in a recent systematic review of only percutaneous repairs, reported rates of sural nerve injury and rerupture were only 3.3% and 2.1%, respectively.

Discussion/Conclusion:

Compared to open repair, percutaneous Achilles repair allows for decreased risk of soft-tissue complications with comparable functional outcomes and earlier return to activity.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
What if children are not the future? How to support educational possibility
Authors: Sobe Noah W.
Published: April 2023

This essay begins from the position that the planetspeak bromide “children are the future” has been banalized far past the point any usefulness. Despite the sensible attractiveness of teaching children well and letting them lead the way, the commonplace ad nauseam linking of children to the “future” has perverse disempowering effects. And, in our current moment of conjunctive global crises, it jeopardizes the future as it actually moves us away from—not toward—transformative pedagogies of the possible. This essay suggests ways to rescue educational possibility from narrow “children are the future” banalities.
Impact of St. John’s wort extract Ze 117 on stress induced changes in the lipidome of PBMC
Authors: Bussmann Hendrik , Bremer Swen , Häberlein Hanns , Boonen Georg , Drewe Jürgen , Butterweck Veronika , Franken Sebastian
Published: April 2023

Background

Membrane lipids have an important function in the brain as they not only provide a physical barrier segregating the inner and outer cellular environments, but are also involved in cell signaling. It has been shown that the lipid composition effects membrane fluidity which affects lateral mobility and activity of membrane-bound receptors.

Methods

Since changes in cellular membrane properties are considered to play an important role in the development of depression, the effect of St. John’s wort extract Ze 117 on plasma membrane fluidity in peripheral blood mononuclear cells (PBMC) was investigated using fluorescence anisotropy measurements. Changes in fatty acid residues in phospholipids after treatment of cortisol-stressed [1 μM] PBMCs with Ze 117 [10–50 µg/ml] were analyzed by mass spectrometry.

Results

Cortisol increased membrane fluidity significantly by 3%, co-treatment with Ze 117 [50 µg/ml] counteracted this by 4.6%. The increased membrane rigidity by Ze 117 in cortisol-stressed [1 μM] PBMC can be explained by a reduced average number of double bonds and shortened chain length of fatty acid residues in phospholipids, as shown by lipidomics experiments.

Conclusion

The increase in membrane rigidity after Ze 117 treatment and therefore the ability to normalize membrane structure points to a new mechanism of antidepressant action of the extract.
Modified Model of Crack Tip Stress Field Considering Dislocation Slip Accumulation and Crack Tip Blunting
Authors: Li Jian , Yang Bing , Wang Shuancheng , James M. N. , Xiao Shoune , Zhu Tao , Yang Guangwu
Published: April 2023

This study uses the digital image correlation technique to measure the crack tip displacement field at various crack lengths in U71MnG rail steel, and the interpolated continuous displacement field was obtained by fitting with a back propagation (BP) neural network. The slip and stacking of dislocations affect crack initiation and growth, leading to changes in the crack tip field and the fatigue characteristics of crack growth. The Christopher-James-Patterson (CJP) model describes the elastic stress field around a growing fatigue crack that experiences plasticity-induced shielding. In the present work, this model is modified by including the effect of the dislocation field on the plastic zone of the crack tip and hence on the elastic field by introducing a plastic flow factorρ, which represents the amount of blunting of the crack tip. The Levenberg-Marquardt (L-M) nonlinear least squares method was used to solve for the stress intensity factors. To verify the accuracy of this modified CJP model, the theoretical and experimental plastic zone errors before and after modification were compared, and the variation trends of the stress intensity factors and the plastic flow factorρwere analysed. The results show that the CJP model, with the introduction ofρ, exhibits a good blunting trend. In the low plasticity state, the modified model can accurately describe the experimental plastic zone, and the modified stress intensity factors are more accurate, which proves the effectiveness of dislocation correction. This plastic flow correction provides a more accurate crack tip field model and improves the CJP crack growth relationship.
Incidence and progression of osteoarthritis following curettage and cementation of giant cell tumor of bone around the knee: long-term follow-up
Authors: Ebeid Walid Atef , Badr Ismail Tawfeek , Mesregah Mohamed Kamal , Hasan Bahaa Zakarya
Published: April 2023

Background

Giant cell tumor of bone (GCTB) is a benign locally aggressive tumor frequently treated with intralesional curettage and cementation. The aim of this study was to investigate the long-term incidence of arthritic changes following curettage and cementation of GCTB around the knee.

Materials and methods

This study was a retrospective review of patients with GCTB around the knee treated with curettage and cementation with a minimum follow-up of 10 years. The functional results were assessed using the Musculoskeletal Tumor Society (MSTS) score. The arthritic changes were classified using the Kellgren–Lawrence (KL) classification system of osteoarthritis.

Results

This study included 119 patients, 54 males and 65 females, with a mean age of 29.4 ± 9.2 years. There were 35 (29.4%) patients with pathological fractures. There were 84 (70.6%) patients with de novo lesions and 35 (29.4%) with recurrent lesions. The mean follow-up period was 13.2 ± 3.16 years. The mean MSTS score was 28.5 ± 1.9. Overall, 25 (21%) patients developed variable degrees of arthritis of KL grade 1 (n = 7), KL grade 2 (n = 11), KL grade 3 (n = 4), and KL grade 4 (n = 3). Ten patients showed progression of arthritis during the follow-up period. Age at presentation, gender, presence of pathological fracture, whether the tumor was de novo or recurrent, and tumor location were not associated with arthritis incidence.

Conclusions

Curettage and cementation can be used safely to treat GCTB around the knee. Arthritis of the knee is a possible complication, but mild grades are expected in most cases. There was no association between arthritis incidence and age, gender, pathological fractures, tumor location, or recurrent tumors.

Level of evidence

Level IV.