bluuebunny/crossref_metadata_2025 huggingface dataset:
Achieving Financial Sustainability in Ghana’s Banking Sector: Is Environmental, Social and Governance Reporting Contributive?
Authors: Maama Haruna
Published: September 2021

Despite banks not having any significant direct negative impacts on the environment and society, they adopt environmental, social and governance (ESG) accounting. Meanwhile, ESG reporting consumes additional resources and exposes firms’ strategies to competitors. The study employed a legitimacy theory to investigate the impact of ESG reporting on the financial sustainability of banks in Ghana. The study relied on 10 years of annual reports of all the banks in Ghana. The banks’ ESG reporting practices were assessed based on a content analysis method. The financial sustainability was measured based on return on assets (ROA) and net interest margin (NIM). Evidence showed that environmental reporting (ERI) impacted the banks’ NIM and ROA inversely and significantly, whilst governance reporting had a positive but insignificant relationship with NIM and ROA. The result further demonstrated that social reporting (SRI) impacted NIM and ROA positively and significantly. The overall ESG reporting had a negative and significant relationship with the banks’ financial sustainability. Hence, the ESG reporting did not improve the financial sustainability of banks, and banks in Ghana have less of an incentive to report on ESG as opposed to banks in other countries, where such reporting generally makes financial sense.
The Indian Council of World Affairs: Revisiting Formative Points of Institutional History
Authors: Mishra Vivek
Published: September 2021

This commentary recounts the important hallmarks of the institutional history of the Indian Council of World Affairs, one of India’s first publicly funded research institutions. It presents a brief account of its long history since 1943, its career in acquiring prominence, its decline and its revival. This commentary takes off from its recently published institutional history (Raghavan, T., & Mishra, V. [2021]. Sapru House: A story of institution building in world affairs).
“You Are Always at War With Yourself” The Perceptions and Beliefs of People With Obesity Regarding Obesity as a Disease
Authors: Grannell Andrew , le Roux Carel W. , McGillicuddy Deirdre
Published: September 2021

Obesity as a disease remains poorly understood by key stakeholders. Here, in people living with severe obesity, perceptions and beliefs relating to obesity as a disease and obesity causality were examined. Semi-structured interviews were conducted in a tertiary care obesity clinic. 23 people with obesity (10 males, 13 females) volunteered. An overall agreement that obesity is a disease was present. Perceptions related to why obesity is and is not a disease were diverse: Lack of control and addiction, biological determinism, and personal responsibility. For weight loss maintenance, the perceptions and beliefs were heterogeneous with biological factors not considered a determinant of success. Instead, exercise, support, and willpower were described as associated with success. Barriers related to remaining in a weight-reduced state included the following: Emotional eating, sustainability of diet, occupational impact, and defeatism due to misaligned expectation and outcome. In conclusion, people living with obesity tend to agree obesity is a disease yet an incomplete understanding of the disease is present.
“Gambling With My Cards Face Up”: Vulnerability as a Risky Act Among Men
Authors: Durón Delfín Florencia , Leach Rebecca B.
Published: September 2021

This study examines men’s lived experiences of suppressing vulnerability in a conflict. These moments of suppression happened during conflicts with friends, romantic partners, or family members. A phronetic-iterative approach guided an in-depth analysis of 16 qualitative interviews to illuminate the social conditions and expectations that prevented men from verbally expressing vulnerability. Men made sense of their own and others’ suppression patterns by naming cultural, relational, and individual factors. We argue that the toxic culture of masculinity is constructed collectively, such that men’s communication creates and reinforces expectations of what it means to be “strong” men. Reshaping the current culture into a safe space for men to express emotions will require intentional efforts from both men and their support systems.
Outcomes and Complications of Open vs Posterior Arthroscopic Subtalar Arthrodesis: A Prospective Randomized Controlled Multicenter Study
Authors: Rungprai Chamnanni , Jaroenarpornwatana Aekachai , Chaiprom Nusorn , Phisitkul Phinit , Sripanich Yantarat
Published: September 2021

Background:

Open subtalar arthrodesis is the standard treatment for subtalar arthritis. Posterior arthroscopic subtalar arthrodesis (PASTA) has recently gained increasing popularity due to a shorter recovery time and better cosmesis. However, studies comparing outcomes and complications between these 2 techniques are limited.

Methods:

In total, 56 patients with subtalar joint arthritis were prospectively randomized to 2 parallel groups to receive either PASTA (n = 28 patients) or open subtalar arthrodesis (n = 28 patients). The minimum follow-up period was 12 months. Primary outcome was union rate confirmed on postoperative computed tomography (CT) scan. Secondary outcomes were union time; visual analog scale (VAS), Short Form–36 (SF-36), and Foot and Ankle Ability Measure (FAAM) scores; tourniquet time; and complications.

Results:

Union time (9.4 vs 12.8 weeks) and recovery time (time to return to activities of daily living [8.4 vs 10.8 weeks], work [10.6 vs 12.9 weeks], and sports [24.9 vs 32.7 weeks]) were significantly shorter with PASTA than with the open technique ( P < .05 all). Both techniques led to significant improvements in all functional outcomes (FAAM, SF-36, and VAS scores; P < .01 all); however, there was no significant difference between the techniques in these outcomes ( P > .05 all). Other outcomes, including tourniquet time (55.8 vs 67.2 min), union rate (96.3% vs 100%), and complication rate, were not significantly different between the techniques.

Conclusion:

Both open and PASTA techniques led to significant improvements in pain and function in patients with isolated subtalar joint arthritis. Although short-term functional outcomes and complication rates were not significantly different between the techniques, the PASTA technique was better at shortening the union and recovery times.

Level of Evidence:

Level I, prospective multicenter randomized controlled trial.
Multicenter, Open-Label, 2-Arm, Pilot Trial for Safe Reduction of Basal Insulin Dose Combined with SGLT2 Inhibitor in Type 1 Diabetes Mellitus: Study Protocol for a RISING-STAR Trial
Authors: Hamaguchi Masahide , Hashimoto Yoshitaka , Tanaka Toru , Hasegawa Goji , Ishii Michiyo , Okada Hiroshi , Mitsuhashi Kazuteru , Kitagawa Noriyuki , Ushigome Emi , Yamazaki Masahiro , Fukui Michiaki
Published: September 2021

Background:

The safe method of instructing insulin dose reduction in combination with SGLT2 inhibitors, dapagliflozin for patients with type 1 diabetes mellitus has not been clarified. In this study, we conducted a stratified, 2-arm, parallel comparative study with the primary endpoint of decreasing the frequency of hypoglycemia by instructing basal insulin dose reduction.

Methods:

The study has a multicenter, open-label, 2-arm design; 60 type 1 diabetes mellitus patients are being recruited from 7 hospitals. Study subjects have been stratified into 2 groups based on the ratio of basal insulin daily dose (Basal) to total daily insulin dose (TDD). The subjects whose Basal/TDD ratio is <0.4 are instructed not to reduce Basal but to reduce bolus insulin dose by 10% (group A), and subjects with a Basal/TDD ratio >0.4 will be instructed to reduce Basal by 10% (group B). The primary outcome is the daily frequency of hypoglycemia during the intervention period (SGLT2 inhibitor administration), as determined by self-monitoring of blood glucose. We aimed to confirm a greater reduction in frequency of hypoglycemia in group B (reduced Basal), than in group A (non-reduction of Basal and reduced insulin effect levels by 10%). Baseline hypoglycemia was set at 7 ± 6 times/month. The minimum sample size required to achieve a significance of .05 for a 1-sided t-test with a statistical power at 80% is determined. When the sample size is 26 patients in 1 group, the percentage increase in hypoglycemia exceeds 60%, and the sample size is considered sufficient.

Discussion:

In this pilot study, we assumed that, given a sufficient Basal, hypoglycemia would be more frequent in patients with type 1 diabetes when combined with SGLT2 inhibitors, provided the Basal was not reduced.
Telemedicine: Niche or mainstream? A bibliometric analysis and review of the output of highly ranked clinical journals
Authors: Edirippulige Sisira , Senanayake Buddhika , Fatehi Farhad , Hansen Julie , Bambling Matthew , Smith Anthony C , Armfield Nigel R
Published: September 2021

Historically, telemedicine research is predominantly published in discipline-specific telemedicine journals. However, in recent times the number of publications on telemedicine in clinical journals has increased. Acceptance of telemedicine research by clinical journals indicates a maturing of the telemedicine field. This bibliometric study reviewed telemedicine-related literature published in clinical journals from 2008 to 2018. A search was conducted in PubMed using two types of clinical outlets. (1) Top 20 journals with highest Impact Factor in the field of Medicine. (2) Top five journals with highest Impact Factor in most common Medical Specialty Areas. Analysis showed that there is a steady growth of literature relating to research and non-research publications appearing in clinical journals. Top five journals in the field of Medicine – BMJ, JAMA, Cochrane database, Medical Journal of Australia and Lancet have published 64% ( n = 270) of telemedicine-related articles for the study period. Disease areas associated with telemedicine publications are consistent with global disease priorities. The review demonstrated that the most significant increase in telemedicine research published in clinical journals was focused on patient care.
Small Stories of Home Moves: A Gendered and Generational Breadth-and-Depth Investigation
Authors: Edwards Rosalind , Weller Susie , Davidson Emma , Jamieson Lynn
Published: September 2021

This article explores the way people from different age cohorts and genders talk about home moves to contribute a rounded and nuanced relational understanding. We draw on a secondary analysis of qualitative longitudinal data from multiple archived studies, using a breadth-and-depth analytic approach. Conceptually, we apply a linked lives perspective that understands home moves as tied to sets of social relationships and involving the navigation of structural circumstances. We identify complex discrete and serial small stories where moving away from or returning to is interdependently linked to others staying put, and staying put to others’ home moves, at local, intra-national, and trans-national levels. Home moves are shaped structurally by gender and age cohort generation. Home and moving tend to be more salient in women’s accounts, articulating with familial generation as their own and others’ comings and goings accumulated over their lifetime. Structural issues are also evident in the material and social resources that enable and constrain home moves, with more micro-level identification of recurrent themes of anxieties in the accounts of men who are starting/have young families, in contrast to women’s anxieties concerning the relational implications of home moves.
Teachers’ practices of proactive and reactive classroom management strategies and the relationship to their self-efficacy
Authors: Alasmari Nada Jaber , Althaqafi Abeer Sultan Ahmed
Published: September 2021

Teachers’ proactive and reactive classroom management strategies are a significant component of teaching effectiveness. Teachers need to develop such strategies to structure a positive classroom environment. In addition, teachers’ self-efficacy beliefs concerning their classroom management strategies are equally significant. This research aimed to identify the teachers’ effective proactive and reactive classroom management strategies. It also sought to investigate the obstacles that inhibit proactive classroom management use and identify the association between teachers’ self-efficacy and classroom management practices. The research adopted a mixed-methods paradigm, consisting of two tools: a questionnaire and semi-structured interviews. The sampling included 80 Saudi teachers of English as a foreign language (EFL) participated in the survey and eight teachers participated in the interviews. The results showed that EFL teachers find proactive classroom management strategies more effective than reactive strategies. In addition, there was a difference between novice and experienced teachers’ effective classroom management strategies, in which experienced teachers found proactive strategies more effective. The findings also indicated that there are four types of obstacles that hinder proactive classroom management strategies. System-related obstacles (subject-centered curriculum and institutional rules), system/teacher related obstacles (institutional rules and teachers’ predispositions concerning e-tools), teacher-related obstacles (lack of understanding of the discipline plan), and student-related obstacles (unmotivated students). The final finding cited the positive association between teachers’ high self-efficacy and proactive classroom management application.
Can ingroup love harm the ingroup? Collective narcissism and objectification of ingroup members
Authors: Cichocka Aleksandra , Cislak Aleksandra , Gronfeldt Bjarki , Wojcik Adrian Dominik
Published: September 2021

We examined how collective narcissism (a belief in ingroup greatness that is underappreciated by others) versus ingroup identification predicts treatment of ingroup members. Ingroup identification should be associated with favorable treatment of ingroup members. Collective narcissism, however, is more likely to predict using ingroup members for personal gain. In organizations, collective narcissism predicted promoting one’s own (vs. group) goals (prestudy: N = 179), and treating coworkers instrumentally (Study 1: N = 181; and longitudinal Study 2: N = 557). In Study 3 ( N = 214, partisan context), the link between collective narcissism and instrumental treatment of ingroup members was mediated by self-serving motives. In the experimental Study 4 ( N = 579, workplace teams), the effect of collective narcissism on instrumental treatment was stronger when the target was an ingroup (vs. outgroup) member. Across all studies, ingroup identification was negatively, or nonsignificantly, associated with instrumental treatment. Results suggest that not all forms of ingroup identity might be beneficial for ingroup members.
The Taint of The Other: Prison Work as ‘Dirty Work’ In Australia
Authors: Eriksson Anna
Published: September 2021

This article explores how prison staff in Australia view their work and how their work is viewed by others, by applying a theoretical framework of ‘dirty work’. ‘Dirty work’ is a social construction that refers to tasks that are ‘physically, socially or morally tainted’ ( Ashforth and Kreiner, 1999 ; Hughes, 1958 ) and this article will apply this concept to prison staff in Australia for the first time. The discussion is based on qualitative research in seven different Australian prisons, ranging from high to low security. The article illustrates how staff responds to working in a ‘dirty’ profession by reframing, refocusing, and recalibrating their daily work tasks; how the staff uniform can be utilised as a status shield and protector from taint; and how the stigma of ‘dirtiness’ tends to foster strong occupational and workgroup cultures which in turn makes cultural change of a profession difficult. The consequences of the dirty work stigma for staff and prisoners are discussed, with a focus on informal interactions, case work and dynamic security.
Citizenship-as-knowledge: How perspectives from Bildung-centred Didaktik can contribute to European Citizenship Education beyond competence
Authors: Ryen Erik , Jøsok Evy
Published: September 2021

How can the teaching of knowledge in schools contribute to the development of students as individual human beings, with the capacity not only for problem solving within the existing structures of society but also for developing ideas and solutions that go beyond the existing structures? The purpose of this article is to bring this question to the forefront within the context of citizenship education (CE) through a theoretical analysis of the epistemology underpinning two dominant conceptualisations of teaching CE. The analysis shows that both the model of teaching about, through and for democracy that underpins the understanding of CE in competence frameworks and the conceptualisation of CE as teaching directed towards qualification, socialisation and subjectification that is used to criticise citizenship-as-competence fall short in accounting for how knowledge can play a part in taking us beyond the existing. Turning to Bildung-centred Didaktik, which has dealt extensively with questions of knowledge in relation to the formation of the individual subject, the article explores how a renewed focus on knowledge can contribute to answering the question that Joris et al. pose in the title of their article ‘Citizenship -as-competence, what else?’
The Nature, Patterns and Consequences of Technology-Facilitated Domestic Abuse: A Scoping Review
Authors: Afrouz Rojan
Published: September 2021

Women are increasingly at risk of gender-based violence through technology and digital tools. Some digital devices and apps such as GPS location tracking, spyware, mobile phones and social media platforms have become new tools for perpetrators to monitor, harass and abuse victims. However, the nature and impacts of technology on intimate partner violence (IPV) have remained perplexing and ambiguous. Hence, this scoping review was conducted to explore the nature, patterns and consequences of technology-facilitated domestic abuse (TFDA). All journal articles and grey literature exploring the TFDA phenomenon, its nature and impacts on victims and services providers were scanned, and twenty-two papers were included in this scoping review. Overall, findings showed that digital devices, online applications and social media accounts facilitated IPV and exacerbated the consequences of abuse. Yet, many victims and frontline workers found understanding the nature and impacts of TFDA difficult. They faced many challenges addressing this form of abuse. Thus, several strategies are needed to adequately tackle TFDA, including conducting further research on the issue, developing appropriate policy and addressing gender inequality in the online environment.
Counseling on Complementary Methods in the Treatment of Side Effects of Oncological Therapies: A Project of the Breast and Bowel Center Nahe at the Hospital Sankt Marienwoerth Bad Kreuznach
Authors: Muecke Ralph , Gosenheimer Robert , Schulz Christoph , Heim Gabor , Schmitz Volker , Harvey Christina , Zosel-DeIturri Annette , Nissen Arnold , Hemberger Ulrike , Romeis Verena , Lochhas Gabriele , Metzmann Ute , Bussmann Matthias , Paschold Markus
Published: September 2021

Background:

Increasingly, patients with cancer are asking for additional, complementary therapy options for treating the side effects of oncological therapy. Thus, the members of the Breast and Bowel Center Nahe at the Sankt Marienwörth Hospital Bad Kreuznach decided to define the content of this type of counseling for patients before treatment.

Methods:

In 2018, a team of internal oncologists, gynecological oncologists, radio-oncologists, nutritionists, psycho-oncologists, and study nurses met several times to define the content of counseling. To inform the team, an intensive literature review was conducted.

Results:

Counseling content was determined for complementary treatment options for the most frequent side effects of oncological therapies. Counseling sessions were formulated as frontal lectures (slide presentations), given at regular intervals for patients and relatives. These lectures were highly appreciated by patients.

Conclusion:

These counseling sessions increased patient understanding of both useful complementary measures and harmful measures they should not use.
Making new meanings: The entextualisation of digital communications evidence in English sexual offences trials
Authors: Daly Ellen
Published: September 2021

There have been growing concerns about the malleability of digital communications evidence and its potential to reinforce embedded rape myths and cultural narratives that undermine victim-survivors in sexual offences trials. There is however a paucity of research exploring this issue in practice, and none in England and Wales. This article therefore uses two case studies, drawn from court observation research in 2019, to explore how digital communications evidence is used in English sexual offences trials. In both case studies the prosecution argued that digital communications between defendant and victim-survivor constituted admissions of guilt; both defendants resisted this by providing alternative meanings to the well-known colloquial phrases within the messages. Through the process of entextualisation, defence counsel bolstered the meanings defendants attributed to digital communications by drawing upon rape myths and deeply embedded gendered narratives. Defence counsel further employed rape myths and gendered narratives to undermine prosecution entextualisations of the digital evidence. This analysis builds on the existing literature by demonstrating that the malleability of digital evidence extends even to seemingly unambiguous communications.
Discriminative non-negative representation based classifier for image recognition
Authors: Hu Kai-Jun , Yin He-Feng , Sun Jun
Published: September 2021

During the past decade, representation based classification method has received considerable attention in the community of pattern recognition. The recently proposed non-negative representation based classifier achieved superb recognition results in diverse pattern classification tasks. Unfortunately, discriminative information of training data is not fully exploited in non-negative representation based classifier, which undermines its classification performance in practical applications. To address this problem, we introduce a decorrelation regularizer into the formulation of non-negative representation based classifier and propose a discriminative non-negative representation based classifier for pattern classification. The decorrelation regularizer is able to reduce the correlation of representation results of different classes, thus promoting the competition among them. Experimental results on benchmark datasets validate the efficacy of the proposed discriminative non-negative representation based classifier, and it can outperform some state-of-the-art deep learning based methods. The source code of our proposed discriminative non-negative representation based classifier is accessible at https://github.com/yinhefeng/DNRC .
Controlled Differentiation of Mesenchymal Stem Cells into Hyaline Cartilage in miR-140-Activated Collagen Hydrogel
Authors: Rajagopal Karthikeyan , Arjunan Porkizhi , Marepally Srujan , Madhuri Vrisha
Published: September 2021

Objective

Hypertrophic cartilage formation is a major setback in mesenchymal stem cells (MSCs)–mediated cartilage repair, and overcoming it requires optimization of differentiation. Here, we tested the miR-140 activated collagen hydrogel for the chondrogenic differentiation of MSCs and to produce hyaline cartilage.

Methods

Bone marrow MSCs isolated from 3 patients were pretreated with miR-140 and then chondrogenic differentiated. The 3-dimensional (3D) transfection potential of 5 different transfection reagents (Polyethylenimine, Lipofectamine, TransIT-X2, Amide:Cholesterol-based liposomes [AmC] and AmC pegylated with Tocofersolan [AmCTOC]) was compared and the reagent that showed higher green fluorescent protein (GFP) expression was selected. Finally, the collagen hydrogel was activated using miR-140-transfection complex and sustained delivered to MSCs during chondrogenic differentiation. After differentiation, the outcome was assessed by reverse transcription–polymerase chain reaction (RT-PCR), histology, immunohistochemistry, and compared with scrambled miRNA treated control.

Results

Pretreatment of MSCs with miR-140 significantly increased the expression of cartilage-specific genes ( COL2A1, SOX9, and ACAN) with reduced hypertrophic chondrocyte ( COL10A1) marker expression and better safranin-O staining than the control. The AmCTOC liposome showed a significant increase in 3D transfection of GFP expressing plasmid than the others. Furthermore, the knockdown of GAPDH using siRNA in HEK cells and expression of GFP mRNA in human bone marrow MSCs confirmed the 3D-transfection efficiency of AmCTOC. The sustained delivery of miR-140 using activated matrix formed a hyaline cartilage-like tissue with minimal COL10A1 expression in RT-PCR and immunohistochemistry.

Conclusion

Our results demonstrated the therapeutic potential of miR-140-activated hydrogel for MSCs-based cartilage tissue engineering, which could also be used for endogenous stem cells–mediated cartilage repair.
Increasing utility of Google Trends in monitoring cardiovascular disease
Authors: Senecal Conor , Mahowald Madeline , Lerman Lilach , Lopes-Jimenez Francisco , Lerman Amir
Published: September 2021

Introduction

Cardiovascular disease is the most common cause of morbidity and mortality in the United States. Patients are increasingly using internet search to find health-related information, including searches for cardiovascular diseases and risk factors. We sought to evaluate the change in the state by state correlation of cardiovascular disease and risk factors with Google Trends search volumes.

Methods

Data on cardiovascular disease hospitalizations and risk factor prevalence were obtained from the publically available Centers for Disease Control and Prevention website from 2006 to 2018. Google Trends data were obtained for matching conditions and time periods. Simple linear regression was performed to evaluate for an increase in correlation over time.

Results

Hospitalizations for six separate cardiovascular disease conditions showed moderate to strong correlation with online search data in the last period studied (heart failure (0.58, p < .001), atrial fibrillation (0.57, p < .001), coronary heart disease (0.58, p < .001), myocardial infarction (0.70, p < .001), stroke (0.62, p < .001), cardiac dysrhythmia (0.46, p < .001)) in the United States. All diseases studied showed a positive increase in correlation throughout the time period studied ( p < .05). All five of the cardiovascular risk factors studied showed strong correlation with online search data; diabetes ( R = 0.78, p < .001), cigarette use ( R = 0.79, p < .001), hypertension ( R = 0.81, p < .001), high cholesterol ( R = 0.59, p < .001), and obesity ( p = 0.80, p < .001) in the United States. Three of the five risk factors showed an increasing correlation over time.

Conclusion

The prevalence of and hospitalizations for cardiovascular conditions in the United States strongly correlate with online search volumes in the United States when analyzed by state. This relationship has progressively strengthened or been strong and stable over recent years for these conditions. Google Trends represents an increasingly valuable tool for evaluating the burden of cardiovascular disease and risk factors in the United States.
Predictors of Compliance to COVID-19 Containment Communications in Nigeria’s Federal Capital Territory, Enugu, and Lagos States
Authors: Ukonu Michael O. , Mbamalu Marcel
Published: September 2021

The difficulty in understanding new virus strains affects scientific efforts to immediately develop drugs and vaccines to stem the spread of viral diseases. As a result, social measures remain handy tools to address viral diseases. Nigeria joined the rest of the world to introduce social containment measures for the new COVID-19 pandemic. The study examines the factors predicting adherence to COVID-19 containment measures in selected Nigerian communities. It adopts multi-stage cluster sampling in a survey involving 183 respondents from two states and Nigeria’s Federal Capital Territory, Abuja. Multiple regression and descriptive statistics were used to estimate the influences of social factors (religion, family, friends), demographic characteristics (age, residential area, gender), and credibility factors (perceived trust, ease of adherence) on attitudes toward media messages and social measures on COVID-19 prevention guidelines. Results show that age, gender, marital status, type of street, education, and state of residence have significant influence on adherence to COVID-19 messages. While age and gender positively correlated with credibility assessment, type of street was negatively associated with credibility assessment of COVID-19 messages. Social factors have more predictive influence on adherence to COVID-19 messages than credibility assessment of COVID-19 messages. The study discusses the implications of relationships between demographic factors and adherence to COVID-19 messages.
In Vitro Testing of 2 Adjustable-Loop Cortical Suspensory Fixation Systems Versus Interference Screw for Anterior Cruciate Ligament Reconstruction
Authors: Garcés Gerardo L. , Martel Oscar , Yánez Alejandro , Manchado-Herrera Ignacio , Motta Luci M.
Published: September 2021

Background:

It is not clear whether the mechanical strength of adjustable-loop suspension devices (ALDs) in anterior cruciate ligament (ACL) reconstruction is device dependent and if these constructs are different from those of an interference screw.

Purpose:

To compare the biomechanical differences of 2 types of ALDs versus an interference screw.

Study Design:

Controlled laboratory study.

Methods:

ACL reconstruction was performed on porcine femurs and bovine extensor tendons with 3 types of fixation devices: interference screw, UltraButton (UB) ALD, and TightRope (TR) ALD (n = 10 for each). In addition to specimen testing, isolated testing of the 2 ALDs was performed. The loading protocol consisted of 3 stages: preload (static 150 N load for 5 minutes), cyclic load (50-250 N at 1 Hz for 1000 cycles), and load to failure (crosshead speed 50 mm/min). Displacement at different cycles, ultimate failure load, yield load, stiffness, and failure mode were recorded.

Results:

In specimen testing, displacement of the ALDs at the 1000th cycle was similar (3.42 ± 1.34 mm for TR and 3.39 ± 0.92 mm for UB), but both were significantly lower than that of the interference screw (7.54 ± 3.18 mm) ( P < .001 for both). The yield load of the UB (547 ± 173 N) was higher than that of the TR (420 ± 72 N) ( P = .033) or the interference screw (386 ± 51 N; P = .013), with no significant difference between the latter 2. In isolated device testing, the ultimate failure load of the TR (862 ± 64 N) was significantly lower than that of the UB (1879 ± 126 N) ( P < .001).

Conclusion:

Both ALDs showed significantly less displacement in cyclic loading at ultimate failure than the interference screw. The yield load of the UB was significantly higher than that of the other 2. The ultimate failure occurred at a significantly higher load for UB than it did for TR in isolated device testing.

Clinical Relevance:

Both UB and TR provided stronger fixation than an interference screw. Although difficult to assess, intrinsic differences in the mechanical properties of these ALDs may affect clinical outcomes.
Return to Performance After Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers: A Case-Control Assessment of Advanced Analytics, Velocity, Spin Rates, and Pitch Movement
Authors: Fury Matthew S. , Oh Luke S. , Linderman Shannon E. , Wright-Chisem Joshua , Fury Jacob N. , Scarborough Donna M. , Berkson Eric M.
Published: September 2021

Background:

There are limited data on the performance or pitching metrics of Major League Baseball (MLB) pitchers who returned to play after ulnar collateral ligament reconstruction (UCLR).

Purpose:

To describe MLB pitcher performance after return from primary UCLR, compare the velocity and pitch characteristics against the preoperative season, and determine if performance analytics can predict successful return to pitching after UCLR.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

This study included 63 pitchers who underwent primary UCLR between 2015 and 2019. Publicly available advanced analytics and pitch metrics from the first 2 postoperative seasons were compared with the preoperative (index) season as well as with an uninjured control group.

Results:

Overall, 57% of the pitchers successfully returned to the MLB level. Although they threw significantly fewer pitches ( P = .012) and innings ( P = .022) in postoperative year 1 as compared with the index season, there were no significant differences in pitch velocity, release extension, perceived velocity, or performance as measured by advanced analytics. Also, as compared with the index season, returners demonstrated increased postoperative spin rates on curveballs ( P = .001) and sliders ( P = .010), and curveball horizontal movement was significantly increased ( P = .007); however, horizontal movement was significantly decreased for 4-seam fastballs ( P = .026), changeups ( P = .005), and sinkers ( P = .019). The vertical movement on 4-seam fastballs was greater ( P < .001) in postoperative year 1, and the vertical movement on curveballs ( P = .031) and sinkers ( P = .010) was greater in postoperative year 2 when compared with the index season. Pitchers who failed to return to the MLB level had a lower preoperative strikeout percentage ( P = .047), fewer strikeouts per 9 innings pitched ( P = .046), fewer wins above replacement ([WAR]; P = .026), and lower player value ( P = .030) than the pitchers who returned.

Conclusion:

Pitchers returning to the MLB level after UCLR demonstrated changes in pitch movement profiles and spin rates postoperatively, but there were no differences in velocity or many advanced analytics upon return. Pitchers with lower strikeout metrics, fewer WAR, and less player value before surgery may have an elevated risk of failing to return to the MLB level.
Validity and Reliability of the Thai Version of the International Hip Outcome Tool in Young to Middle-Aged Physically Active Adults With Hip Disorders
Authors: Lertwanich Pisit , Loog-in Siwa , Pornrattanamaneewong Chaturong , Ganokroj Phob
Published: September 2021

Background:

The International Hip Outcome Tool (iHOT-33), which is a self-administered questionnaire that contains 33 questions, was developed to evaluate young to middle-aged physically active adults with hip pathology.

Purpose:

To translate and cross-culturally adapt the iHOT-33 to create a Thai version of the iHOT-33 (TH-iHOT-33) and to determine the validity and reliability of the TH-iHOT-33.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

Translation and cross-cultural adaptation of the iHOT-33 were performed according to international guidelines. Patients aged 18 to 60 years with hip disorders who had a score ≥4 on a modified version of the Tegner activity scale completed the TH-iHOT-33 twice, 2 weeks apart. The Thai versions of the HOOS (Hip disability and Osteoarthritis Outcome Score) and EQ-5D-5L (European Quality of Life–5 Dimensions–5 Levels) were also completed at baseline. At 2 weeks, the Global Perceived Effect scale was completed in addition to the TH-iHOT-33. The statistical testing for validity included construct validity and hypotheses testing. Internal consistency, test-retest reliability, and measurement error were analyzed to determine reliability.

Results:

The iHOT-33 was successfully translated and cross-culturally adapted to create the TH-iHOT-33. Seventy-two patients with various hip disorders participated in this study. Of the predefined hypotheses used for construct validity, 86% were confirmed. A Cronbach alpha of 0.98 (95% CI, 0.97-0.99) demonstrated excellent internal consistency. Test-retest reliability was high, with an intraclass correlation coefficient of 0.83 (95% CI, 0.73-0.90). The standard error of measurement was 5.1 points. The smallest detectable change was 14.2 points at the individual level and 1.9 points at the group level. The minimal important change was 10.9 points. The TH-iHOT-33 had no observable floor or ceiling effects.

Conclusion:

The TH-iHOT-33 is a valid and reliable instrument for assessing the functional status and health-related quality of life of young to middle-aged physically active Thai adults with hip disorders.
Physical Activity and Aging: Exploring Motivations of Masters Swimmers
Authors: Brilliant Susan L. , Claver Maria , LaPlace Patti , Schlesinger Cynthia
Published: September 2021

Physical activity benefits the health of older adults (e.g., lowering risk of cardiovascular disease, depression, dementia, and falls). However, less than one in four Americans meets guidelines for physical activity and inactivity increases with age. Masters athletes are exemplary because of their remarkable physical functioning. Swimming is a global, fast-growing sport in Masters athletics. This qualitative study explored motivations and barriers of 18 older adult members of a Masters swim club in Southern California. Guided by a primary research question: Why do Masters swimmers choose swim late in life, when most of their age cohort are becoming less physically active, semi-structured interviews delved into the lived experiences of the participants, and solicited peer feedback. Four main themes emerged: (1) I Just Love the Sensation of Being in the Water, (2) Tell Your Body What to Do Instead of the Other Way Around, (3) Make a Commitment to Your Friends That You’re Going to be There, and (4) I’ve Never Gone This Long in My Life Without Swimming. Participants expressed longing and regret that they could not swim due to COVID risk and safety guidelines. These findings can be used to design community programs to promote lifelong physical activity participation.
Linguistic ambivalence amidst suburban diversity: LGBTQ2S municipal ‘social inclusions’ on Vancouver’s periphery
Authors: Bain Alison L , Podmore Julie A
Published: September 2021

Social inclusion frameworks to enhance ‘diversity’ inform late neoliberal municipal governance in North American metropolitan areas, especially in central cities, but suburban LGBTQ2S constituencies are neglected by researchers. This paper, therefore, uses linguistic discourse and content analysis of an LGBTQ2S-inclusion archive of municipal public-facing communication in the Canadian peripheral municipalities of Burnaby, New Westminster, and Surrey, in the Vancouver city-region to trace the micro-patterns of linguistic ambivalence shaping suburban sexual citizenship. It demonstrates municipal variance in vernacular vocabularies of LGBTQ2S social inclusion that signals equivocation within divergent local linguistic political opportunity structures for suburban sexual and gender minorities. It concludes with a typological narration that details varied gradations of linguistic obfuscation, revealing patterns of civic ambivalence towards LGBTQ2S social inclusion amidst suburban diversity. Across a shared regional geography, the paper shows that LGBTQ2S populations are infrequently referenced relative to other marginalized social groups and that their presence in social inclusion frameworks is dictated by the extent to which they align with civic priorities, particularly festivalization and marketization, but also safety, welcoming newcomers, integrating seniors, and anti-discrimination initiatives.
Long-term Follow-up of Lisfranc Injuries Treated With Open Reduction Internal Fixation Patient-Reported Outcomes
Authors: Walley Kempland C. , Semaan Derek J. , Shah Ronit , Robbins Christopher , Walton David M. , Holmes James R. , Talusan Paul G.
Published: September 2021

Background:

There remains a paucity of data regarding long-term patient-reported outcomes following Lisfranc injuries. We sought to collect long-term clinical outcome data following Lisfranc injuries using PROMIS Physical Function (PROMIS-PF) and visual analog scale–foot and ankle (VAS-FA).

Methods:

A chart review was performed to identify all patients who had surgical treatment of an acute Lisfranc injury at our institution from 2005 to 2014. Of the 45 patients identified, we were able to recruit 19 for a follow-up clinic visit consisting of physical examination, administration of questionnaires addressing pain and medication usage, radiographs, and completion of outcome surveys including PROMIS-Physical Function and visual analog scale–foot and ankle.

Results:

There were 14 female and 5 male patients enrolled in the study with a mean time of 6.25 years from the time of injury. Within this cohort, the mean PROMIS-PF score was 52.4±8.2 and the mean VAS–foot and ankle score was 76.6±22.3.

Conclusion:

We report satisfactory long-term patient-reported outcomes using PROMIS-PF and VAS-FA.

Level of Evidence:

Level III, retrospective cohort study.
A patient safety and quality improvement curriculum for child and adolescent psychiatry fellows using the Learning from Defect Tool
Authors: Reynolds Elizabeth K , Connors Cheryl , Taylor J Lynn , Vasa Roma A
Published: September 2021

The purpose of this article is to describe the development and evaluation of an 11-session patient safety and quality improvement curriculum for first-year child and adolescent psychiatry fellows. The curriculum uses the Learning from Defects tool which teaches fellows how to conduct an analysis of a safety event they have encountered in their clinical work. The Learning from Defects tool provides a structured approach to address adverse clinical events and identify system failures by providing a framework to determine what happened, examine why it happened, implement interventions to reduce the probability that a similar event will recur, and evaluate whether the interventions were effective. Six fellows participated in the curriculum during their protected didactics time. Curriculum evaluation included an assessment of fellows’ knowledge, skills, and attitudes toward patient safety and quality improvement before and immediately after the curriculum, and 6-months later. Immediately upon completion of the curriculum, fellows reported more confidence and comfort with patient safety and quality improvement-related tasks in their clinical practice. Fellows reported a positive perception of the curriculum related to their learning objectives and utility in the future career. At the 6-month follow-up, the majority of fellows continued to work on their Learning from Defects project and endorsed the intention to participate in patient safety and quality improvement work in the future. This study provides preliminary support for implementing this patient safety and quality improvement curriculum utilizing the Learning from Defects tool in child and adolescent psychiatry fellowship programs. The Learning from Defects tool offers a practical way to teach patient safety and quality improvement skills that potentially can be generalized to future clinical work.
The Novel Oral Anticoagulants (NOACs) for the Treatment of Cerebral Venous Thrombosis: A Case Study of 32 Vietnamese Patients
Authors: Nguyen Thang H. , Ngo Triet M. , Phan Bau V. , Pham Binh N. , Dao Nha T. T. , Nguyen An T. T. , Nguyen Trung Q. , Phan Hoang T.
Published: September 2021

Background and Purpose:

Cerebral venous thrombosis (CVT) is a rare cause of cerebral infarction with diverse clinical presentations and outcomes. Novel oral anticoagulants (NOACs) provide an alternative option of systemic anticoagulation in various thromboembolic conditions, but uncertainty exists over the use of NOACs among patients with CVT. We present our initial experience with the use of NOACs for CVT in Vietnam.

Methods:

We included consecutive patients diagnosed with CVT presenting to 115 People’s Hospital in Vietnam between May 2016 and July 2017 and who were treated with NOACs. Data on patient demographics, vascular risk factors, clinical presentations, and outcomes at 180 days follow-up were obtained and analyzed. Modified Rankin scale (mRS) scores on admission, at discharge, and 180 days were assessed. Recanalization was assessed using magnetic resonance venography at 180 days follow-up. Venous thrombo-embolism events were defined as primary outcome, while bleeding complications were defined as safety outcome.

Results:

Among 32 patients with CVT (72% females; mean age: 40 ± 9.7 years), 15 were treated with rivaroxaban and 17 with dabigatran. A common risk factor was the usage of oral contraception (70%) on presentation. The mean mRS score on admission was 3.1 points (± 1.4). At FUP (median 8.5 months, IQR 5.5-9.5), clinical outcome (mRS ≤ 1) was excellent in most patients. All patients had at least partial recanalization and half of them achieved complete recanalization at 180 days follow-up. There were no bleeding complications.

Conclusion:

NOACs may offer clinical benefits with minimal complications in the treatment of CVT. Further prospective assessment with randomized controlled studies is warranted.
Passing the Baton: Building Student Autonomy and Democracy in the Large Ensemble Setting
Authors: Schatt Matthew D.
Published: September 2021

The purpose of this study was to explore the phenomena of participation in a democratic large ensemble experience in a secondary public school setting. Specific research questions included (a) Do high school band students feel capable of performing a music work without teacher intervention? (b) In what ways do high school band students describe the experience of performing in a student-led large ensemble? (c) What music decisions were most often made by high school band students in a student-led large ensemble? and (d) Were there any changes in high school students’ perceptions of autonomy following a student-led large ensemble music rehearsal and performance experience? Findings illustrated that the democratic experience increased student autonomy and music discrimination across larger distances in the classroom as students listened to other nonsimilar sections. Furthermore, student voice, self-efficacy, and personal affect also increased as a result of the experience. Students felt empowered to offer their rehearsal critiques; however, a lingering concern is that participants continued to feel that their peers would not listen to their opinions on rehearsal issues or strategy usage.