Search

Background: Shoulder arthroplasty has become an increasingly common procedure used to treat degenerative, inflammatory, and traumatic conditions of the glenohumeral joint. With a significant increase in primary anatomic and reverse total shoulder arthroplasty, revision procedures have likewise increased. Updates in shoulder arthroplasty have allowed for the convertibility of implants, which allows for the retention of both glenoid and humeral components during revision surgery. This review aims to highlight the epidemiology, indications, and outcomes of convertible-platform total shoulder arthroplasty procedures. Methods: A review of the current literature surrounding convertible-platform shoulder arthroplasty was completed to highlight the advantages and disadvantages of commercially available instrumentation and implant systems as well as their outcomes. Discussion: Leading causes of shoulder arthroplasty revision surgery include glenoid failure, implant instability, and rotator cuff dysfunction. Variations in implant design between inlay and onlay humeral components and metal-backed glenoid components are important considerations at the time of revision surgery. Advantages of convertible-platform systems include increased efficiency and decreased complications during revision procedures as well as shorter recovery, lower cost, and better functional outcomes. Limitations of convertible systems include poorly positioned components during the index procedure, excessive soft-tissue tensioning, and problems associated with metal-backed glenoid implants. Changes in arm length have also been documented. These findings indicate the benefit of additional research and design to improve the effectiveness and utility of convertible-platform shoulder arthroplasty systems.

A number of policies mandate that autistic transition-age youth receive employment services to prepare for the workforce before high school graduation. A key limitation to these services is the job interview component, which relies on non-standardized, resource-intensive, staff-led role-plays to help autistic transition-age youth improve their interview skills. The autism community has called for better job interview preparation. To address this gap in services, our team, collaborated with the autism community to adapt the intervention, Virtual Reality Job Interview Training (VR-JIT; effective among adults with serious mental illness), into Virtual Interview Training for Transition Age Youth (VIT-TAY). This adapted intervention was tailored to meet the needs of autistic transition age youth while maintaining the core components of VR-JIT (i.e., an online job interview simulator with four levels of automated feedback and e-learning content). A pilot randomized controlled trial (RCT) demonstrated VIT-TAY's feasibility and initial effectiveness at improving job interview skills, reducing anxiety, and increasing employment rates within six months when added to transition services or pre-employment transition services (Pre-ETS). Thus, the overarching goal of this Hybrid Type 1 effectiveness-implementation study protocol is to conduct a fully-powered RCT of VIT-TAY across 16 schools in various geographical locations. Our specific aims are to 1) Evaluate whether Pre-ETS (or transition services) with VIT-TAY, as compared to Pre-ETS (or transition services) with an active control intervention (i.e., job interview didactics/e-learning with a series of 3–5 min videos of employed autistic adults talking about their career pathways) enhances employment outcomes; 2) Evaluate mechanisms of employment by nine months post-randomization; and 3) Conduct a multilevel, mixed-method process evaluation of the initial implementation of VIT-TAY across settings (e.g., acceptability, feasibility, and barriers and facilitators of implementation).

These concluding remarks place the contributions to this special issue Repentance and Reappraisal: Historicising the Defenders of Slavery in the Netherlands in conversation with the history-writing on emancipation and anti-abolitionism in Atlantic studies. Along the way, this essay discusses some of the main themes in the literature and their parallels and departures with the findings and arguments presented by the contributors.

This essay examines the role of Anglo Protestant missions in the Persian Gulf in racializing “the Moslem world” for the emergent white world order at the beginning of the 20th century. More specifically, I consider the way Protestant missionaries extracted knowledge about Islam, racializing “the Moslem world” as a civilizational “unit” devoid of energetic life—and therefore incompatible with the modern world—even as they simultaneously mediated the rise of oil extraction along the Persian Gulf in that same period. Extraction was not only evident in the material relations of empire, but also in the way Protestant missionary discourse shaped “the Muslim world” into a racial unit in need of management and optimization. I consider two energetic grammars used by Protestant missionaries to signify the changes occurring in “the Moslem World”, namely, Samuel Zwemer’s use of “disintegration” and Basil Mathews use of “ferment”. I argue that it was in these material and discursive entanglements of oil extraction where knowledge about Islam became an important tool of European colonial governance, and where energetic grammars of religion became critical to the biopolitical production and management of racialized Muslim populations.

In this paper, an optimisation framework is presented for planning a stand-alone microgrid for supplying EV charging (EVC) stations as a design and modelling approach for the FEVER (future electric vehicle energy networks supporting renewables) project. The main problem of the microgrid capacity sizing is making a compromise between the planning cost and providing the EV charging load with a renewable generation-based system. Hence, obtaining the optimal capacity for the microgrid components in order to acquire the desired level of reliability at minimum cost can be challenging. The proposed planning scheme specifies the size of the renewable generation and battery energy storage systems not only to maintain the generation–load balance but also to minimise the capital cost (CAPEX) and operational expenditures (OPEX). To study the impact of renewable generation and EV charging uncertainties, the information gap decision theory (IGDT) is used to include risk-averse (RA) and opportunity-seeking (OS) strategies in the planning optimisation framework. The simulations indicate that the planning scheme can acquire the global optimal solution for the capacity of each element and for a certain level of reliability or obtain the global optimal level of reliability in addition to the capacities to maximise the net present value (NPV) of the system. The total planning cost changes in the range of GBP 79,773 to GBP 131,428 when the expected energy not supplied (EENS) changes in the interval of 10 to 1%. The optimiser plans PV generation systems in the interval of 50 to 63 kW and battery energy storage system in the interval of 130 to 280 kWh and with trivial capacities of wind turbine generation. The results also show that by increasing the total cost according to an uncertainty budget, the uncertainties caused by EV charging load and PV generation can be managed according to a robustness radius. Furthermore, by adopting an opportunity-seeking strategy, the total planning cost can be decreased proportional to the variations in these uncertain parameters within an opportuneness radius.

This paper presents a capacity planning framework for a microgrid based on renewable energy sources and supported by a hybrid battery energy storage system which is composed of three different battery types, including lithium-ion (Li-ion), lead acid (LA), and second-life Li-ion batteries for supplying electric vehicle (EV) charging stations. The objective of this framework is to determine the optimal size for the wind generation systems, PV generation systems, and hybrid battery energy storage systems (HBESS) with the least cost. The framework is formulated as a mixed integer linear programming (MILP) problem, which incorporates constraints for battery ageing and the amount of unmet load for each year. The system uncertainties are managed by conducting the studies for various scenarios, generated and reduced by generative adversarial networks (GAN) and the k-means clustering algorithm for wind speed, global horizontal irradiation, and EV charging load. The studies are conducted for three levels of unmet load, and the outputs are compared for these reliability levels. The results indicate that the cost of hybrid energy storage is lower than individual battery technologies (21% compared to Li-ion, 4.6% compared to LA, and 6% compared to second-life Li-ion batteries). Additionally, by using HBESS, the capacity fade of LA batteries is decreased (for the unmet load levels of 0, 1%, 5%, 4.2%, 6.1%, and 9.7%, respectively), and the replacement of the system is deferred proportional to the degradation reduction.

Abstract Background Non-communicable diseases (NCDs) are the leading cause of mortality across the Caribbean and similar regions. Structural determinants include a marked increase in the dependency on food imports, and the proliferation of processed foods, including sugar-sweetened beverages (SSBs). We focused on Jamaica as a case study and the health challenge of SSBs, and situated contemporary actions, experiences and policies within their historical context to investigate underlying drivers of commercial determinants of health and attempts to counter them. We asked: how can a historical perspective of the drivers of high level SSB consumption in Jamaica contribute to an enhanced understanding of the context of public health policies aimed at reducing their intake? Methods An ethnographic approach with remote data collection included online semi-structured interviews and workshops with 22 local experts and practitioners of health, agriculture and nutrition in Jamaica and attending relevant regional public webinars on SSBs and NCD action in the Caribbean. Our analysis was situated within a review of historical studies of Caribbean food economies with focus on the twentieth century. Jamaican and UK-based researchers collected and ethnographically analysed the data, and discussed findings with the wider transdisciplinary team. Results We emphasise three key areas in which historical events have shaped contextual factors of SSB consumption. Trade privileged sugar as a cash crop over food production during Jamaica’s long colonial history, and trade deregulation since the 1980s through structural adjustment opened markets to transnational companies. These changes increased Jamaican receptiveness to the mass advertisement and marketing of these companies, whilst long-standing power imbalances hampered taxation and regulation in contemporary public health actions. Civil society efforts were important for promoting structural changes to curb overconsumption of SSBs and decentring such entrenched power relations. Conclusion The contemporary challenge of SSBs in Jamaica is a poignant case study of commercial determinants of health and the important context of global market-driven economies and the involvement of private sector interests in public health policies and governance. Historically contextualising these determinants is paramount to making sense of the sugar ecology in Jamaica today and can help elucidate entrenched power dynamics and their key actors.

Leadership development in college is frequently cited as developing during undergraduate years. Nevertheless, some graduate and professional students develop further as leaders through involvement at the graduate level. This paper explores a case study examining the ways Doctor of Pharmacy (Pharm.D.) students commenced leadership development during pharmacy school through their co-curricular involvement.

BackgroundEmployment is a major contributor to quality of life. However, autistic people are often unemployed and underemployed. One potential barrier to employment is the job interview. However, the availability of psychometrically-evaluated assessments of job interviewing skills is limited for autism services providers and researchers.ObjectiveWe analyzed the psychometric properties of the Mock Interview Rating Scale that was adapted for research with autistic transition-age youth (A-MIRS; a comprehensive assessment of video-recorded job interview role-play scenarios using anchor-based ratings for 14 scripted job scenarios).MethodsEighty-five transition-age youth with autism completed one of two randomized controlled trials to test the effectiveness of two interventions focused on job interview skills. All participants completed a single job interview role-play at pre-test that was scored by raters using the A-MIRS. We analyzed the structure of the A-MIRS using classical test theory, which involved conducting both exploratory and confirmatory factor analyzes, Rasch model analysis and calibration techniques. We then assessed internal consistency, inter-rater reliability, and test–retest reliability. Pearson correlations were used to assess the A-MIRS’ construct, convergent, divergent, criterion, and predictive validities by comparing it to demographic, clinical, cognitive, work history measures, and employment outcomes.ResultsResults revealed an 11-item unidimensional construct with strong internal consistency, inter-rater reliability, and test–retest reliability. Construct [pragmatic social skills (r = 0.61, p

While there has been significant research on both how academic struggles impact college students, as well as factors that impact the sense of belonging for college students, there has been little research examining how a significant academic struggle impacts a students’ perception of sense of belonging at that institution. This qualitative study explores how an academic struggle impacts students’ sense of belonging at that institution, as well as other findings from this study.

Myoblast fusion is essential for development of multinucleated myofibers. Here, the authors show that ablation of Elmo 1 and Elmo2 impairs myoblast fusion in mice, and that expression of an open conformation of Elmo2 promotes muscle regeneration and improves the phenotype of Dysferlin-null dystrophic mice.

IntroductionKessler Foundation Strength Identification and Expression (KF-STRIDE) is a strength-based job interview training tool developed for young adults on the autism spectrum. The intervention is based on a positive psychology framework to increase knowledge of character strengths, and how to relate them to a future employer. The current study sought to evaluate the acceptability, usability and feasibility of KF-STRIDE, as well as to guide adaptations to improve the tool’s ability to meet the needs of those on the spectrum.MethodsMixed methods (post-intervention surveys, and semi-structured interviews with key stakeholders) were used to inform the evaluation and consequent adaptations of KF-STRIDE.ResultsThe major findings of the study were that KF-STRIDE was found to be largely acceptable and usable. Importantly, however, our qualitative analysis revealed modifications that could help to better suit the needs of young adults on the spectrum, which included the incorporation of additional skills (i.e. etiquette, practicing hygiene) and more opportunities to practice job interviewing. Thus, we altered the implementation of the intervention to be web-based to improve accessibility. We incorporated the presence of an animated character to deliver the content, to eliminate the need for a highly trained interventionist.DiscussionKF-STRIDE was modified to increase access by incorporating feedback from the autism community. Future directions include assessing the efficacy of KF-STRIDE in young adults on the spectrum to identify whether employment outcomes are improved after using the tool.

Autistic transition-age youth experience high rates of unemployment and underemployment, in part due to the social challenges they may face when having conversations in the workplace. In an effort to help enhance conversational abilities in the workplace, our collaborative team partnered to develop WorkChat: A Virtual Workday. Specifically, our team of scientists, community partners, and diversity and inclusion experts participated in a community-engaged process to develop WorkChat using iterative feedback from autistic transition-age youth and their teachers. With initial development complete, this study reports on the protocol that our collaborative team developed, reviewed, and approved to conduct a randomized controlled trial (RCT) to evaluate the real-world effectiveness and initial implementation process outcomes of WorkChat when integrated into post-secondary pre-employment transition services (Pre-ETS). Our aims are to: 1) evaluate whether services-as-usual in combination with WorkChat, compared to services-as-usual with an attention control, enhances social cognition and work-based social ability (between pre- and post-test); reduces anxiety about work-based social encounters (between pre- and post-test), and increases sustained employment by 9-month follow-up; 2) evaluate whether social cognitive ability and work-based social ability mediate the effect of WorkChat on sustained employment; and 3) conduct a multilevel, mixed-method process evaluation of WorkChat implementation.

Zinc (Zn) has antioxidant, anti-inflammatory and anti-proliferative actions, with Zn dysregulation associated with coronary ischemia/reperfusion injury and smooth muscle cell dysfunction. As the majority of studies concerning Zn have been conducted under non-physiological hyperoxic conditions, we compare the effects of Zn chelation or supplementation on total intracellular Zn content, antioxidant NRF2 targeted gene transcription and hypoxia/reoxygenation-induced reactive oxygen species generation in human coronary artery smooth muscle cells (HCASMC) pre-adapted to hyperoxia (18 kPa O2) or normoxia (5 kPa O2). Expression of the smooth muscle marker SM22-α was unaffected by lowering pericellular O2, whereas calponin-1 was significantly upregulated in cells under 5 kPa O2, indicating a more physiological contractile phenotype under 5 kPa O2. Inductively coupled plasma mass spectrometry established that Zn supplementation (10 μM ZnCl2 + 0.5 μM pyrithione) significantly increased total Zn content in HCASMC under 18 but not 5 kPa O2. Zn supplementation increased metallothionein mRNA expression and NRF2 nuclear accumulation in cells under 18 or 5 kPa O2. Notably, NRF2 regulated HO-1 and NQO1 mRNA expression in response to Zn supplementation was only upregulated in cells under 18 but not 5 kPa. Furthermore, whilst hypoxia increased intracellular glutathione (GSH) in cells pre-adapted to 18 but not 5 kPa O2, reoxygenation had negligible effects on GSH or total Zn content. Reoxygenation-induced superoxide generation in cells under 18 kPa O2 was abrogated by PEG-superoxide dismutase but not by PEG-catalase, and Zn supplementation, but not Zn chelation, attenuated reoxygenation-induced superoxide generation in cells under 18 but not 5kPaO2, consistent with a lower redox stress under physiological normoxia. Our findings highlight that culture of HCASMC under physiological normoxia recapitulates an in vivo contractile phenotype and that effects of Zn on NRF2 signaling are altered by oxygen tension.

This paper presents both the techno-economic planning and a comprehensive sensitivity analysis of an off-grid fully renewable energy-based microgrid (MG) intended to be used as an electric vehicle (EV) charging station. Different possible plans are compared using technical, economic, and techno-economic characteristics for different numbers of wind turbines and solar panels, and both single and hybrid energy storage systems (ESSs) composed of new Li-ion, second-life Li-ion, and new lead–acid batteries. A modified cost of energy (MCOE) index including EVs’ unmet energy penalties and present values of ESSs is proposed, which can combine both important technical and economic criteria together to enable a techno-economic decision to be made. Bi-objective and multi-objective decision-making are provided using the MCOE, total met load, and total costs in which different plans are introduced as the best plans from different aspects. The number of wind turbines and solar panels required for the case study is obtained with respect to the ESS capacity using weather data and assuming EV demand according to the EV population data, which can be generalized to other case studies according to the presented modelling. Through studies on hybrid-ESS-supported MGs, the impact of two different global energy management systems (EMSs) on techno-economic characteristics is investigated, including a power-sharing-based and a priority-based EMS. Single Li-ion battery ESSs in both forms, new and second-life, show the best plans according to the MCOE and total met load; however, the second-life Li-ion shows lower total costs. The hybrid ESSs of both the new and second-life Li-ion battery ESSs show the advantages of both the new and second-life types, i.e., deeper depths of discharge and cheaper plans.

Goudreault et al. investigate the role of Afadin downstream of RAS GTPases, substantiating this cell adhesion protein as a true RAS effector that couples its activation to cell polarity through the Scribble protein.