bluuebunny/crossref_metadata_2025_split huggingface dataset:
Religious Agency and Time Regimes in the Roman Empire: The Cult of Anubis as a Case Study
Authors: Gasparini Valentino 
Published: December 2020

Abstract
This article analyzes three different case studies related to the Graeco-Roman cult of Anubis, located in different historical periods (Early, Middle, and Late Roman Empire) and approached by the study of different types of material (namely literary, epigraphic/archaeological, and iconographic sources). The goal of this study is to explore the social dimension of religious practice, stressing its variety, creativity, multiplicity, fluidity, and flexibility of identities, changes in forms of individuality, and spaces for individual distinction. By means of a detailed inquiry of Mustafa Emirbayer and Ann Mische’s schema of “disaggregation” of agency into three component elements (iteration, projectivity, and presentification), this analysis will stress the historical variability of religious agency and will show how, across time, emerging situations forced religious actors to select among alternative possibilities of action by recovering patterns belonging to past routines and creating new future options that responded to present hopes and fears. The results of this investigation will then be conceptualized according to the methodological framework of the Lived Ancient Religion paradigm.
A note on Nuba Mountain verb extensions
Authors: Hyman Larry M. 
Published: December 2020

Abstract
Based on the available literature and personal communications with specialists, this paper surveys the rich occurrence of verb extensions in the Nuba mountain languages which mark different grammatical functions such as causative, dative and locative applicatives, comparative, passive, antipassive, reciprocal/reflexive, and associative/instrumental, as well as ventive, itive, habitual, iterative and pluractional marking. Given the diversity of forms among the different groups in the area, a set of guidelines is considered to determine whether specific extensions can be reconstructed or are recent innovations. An extensive table is provided which provides the forms of the reported extensions and compares them with those reconstructed in specific subbranches of Niger-Congo, Nilo-Saharan, Afro-Asiatic, and in Khoe.
Mencius, Xunzi, and the Third Stage of Confucianism
Authors: Tu Weiming 
Published: December 2020

Abstract
According to Karl Jaspers’s theory of the Axial age, many important cultures in the world experienced a “transcendental breakthrough” between 800 and 200 BCE; no more transformations occurred until Martin Luther’s Protestant Reformation in the sixteenth century, which eventually ushered in the modern era. The implication of this theory is that only the West had a second cultural breakthrough, thus rendering moot the discussion of a third Confucian epoch. But, in reality, Confucianism had a second breakthrough during the Song—Ming period (tenth to seventeenth centuries) and spread from China to East Asia; this new form of Confucianism is called “neo-Confucianism” by Western scholars. The third Confucian epoch is a forward-looking concept that uses the lexicon of Western science and democracy to trace Confucianism’s philosophical transformation from a Chinese tradition into a part of world culture, and the integration of Mencian and Xunzian thought has to be treated in this light. Faced with Western cultural challenges, modern Confucianism has broken new ground in many ways. Mou Zongsan 牟宗三 is Mencian (as represented by Lu Xiangshan 陸象山, Wang Yangming 王陽明, and Liu Jishan 劉蕺山) in spirit and Xunzian (as represented by Zhu Xi 朱熹) in practice. Li Zehou 李澤厚, by contrast, exhorts us to talk the Mencian talk but walk the Xunzian walk; this contradictory stratagem, which he thinks will lead to a brighter and healthier future, only accentuates the power of Mencius 孟子 as a philosopher of the mind. Mencius and Xunzi 荀子 are very important in a modern deconstruction of Confucianism and the integration of their thought may very well become the impetus for another transcendental breakthrough. Is integration possible? How should they be integrated? We await the results of Confucian scholars’ open-minded explorations.
Leans Illusion in Hexapod Simulator Facilitates Erroneous Responses to Artificial Horizon in Airline Pilots
Authors: van den Hoed Annemarie , Landman Annemarie , Van Baelen Dirk , Stroosma Olaf , van Paassen M. M. (René) , Groen Eric L. , Mulder Max 
Published: December 2020

Objective We tested whether a procedure in a hexapod simulator can cause incorrect assumptions of the bank angle (i.e., the “leans”) in airline pilots as well as incorrect interpretations of the attitude indicator (AI). Background The effect of the leans on interpretation errors has previously been demonstrated in nonpilots. In-flight, incorrect assumptions can arise due to misleading roll cues (spatial disorientation). Method Pilots ( n = 18) performed 36 runs, in which they were asked to roll to wings level using only the AI. They received roll cues before the AI was shown, which matched with the AI bank angle direction in most runs, but which were toward the opposite direction in a leans-opposite condition (four runs). In a baseline condition (four runs), they received no roll cues. To test whether pilots responded to the AI, the AI sometimes showed wings level following roll cues in a leans-level condition (four runs). Results Overall, pilots made significantly more errors in the leans-opposite (19.4%) compared to the baseline (6.9%) or leans-level condition (0.0%). There was a pronounced learning effect in the leans-opposite condition, as 38.9% of pilots made an error in the first exposure to this condition. Experience (i.e., flight hours) had no significant effects. Conclusion The leans procedure was effective in inducing AI misinterpretations and control input errors in pilots. Application The procedure can be used in spatial disorientation demonstrations. The results underline the importance of unambiguous displays that should be able to quickly correct incorrect assumptions due to spatial disorientation.
Poor Appetite and Eating Difficulties Can Predict the Long-Term Risk of Falling: A Longitudinal Study in Middle-Aged and Older Adults
Authors: Lin Yu-Chun , Chang Yu-Hung 
Published: December 2020

Objectives: This study investigates whether self-reported nutritional status affects falling among middle-aged and older adults. Method: We used 8-year follow-up data from the Taiwan Longitudinal Study on Aging. At baseline, respondents’ appetite, changes in amount of food intake, and eating difficulties were assessed in a questionnaire-based survey in addition to anthropometric measurements (body mass index, mid-arm circumferences, and involuntary body weight loss). Their associations with falls in the follow-up were examined using multivariable log-binomial regression. Results: The study included 2,519 respondents aged 50 years and older. Poor appetite (prevalence ratio [PR] = 1.25, 95% confidence interval [CI] = [1.07, 1.46]) and eating difficulties (PR = 1.16, 95% CI = [1.02, 1.32]) significantly predicted falling 8 years later with adjustments for sociodemographics, health behaviors, comorbidities, and anthropometric measures by taking into account probabilities of follow-up. Conclusion: Poor appetite and eating difficulties can predict falling in the long-term independent of anthropometric measurements among middle-aged and older adults.
Promoting Physical Activity Among Older Adults Using Community-Based Participatory Research With an Adapted PRECEDE-PROCEED Model Approach: The AEQUIPA/OUTDOOR ACTIVE Project
Authors: Bammann Karin , Recke Carina , Albrecht Birte Marie , Stalling Imke , Doerwald Friederike 
Published: December 2020

Purpose: The PRECEDE-PROCEED model (PPM) is a community-based participatory research (CBPR) framework for health promotion, yet the direct application of the PPM into practice is unclear. This paper describes how the PPM was adapted for the development and application of a pilot intervention study to promote outdoor physical activity (PA) in older adults (OUTDOOR ACTIVE). We illustrate the steps and adaptations we applied to put the PPM into practice and present the developed interventions. Design: The PPM was adapted by incorporating a socio-ecological model. This ensured the design of any resultant intervention would explicitly address multi-level determinants of physical activity. The list of possible program components to select from for the design of an intervention was also extended. Setting: Bremen, Germany. Participants: Participants in the intervention development were 924 noninstitutionalized older adults, aged 65-75 years (response: 25.2%), living in Bremen-Hemelingen, Germany. For implementation of the intervention and to ensure sustainability, several groups of stakeholders were involved throughout the process. Methods: A mixed method design was employed (e.g., focus groups, quantitative survey) to identify determinants. A round table and participatory workshops were held to involve the target group and community stakeholders in the design of an intervention using the adapted PPM model. Results: A conceptual model was developed illustrating the integration of a socio-ecological model into the PPM. The model received ecological validity, as it was affirmed by community stakeholders as an appropriate method for designing a community-level PA intervention. Target goals to address PA determinants were selected by target group members. An intervention to meet the goals was developed and implemented with target group input. Conclusion: The adapted PPM is a promising starting point for developing multi-level interventions. Steps should be taken to ensure all social groups are participating in the process and all levels of determinants are addressed.
The Role of the Pharmacist in Optimizing Outcomes With Roflumilast, a PDE4 Inhibitor for the Treatment of COPD
Authors: Williams Dennis 
Published: December 2020

Purpose The pharmacology of roflumilast, recent dosing revisions, and the integral roles of pharmacists in effective chronic obstructive pulmonary disease (COPD) management are reviewed here. Summary COPD is characterized by progressive airflow limitation and intermittent acute exacerbations of symptoms, which contribute to disease progression, worsening of comorbidities, and reduced health-related quality of life. Patients with COPD may use a variety of pharmacotherapies (in combination with nonpharmacological modalities) to prevent exacerbations, reduce the impact of symptoms, and reduce or prevent COPD progression. Given the complex and multifaceted nature of disease management, pharmacists are uniquely positioned to collaborate with other clinicians to improve treatment adherence and efficacy via a number of diverse avenues in patients with COPD. Central to this endeavor is patient education and counseling regarding their treatment regimen. Conclusion Recent findings from a phase 3 clinical trial demonstrate improved tolerability and reduced treatment discontinuation resulting from the use of an uptitration regimen in patients with severe COPD who initiate therapy with roflumilast. Pharmacists have a central role in effective COPD management, especially with respect to patient education about treatments.
Prejudiced Attitudes of Nursing Students in Southern Spain Toward Migrant Patients
Authors: Alemany-Arrebola Inmaculada , Plaza del Pino Fernando J. , Sánchez-Ojeda María A. 
Published: December 2020

Introduction The increase in the migrant population in Spain has transformed the cultural profile of public health care users. The purpose of this study is to recognize the subtle and blatant prejudices nursing students have toward migrant patients. Method An ex post facto descriptive study, using a transversal design ( N = 1,393). Results Males showed a higher degree of prejudice ( p < .05). Students in their first year have more subtle prejudices than those in their fourth year ( p < .005). Blatant prejudice increases from the first year to the fourth year of the degree program ( p < .05). Regarding context, there were differences found between subtle and blatant prejudice (both, p < .05), as students in areas with high migratory pressure showed more prejudiced attitudes toward migrant patients. Discussion Students display subtle prejudices, which is why education in culturally congruent health care must be integrated across all levels of nursing education, with the objective of diminishing prejudice against the migrant population.
The international normalised ratio predicts perioperative complications in revision total hip arthroplasty
Authors: Arnold Nicholas R , Samuel Linsen T , Karnuta Jaret M , Acuña Alexander J , Kamath Atul F 
Published: December 2020

Background: Standard preoperative protocols in total joint arthroplasty utilise the international normalised ratio (INR) to determine patient coagulation profiles. However, the relevance of preoperative INR values in joint arthroplasty remains controversial. Therefore, we examined (1) the relationship between preoperative INR values and various outcome measures, including, but not limited to: surgical site complications, medical complications, bleeding, number of readmissions, and mortality. Additionally, we sought to determine (2) specific INR values associated with these complications and (3) cutoff INR levels which correlated with specific outcomes. We additionally applied these analyses to (4) examine the relationship between INR and length-of-stay (LOS). Methods: The American College of Surgeons National Surgical Quality Improvement Program database (ACS-NSQIP) was queried for rTHA procedures performed between 2006 and 2017. INR ranges were used to stratify cohorts: ⩽1.0, 1.0–⩽1.25, 1.25–⩽1.5, >1.5. INR values were determined using receiver operating characteristics (ROC) curves for each outcome of interest. Optimal cutoff INR values for each outcome were then obtained using univariate/multivariate models. 2012 patients who underwent rTHA met inclusion criteria. Results: Patients with progressively higher INR values had a significantly different risk of mortality within 30 days ( p = 0.005), bleeding requiring transfusion ( p < 0.001), sepsis ( p = 0.002), stroke ( p < 0.001), failure to wean from ventilator within 48 hours ( p = 0.001), readmission ( p = 0.01), and hospital length of stay ( p < 0.001). Similar results were obtained when utilising optimal INR cutoff values. When correcting for other factors, the following poor outcomes were significantly associated with the respective INR cutoff values (Estimate, 95% CI, p-value): LOS >4 days (1.67, 1.34–2.08, p < 0.001), bleeding requiring transfusion (1.65, 1.30–2.09, p < 0.001), sepsis (2.15, 1.11–4.17, p = 0.022), and any infection (1.82, 1.01–3.29, p = 0.044). Conclusions: Our analysis illustrates a direct relationship between specific preoperative INR levels and poor outcomes following rTHA, including increased LOS, transfusion requirements and infection. Therefore, current INR guideline targets may need to be re-examined when optimising patients for revision arthroplasty.
The pericapsular nerve group block: a step towards outpatient total hip arthroplasty?
Authors: Remily Ethan A , Hochstein Steven R , Wilkie Wayne A , Mohamed Nequesha S , Thompson John V , Kluk Matthew W , Nace James , Delanois Ronald E 
Published: December 2020

Introduction: A new regional anaesthetic technique, coined the pericapsular nerve group (PENG) block, targets the anterior hip capsule by blocking the articular branches of the femoral nerve and accessory obturator nerve. In this study, we evaluated: (1) patient outcomes; (2) postoperative pain scores; and (3) postoperative opioid consumption in total hip arthroplasty (THA) patients who received a PENG block in comparison to a control group. Methods: A retrospective chart review was performed for patients who underwent primary THA and met criteria at a single institution ( n = 48), with an additional cohort of patients collected as controls ( n = 48). Postoperative pain scores were measured by obtaining the cumulative visual analogue scores (VAS) at 12-hour intervals until the 48-hour benchmark. All administered opioids were collected from postoperative day (POD) 0 to POD2 and converted to morphine milligram equivalents (MME). Results: In the PENG group, length of stay was significantly shorter ( p  < 0.001) and the initial postoperative distance walked was significantly farther ( p = 0.001). The PENG group consistently demonstrated significantly lower mean cumulative pain scores until the 48-hour mark ( p  < 0.001 for all). Patients receiving the PENG block also experienced a significantly longer therapeutic window before requiring their first opioid ( p  < 0.002). The PENG group required significantly less opioid MMEs on POD1, POD2, and cumulatively over the entire stay ( p  < 0.022 for all). Conclusions: Our findings suggest that the PENG block has the potential of impacting THA recovery pathways and contributing to cost savings. Thus, its use further supports the transition to the outpatient setting and drives us towards achieving value-driven healthcare.
Short- to midterm results of early cannulation arteriovenous grafts (Gore® ACUSEAL) for hemodialysis: Experience with the ACUSEAL in a Japanese cohort
Authors: Honma Kenichi , Eguchi Daihiko 
Published: December 2020

Background: In patients without suitable vasculature for autologous arteriovenous fistula, vascular access using a prosthetic graft is an option for hemodialysis. Gore® ACUSEAL Vascular graft is an early cannulation arteriovenous graft (AVG) that allows early puncture within 24 h after surgery. We aimed to report the outcomes of using this graft in patients from a single center. Methods: This study included 113 patients who underwent surgery for a new AVG using ACUSEAL, between December 2015 and December 2017, and were followed up. The primary outcomes were primary patency, assisted-primary patency, and secondary patency. Secondary outcomes were postoperative complications such as graft infection and steal syndrome. Results: Of the 113 patients, 60 were male and 53 were female. The average age was 74.4 ± 10.7 years. We could cannulate 69.1% of patients within 24 h. The average follow-up period was 20.1 ± 10.8 months. The primary patency rates after 3 months, 6 months, and 1 year were 76.2%, 60.4%, and 33.8%, respectively. The assisted-primary patency rates after 3 months, 6 months, and 1 year were 88.8%, 73.2%, and 58.9%, respectively. The secondary patency rates after 3 months, 6 months, and 1 year were 100%, 100%, and 98.8%, respectively. Fourteen patients (12.4%) developed graft infection and two patients (1.8%) developed steal syndrome. Conclusion: In our study, ACUSEAL showed satisfactory patency and acceptable complication rates in the short to medium term, similar to previous studies. ACUSEAL is beneficial for surgeons who are familiar with using AVG and for medical staff who control bleeding after dialysis. However, due to the large outer diameter of the graft, surgical wounds might become dehiscent, and careful designing of the subcutaneous graft route is necessary. It might be possible to reduce the rate of graft infection by planning the site and skin incision.
The influence of workforce agility on high-growth firms: The mediating role of innovation
Authors: Abrishamkar Mohammed Mahdi , Abubakar Yazid Abdullahi , Mitra Jay 
Published: December 2020

An agile workforce refers to a workforce that is proactive, flexible and resilient in dealing with non-routine and unpredictable circumstances. Even though past research suggests that agility could have a positive effect on firm performance, there is hardly any empirical evidence on whether agility matters for high-growth firms (HGFs). The purpose of this research is therefore to investigate the extent to which workforce agility increases the likelihood of firms becoming HGFs in the high-tech manufacturing sector of a developing economy, and whether the relationship is mediated by new product innovation. We develop a theoretical framework that explains how and why a firm that has an agile workforce that is proactive in creating new products, flexible in responding to changing environment, and resilient in turbulent times, is more likely to create innovative products, and thus secure temporary monopoly, which increases the likelihood of the firm becoming a HGF. Then, utilizing firm-level data from high-tech manufacturing sector of a developing country, Iran, we test several hypotheses using logistic regressions. We find that workforce agility significantly increases the probability of high-tech manufacturing firms becoming HGFs, but that this relationship is mediated by new product innovation. Implications are drawn for theory and practice.
Prospective Comparison of Subtalar Arthroereisis With Calcaneal Lengthening in the Management of Planovalgus Feet of Ambulatory Children With Spastic Cerebral Palsy?
Authors: Ahmed Amr H. , Hanna Atef A. , Arafa Amr S. , El-Sherbini Mostafa H. , Omran Ahmed A. 
Published: December 2020

Background Pes planovalgus (PPV) deformity is common among cerebral palsy (CP) patients. There is no true consensus about the best way of treating this common deformity, especially when surgical interference is required. Treatment options range from orthotics to complex surgical procedures. The purpose of this prospective study was to evaluate and compare the effectiveness of 2 different procedures in the correction of symptomatic flexible PPV in ambulatory CP patients. Methods A total of 57 feet in 35 patients were divided into 2 groups: group 1, subtalar arthroereisis group, using the calcaneostop technique; group 2, lateral column lengthening group, using Evans osteotomy. Patients were assessed clinically by the clinical score proposed by Yoo et al and radiologically by measuring 7 weight-bearing angles, both preoperatively and 12 months postoperatively. Patients’ (or parents’) satisfaction and their tolerance to braces or shoes were assessed 12 months after surgery as secondary outcome parameters. Results There was a statistically significant improvement in both primary and secondary outcome parameters after both procedures in comparison to the preoperative parameters. No statistically significant differences were observed between the 2 groups regarding the outcomes of both procedures except for the greater power of arthroereisis in the correction of hindfoot valgus, which was statistically significant both clinically and radiographically. Conclusion Both procedures are valid options for the surgical management of PPV in ambulatory children with spastic CP. The less-invasive nature and lower potential morbidity suggest that judicious use of arthroereisis is appropriate for some patients, especially in the context of single-event multilevel surgery. Levels of Evidence: Level II: Prospective, comparative study.