Children's and adults' evaluations of self-enhancement and self-deprecation depend on the usual performance of the self-presenter

This study examined how evaluations of self-presentation vary with age depending on the self-presenter's usual performance. People's usual performance is a key factor because it generally influences the social evaluations and judgments that others make about them. Children aged 7 and 8 years (second graders) and 10 and 11 years (fifth graders), as well as adults, were presented with scenarios in which protagonists responded to praise after a good performance using either self-enhancement or self-deprecation. The other person in scenarios knew that the protagonist's usual performance on the task was either good or poor. After the protagonist responded to praise in a self-enhancing or self-deprecating way, the participants judged how the other person would evaluate the protagonist's ability (good/poor) and character (nice/mean). For ability evaluations specifically concerning protagonists who usually performed poorly, the results showed that by around 10 years of age children no longer tended to give more positive ability evaluations for self-enhancement than for self-deprecation. Adults gave less positive ability evaluations for self-deprecation than for self-enhancement, but only when the protagonists usually performed well. In relation to the character evaluations, by around 10 years of age self-enhancement led to less positive character evaluations than self-deprecation, but only when the protagonists usually performed poorly. Overall, second graders evaluated self-presenters as more competent and nicer. These results indicate that the expected evaluation of self-enhancement and self-deprecation is influenced by the usual level of performance but that there are developmental changes in this aspect of social cognition.

An overview of bone cement: Perioperative considerations, complications, outcomes and future implications

Polymethyl methacrylate is commonly known as bone cement and is widely used for implant fixation in various orthopaedic arthroplasty and trauma surgery. The first bone cement use in orthopaedics is widely accredited to the famous English surgeon, John Charnley, who in 1958, used it for total hip arthroplasty. Since then, there have been many developments in cementing techniques in arthroplasty surgery. This overview aims to cover the perioperative considerations of bone cement, including cementing techniques, current outcomes and complications such as bone cement implantation syndrome. The overview will additionally consider future developments involving bone cement in orthopaedic arthroplasty.

Five historical innovations that have shaped modern orthopaedic surgery

Throughout history, many innovations have contributed to the development of modern orthopaedic surgery, improving patient outcomes and expanding the range of treatment options available to patients. This article explores five key historical innovations that have shaped modern orthopaedic surgery: X-ray imaging, bone cement, the Thomas splint, the Pneumatic tourniquet and robotic-assisted surgery. We will review the development, impact and significance of each innovation, highlighting their contributions to the field of orthopaedic surgery and their ongoing relevance in contemporary and perioperative practice.

The incidence and risk factors for abnormal postoperative blood tests following primary total joint replacement

Aims

We aim to evaluate the usefulness of postoperative blood tests by investigating the incidence of abnormal results following total joint replacement (TJR), as well as identifying preoperative risk factors for abnormal blood test results postoperatively, especially pertaining to anaemia and acute kidney injury (AKI).

Methods

This is a retrospective cohort study of patients who had elective TJR between January and December 2019 at a tertiary centre. Data gathered included age at time of surgery, sex, BMI, American Society of Anesthesiologists (ASA) grade, preoperative and postoperative laboratory test results, haemoglobin (Hgb), white blood count (WBC), haematocrit (Hct), platelets (Plts), sodium (Na+), potassium (K+), creatinine (Cr), estimated glomerular filtration rate (eGFR), and Ferritin (ug/l). Abnormal blood tests, AKI, electrolyte imbalance, anaemia, transfusion, reoperation, and readmission within one year were reported.

Results

The study included 2,721 patients with a mean age of 69 years, of whom 1,266 (46.6%) were male. Abnormal postoperative bloods were identified in 444 (16.3%) patients. We identified age (≥ 65 years), female sex, and ASA grade ≥ III as risk factors for developing abnormal postoperative blood tests. Preoperative haemoglobin (≤ 127 g/dl) and packed cell volume (≤ 0.395 l/l) were noted to be significant risk factors for postoperative anaemia, and potassium (≤ 3.7 mmol/l) was noted to be a significant risk factor for AKI.

Conclusion

The costs outweigh the benefits of ordering routine postoperative blood tests in TJR patients. Clinicians should risk-stratify their patients and have a lower threshold for ordering blood tests in patients with abnormal preoperative haemoglobin (≤ 127 g/l), blood loss > 300 ml, chronic kidney disease, ASA grade ≥ III, and clinical concern.

Biomarker discovery and authentication of cold-slaughtered chicken through classical analytical procedures and mass spectrometry based proteomic approaches

1. This study evaluated the suitability of routine analytical procedures and used mass spectrometry-based proteomic approaches to distinguish meat from dead chicken/ cold-slaughtered birds (CS), electrically stunned and slaughtered birds, as per standard protocols (ES), and birds slaughtered according to halal guidelines (HS).2. Meat from CS birds had lower (P < 0.05) pH, water-holding capacity and higher (P < 0.05) lipid oxidation, haem iron content, residual blood and total viable counts relative to ES and HS meat indicating poor quality.3. The results demonstrated the presence of unique protein bands on SDS-PAGE only in CS meat that can be used for routine screening.4. Protein analysis using MALDI-TOF mass spectrometry identified haemoglobin subunit alpha-A and alpha-D; Adenylate kinase isoenzyme 1 as reliable and stable marker proteins for authentication of dead chicken meat under raw and cooked conditions and halal slaughtered chicken, respectively.5. The methods used may be employed by the food safety and regulatory agencies for regular screening of meat quality and to authenticate CS or HS chicken.

The Upscale Manufacture of Chondrocytes for Allogeneic Cartilage Therapies

Allogeneic chondrocyte therapies need to be developed to allow more individuals to be treated with a cell therapy for cartilage repair and to reduce the burden and cost of the current two-stage autologous procedures. Upscale manufacture of chondrocytes using a bioreactor could help provide an off-the-shelf allogeneic chondrocyte therapy with many doses being produced in a single manufacturing run. In this study, we assess a good manufacturing practice-compliant hollow-fiber bioreactor (Quantum®) for adult chondrocyte manufacture. Chondrocytes were isolated from knee arthroplasty-derived cartilage (n = 5) and expanded in media supplemented with 10% fetal bovine serum (FBS) or 5% human platelet lysate (hPL) on tissue culture plastic (TCP) for a single passage. hPL-supplemented cultures were then expanded in the Quantum bioreactor for a further passage. Matched, parallel cultures in hPL or FBS were maintained on TCP. Chondrocytes from all culture conditions were characterized in terms of growth kinetics, morphology, immunoprofile, chondrogenic potential (chondrocyte pellet assays), and single telomere length analysis. Quantum expansion of chondrocytes resulted in 86.4 ± 38.5 × 106 cells in 8.4 ± 1.5 days, following seeding of 10.2 ± 3.6 × 106 cells. This related to 3.0 ± 1.0 population doublings in the Quantum bioreactor, compared with 2.1 ± 0.6 and 1.3 ± 1.0 on TCP in hPL- and FBS-supplemented media, respectively. Quantum- and TCP-expanded cultures retained equivalent chondropotency and mesenchymal stromal cell marker immunoprofiles, with only the integrin marker, CD49a, decreasing following Quantum expansion. Quantum-expanded chondrocytes demonstrated equivalent chondrogenic potential (as assessed by ability to form and maintain chondrogenic pellets) with matched hPL TCP populations. hPL manufacture, however, led to reduced chondrogenic potential and increased cell surface positivity of integrins CD49b, CD49c, and CD51/61 compared with FBS cultures. Quantum expansion of chondrocytes did not result in shortened 17p telomere length when compared with matched TCP cultures. This study demonstrates that large numbers of adult chondrocytes can be manufactured in the Quantum hollow-fiber bioreactor. This rapid, upscale expansion does not alter chondrocyte phenotype when compared with matched TCP expansion. Therefore, the Quantum provides an attractive method of manufacturing chondrocytes for clinical use. Media supplementation with hPL for chondrocyte expansion may, however, be unfavorable in terms of retaining chondrogenic capacity.

Twelve tips for optimising learning for postgraduate doctors in the operating theatre

Learning in the operating theatre forms a critical part of postgraduate medical education. Postgraduate doctors present a diverse cohort of learners with a wide range of learning needs that will vary by their level of experience and curriculum requirements. With evidence of both trainee dissatisfaction with the theatre learning experience and reduced time spent in the operating theatre, which has been exacerbated by the effects of the Covid-19 pandemic, it is vital that every visit to the operating theatre is used as a learning opportunity. We have devised 12 tips aimed at both learners and surgeons to optimise learning in the operating theatre, set out into four domains: educational context, preparation, learning in theatre, feedback and reflection. These tips have been created by a process of literature review and acknowledgment of established learning theory, with further discussion amongst surgical trainees, senior surgical faculty, surgical educators and medical education faculty.

"I miss the normalness": Mother and child perspectives of well-being and effective remote support from primary schools during Covid-19 school closures

BACKGROUND

Covid-19 related school closures radically disrupted children's access to social and educational opportunities and changed daily life for millions of families across the world. Emerging evidence indicates that, overall, closures were associated with a decline in children's mental health and well-being, although individual experiences varied widely. The extent to which primary schools adapted remote well-being support is likely to have contributed to child and family adjustment, although this has not yet been fully explored in Covid related research.

METHODS

This longitudinal qualitative study examines variability in remote well-being provision in primary schools during the pandemic, and following school reopening, from the perspective of mothers and children using a whole school approaches framework. Twenty-one primary school aged children and their mothers took part in a semi-structured interview at two time points: time one during the first UK national lockdown and time two approximately seven months later after most children had returned to school. A hybrid inductive-deductive thematic analysis approach identified key themes relating to trajectories of well-being and remote school approaches over this period.

RESULTS

School closures were associated with a decline in well-being for most children. Disrupted contact with friends and teachers, and limited opportunities for enriched, meaningful activity were identified as key risk factors. Protective factors included family and child characteristics that mitigated against the loss of wider systems of support, including family socioeconomic status, parental availability, child temperament, and structured daily routines. Four key dimensions of effective remote well-being provision were identified (the 4Cs). The 4Cs - contact, content, creativity and community - provide an accessible framework for schools to foster children's social relationships and sense of belonging during periods of closure. Analysis of pupil reintegration outcomes suggest that post-Covid support priorities should include extending social and play-based universal interventions in schools.

CONCLUSION

Remote well-being support for children during Covid-related school closures varied in quality with implications for children's mental health and well-being. Findings from this study highlight the importance of ongoing social contact and enriched daily activities to protect children's well-being and development and present a framework of effective remote wellbeing support for primary schools in the event of future closures or prolonged pupil absence.

Management of idiopathic granulomatous mastitis: a prospective study

INTRODUCTION

Idiopathic granulomatous mastitis (IGM) is an evolving problem with varied presentation. No definite treatment guidelines are available at present that may reduce rate of recurrence. Current evidence suggests a ductal pathology behind IGM, which leads to periductal mastitis, leakage and sinus/fistula formation. Thus, excision of the sinus/fistulous tract with en-bloc wide local excision (WLE) of the lesion could be curative. The objective of this study was to look for the basic aetiology of IGM and evaluate the effectiveness of WLE with total or partial duct excision as a curative approach.

METHODS

An institutional prospective comparative study was conducted over 4 years (2015-2019), in which 59 cases of IGM were randomly divided into three groups. After necessary investigations, patients in group A received steroid therapy, those in group B received WLE and patients in group C received WLE with total or partial duct excision as the mode of treatment. Postoperative follow-up was between 6 months and 3 years.

RESULTS

Histopathological examination (HPE) was found to be the most suitable diagnostic procedure. Patients in group B showed the highest rate of recurrence (73.6%), followed by group A (35.0%) and group C (5.0%). Patients in group C had a significantly lower chance of recurrence compared with both group A and group B (p < 0.05). HPE reports of excised ducts from patients in group C showed ductal disruption and leakage along with periductal granuloma in 70% of cases.

CONCLUSIONS

The presence of duct granuloma indicates the association of ductal pathology in IGM. IGM is therefore a disease of the mammary ducts and en-bloc duct excision is curative in non-responding cases.

Heavy metal deposition temperature tuned spin pumping efficiency control in permalloy/tantalum bilayers

Spin pumping is a key property for spintronic application that can be realized in heavy metal/ferromagnet bilayers. Here we demonstrate the possibility of improving spin pumping in permalloy (Py)/tantalum (Ta) bilayers through control of Ta heavy metal deposition temperature. Through a combination of structural and ferromagnetic resonance based magnetization dynamics study, we reveal the role of Ta deposition temperature in improving spin mixing conductance which is a key parameter for spin pumping across the Py/Ta interface. The results show that by depositing Ta above room temperature, a high spin mixing conductance of 7.7 ×10¹⁸m^-2is obtained withα-Ta layer. The results present an understanding of the correlation between heavy metal deposition temperature and interface structure improvement and consequent control of spin pumping in Py/Ta bilayers.

"It Almost Makes Her Human": How Female Animal Guardians Construct Experiences of Cat and Dog Empathy

Understanding how humans perceive and construct experiences of non-human animal empathy (hereafter, 'animal/s') can provide important information to aid our understanding of how companion animals contribute to social support. This study investigates the phenomenology of animal empathy by examining how humans construct sense-making narratives of these experiences, with the hypothesis that anthropomorphic attributions would play a key role in these constructions. Comprehensive, semi-structured interviews were conducted with six participants, using established interpretative phenomenological analysis methodology to facilitate deep examination of how they interpreted and reacted emotionally. Participants were consistent in reporting changes to their companion animals' normal behaviour as the key to the identification of animal empathy experiences, yet they were highly paradoxical in their constructions of perceived internal drivers within their dogs and cats. Explanations were highly dichotomous, from highly anthropomorphic to highly anthropocentric, and these extremes were combined both within individual participant narratives and within some thematic constructs. This research demonstrates that experiences of companion animal empathy can be powerful and meaningful for humans, but the inconsistent mixture of anthropomorphic and anthropocentric reasoning illustrates the confused nature of human understanding of animals' internal states. Insight into how humans construct animal empathy has implications for the moral status of these animals and an application for companion animals used explicitly for social support, such as in animal-assisted therapy and emotional support animals.

Schematic beliefs, negative affect and paranoia in at-risk youth

OBJECTIVES

Attenuated symptoms of psychosis are a core feature of At-Risk Mental States. However, subthreshold levels of paranoia are also common among nonpsychosis populations. At present, little is known about whether the processes underpinning the experience of paranoid ideation in high-risk youth differ as a consequence of meeting At-Risk Mental States (ARMS) for psychosis criteria.

METHODS

This study utilized path analysis techniques to examine the relationships between schematic beliefs, negative affect and the experience of paranoia for two groups: a group meeting criteria for ARMS (n = 133) and a group presenting with emerging complex mental health difficulties who did not meet the criteria for ARMS (n = 137).

RESULTS

While the ARMS group displayed significantly greater maladaptive schematic beliefs and more severe symptomatology, the associations between schematic beliefs, symptoms of negative affect and paranoia did not differ as a consequence of ARMS status.

CONCLUSIONS

While meeting the ARMS criteria is associated with experiencing more maladaptive cognitions and more negative symptomatology among at-risk youth, the associations between these cognitive beliefs and symptoms may be similar for youth who do not meet ARMS. These findings have implications for broadening the scope of at-risk/high-risk and for developing effective interventions for young people presenting with emerging difficulties.

Clinical and cost-effectiveness of social recovery therapy for the prevention and treatment of long-term social disability among young people with emerging severe mental illness (PRODIGY): randomised controlled trial

BACKGROUND

Young people with social disability and severe and complex mental health problems have poor outcomes, frequently struggling with treatment access and engagement. Outcomes may be improved by enhancing care and providing targeted psychological or psychosocial intervention.

AIMS

We aimed to test the hypothesis that adding social recovery therapy (SRT) to enhanced standard care (ESC) would improve social recovery compared with ESC alone.

METHOD

A pragmatic, assessor-masked, randomised controlled trial (PRODIGY: ISRCTN47998710) was conducted in three UK centres. Participants (n = 270) were aged 16-25 years, with persistent social disability, defined as under 30 hours of structured activity per week, social impairment for at least 6 months and severe and complex mental health problems. Participants were randomised to ESC alone or SRT plus ESC. SRT was an individual psychosocial therapy delivered over 9 months. The primary outcome was time spent in structured activity 15 months post-randomisation.

RESULTS

We randomised 132 participants to SRT plus ESC and 138 to ESC alone. Mean weekly hours in structured activity at 15 months increased by 11.1 h for SRT plus ESC (mean 22.4, s.d. = 21.4) and 16.6 h for ESC alone (mean 27.7, s.d. = 26.5). There was no significant difference between arms; treatment effect was -4.44 (95% CI -10.19 to 1.31, P = 0.13). Missingness was consistently greater in the ESC alone arm.

CONCLUSIONS

We found no evidence for the superiority of SRT as an adjunct to ESC. Participants in both arms made large, clinically significant improvements on all outcomes. When providing comprehensive evidence-based standard care, there are no additional gains by providing specialised SRT. Optimising standard care to ensure targeted delivery of existing interventions may further improve outcomes.

'People like me don't do well at school': The roles of identity compatibility and school context in explaining the socioeconomic attainment gap

BACKGROUND

School students who are eligible for reduced or free school meals (FSM) - an indicator of economic disadvantage - have lower academic attainment than their peers.

AIMS

We investigated whether identity compatibility - the perceived compatibility between one's social identities and the stereotype of a high-achieving student - contributes to this socioeconomic attainment gap, and whether the association between socioeconomic status and identity compatibility is moderated by school context.

SAMPLE

Our sample was 4,629 students aged 15-16 years old across 29 schools in England.

METHOD

We assessed students' perceptions of identity compatibility via self-report questionnaires 8 months prior to them taking national, standardized exams.

RESULTS

Multilevel regression analyses revealed a negative indirect effect from eligibility for FSM to exam results via identity compatibility. These effects existed even while accounting for students' gender and language status, other psychological variables known to predict academic attainment, and their previous exam results. Furthermore, school context moderated the relationship between FSM eligibility and identity compatibility. In line with the identities in context model of educational inequalities, there was a significant negative association between FSM and identity compatibility only for students attending schools in which there was previously a relatively large socioeconomic attainment gap.

CONCLUSIONS

Our results demonstrate the importance of social psychological variables in explaining educational inequalities, and of the local educational context in determining the educational experience of students from lower socioeconomic status backgrounds.

Peer audience effects on children's vocal masculinity and femininity

Existing evidence suggests that children from around the age of 8 years strategically alter their public image in accordance with known values and preferences of peers, through the self-descriptive information they convey. However, an important but neglected aspect of this 'self-presentation' is the medium through which such information is communicated: the voice itself. The present study explored peer audience effects on children's vocal productions. Fifty-six children (26 females, aged 8-10 years) were presented with vignettes where a fictional child, matched to the participant's age and sex, is trying to make friends with a group of same-sex peers with stereotypically masculine or feminine interests (rugby and ballet, respectively). Participants were asked to impersonate the child in that situation and, as the child, to read out loud masculine, feminine and gender-neutral self-descriptive statements to these hypothetical audiences. They also had to decide which of those self-descriptive statements would be most helpful for making friends. In line with previous research, boys and girls preferentially selected masculine or feminine self-descriptive statements depending on the audience interests. Crucially, acoustic analyses of fundamental frequency and formant frequency spacing revealed that children also spontaneously altered their vocal productions: they feminized their voices when speaking to members of the ballet club, while they masculinized their voices when speaking to members of the rugby club. Both sexes also feminized their voices when uttering feminine sentences, compared to when uttering masculine and gender-neutral sentences. Implications for the hitherto neglected role of acoustic qualities of children's vocal behaviour in peer interactions are discussed. This article is part of the theme issue 'Voice modulation: from origin and mechanism to social impact (Part II)'.

Social recovery therapy for young people with emerging severe mental illness: the Prodigy RCT

BACKGROUND

Young people with social disability and non-psychotic severe and complex mental health problems are an important group. Without intervention, their social problems can persist and have large economic and personal costs. Thus, more effective evidence-based interventions are needed. Social recovery therapy is an individual therapy incorporating cognitive-behavioural techniques to increase structured activity as guided by the participant's goals.

OBJECTIVE

This trial aimed to test whether or not social recovery therapy provided as an adjunct to enhanced standard care over 9 months is superior to enhanced standard care alone. Enhanced standard care aimed to provide an optimal combination of existing evidence-based interventions.

DESIGN

A pragmatic, single-blind, superiority randomised controlled trial was conducted in three UK centres: Sussex, Manchester and East Anglia. Participants were aged 16-25 years with persistent social disability, defined as < 30 hours per week of structured activity with social impairment for at least 6 months. Additionally, participants had severe and complex mental health problems, defined as at-risk mental states for psychosis or non-psychotic severe and complex mental health problems indicated by a Global Assessment of Functioning score ≤ 50 persisting for ≥ 6 months. Two hundred and seventy participants were randomised 1 : 1 to either enhanced standard care plus social recovery therapy or enhanced standard care alone. The primary outcome was weekly hours spent in structured activity at 15 months post randomisation. Secondary outcomes included subthreshold psychotic, negative and mood symptoms. Outcomes were collected at 9 and 15 months post randomisation, with maintenance assessed at 24 months.

RESULTS

The addition of social recovery therapy did not significantly increase weekly hours in structured activity at 15 months (primary outcome treatment effect -4.44, 95% confidence interval -10.19 to 1.31). We found no evidence of significant differences between conditions in secondary outcomes at 15 months: Social Anxiety Interaction Scale treatment effect -0.45, 95% confidence interval -4.84 to 3.95; Beck Depression Inventory-II treatment effect -0.32, 95% confidence interval -4.06 to 3.42; Comprehensive Assessment of At-Risk Mental States symptom severity 0.29, 95% confidence interval -4.35 to 4.94; or distress treatment effect 4.09, 95% confidence interval -3.52 to 11.70. Greater Comprehensive Assessment of At-Risk Mental States for psychosis scores reflect greater symptom severity. We found no evidence of significant differences at 9 or 24 months. Social recovery therapy was not estimated to be cost-effective. The key limitation was that missingness of data was consistently greater in the enhanced standard care-alone arm (9% primary outcome and 15% secondary outcome missingness of data) than in the social recovery therapy plus enhanced standard care arm (4% primary outcome and 9% secondary outcome missingness of data) at 15 months.

CONCLUSIONS

We found no evidence for the clinical superiority or cost-effectiveness of social recovery therapy as an adjunct to enhanced standard care. Both arms made large improvements in primary and secondary outcomes. Enhanced standard care included a comprehensive combination of evidence-based pharmacological, psychotherapeutic and psychosocial interventions. Some results favoured enhanced standard care but the majority were not statistically significant. Future work should identify factors associated with the optimal delivery of the combinations of interventions that underpin better outcomes in this often-neglected clinical group.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN47998710.

FUNDING

This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment Vol. 25, No. 70. See the NIHR Journals Library website for further project information.

'Stat' workflow modifications to expedite care after needlestick injuries

BACKGROUND

Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) is recommended to start within hours of needlestick injuries (NSIs) among healthcare workers (HCWs). Delays associated with awaiting the results of testing from the source patient (whose blood was involved in the NSI) can lead to psychological consequences for the exposed HCW as well as symptomatic toxicities from empiric PEP.

AIMS

After developing a 'stat' (immediate) workflow that prioritized phlebotomy and resulting of source patient bloodwork for immediate handling and processing, we retrospectively investigated whether our new workflow had (i) decreased HIV order-result interval times for source patient HIV bloodwork and (ii) decreased the frequency of HIV PEP prescriptions being dispensed to exposed HCWs.

METHODS

We retrospectively analysed NSI records to identify source patient HIV order-result intervals and PEP dispensing frequencies across a 6-year period (encompassing a 54-month pre-intervention period and 16-month post-intervention period).

RESULTS

We identified 251 NSIs, which occurred at similar frequencies before versus after our intervention (means 3.54 NSIs and 3.75 NSIs per month, respectively). Median HIV order-result intervals decreased significantly (P < 0.05) from 195 to 156 min after our intervention, while the proportion of HCWs who received one or more doses of PEP decreased significantly (P < 0.001) from 50% (96/191) to 23% (14/60).

CONCLUSION

Using a 'stat' workflow to prioritize source patient testing after NSIs, we achieved a modest decrease in order-result intervals and a dramatic decrease in HIV PEP dispensing rates. This simple intervention may improve HCWs' physical and psychological health during a traumatic time.

"It All Makes Us Feel Together": Young People's Experiences of Virtual Group Music-Making During the COVID-19 Pandemic

We know little about the psychological experiences of children and young people who have participated in virtual group music-making during the Coronavirus disease (COVID-19) pandemic. Adopting a mixed-methods design, we worked across three music education hubs in the UK, with a total 13 virtual music groups. These included a range of mainstream ensembles, inclusive ensembles targeting young people with special educational needs and/or disabilities, and inclusive music production spaces, targeting young people from lower socio-economic backgrounds. Reported progress in intra- and inter-personal psychological outcomes was investigated using quantitative and qualitative staff session reports, which were collected since before the pandemic (n1 for in-person sessions = 87, n2 for virtual sessions = 68), and surveys distributed to tutors, young people, and their parents during the first and second United Kingdom (UK) national lockdowns (n3 for qualitative responses = 240, n4 for quantitative responses = 96). Satisfaction of three basic psychological needs of self-determination theory and their relation to joint music-making in virtual spaces was also observed in real time by the researchers performing quantitative checklist observations on 16 separate occasions. Findings indicated that virtual music groups represented a meaningful psychological resource for the participating children and young people, especially considering the lack of opportunities offered by their schools and other extra-curricular activities. Through their participation with virtual group music-making activities, young people used music as a tool for self-expression and emotion management, restored lost musical identities and confidence, and preserved treasured social connections. Virtual alternatives to group music-making appear to indirectly nurture the sense of belongingness, mediated by supportive staff behaviors, but their direct connection, which has been widely reported for in-person group music-making experiences, has not been observed in virtual music groups.

Nonreciprocal Transport of Exciton Polaritons in a Non-Hermitian Chain

We consider exciton polaritons in a zigzag chain of coupled elliptical micropillars subjected to incoherent excitation. The driven-dissipative nature of the system along with the naturally present polarization splitting inside the pillars gives rise to nonreciprocal dynamics, which eventually leads to the non-Hermitian skin effect, where all the modes of the system collapse to one edge. As a result, the polaritons propagate only in one direction along the chain, independent of the excitation position, and the propagation in the opposite direction is suppressed. The system shows robustness against disorder and, using the bistable nature of polaritons to encode information, we show one-way information transfer. This paves the way for compact and robust feedback-free one-dimensional polariton transmission channels without the need for external magnetic field, which are compatible with proposals for polaritonic circuits.

"This Is What a Mechanic Sounds Like": Children's Vocal Control Reveals Implicit Occupational Stereotypes

In this study, we explored the use of variation in sex-related cues of the voice to investigate implicit occupational stereotyping in children. Eighty-two children between the ages of 5 and 10 years took part in an imitation task in which they were provided with descriptions of nine occupations (three traditionally male, three traditionally female, and three gender-neutral professions) and asked to give voices to them (e.g., “How would a mechanic say . . . ?”). Overall, children adapted their voices to conform to gender-stereotyped expectations by masculinizing (lowering voice pitch and resonance) and feminizing (raising voice pitch and resonance) their voices for the traditionally male and female occupations, respectively. The magnitude of these shifts increased with age, particularly in boys, and was not mediated by children’s explicit stereotyping of the same occupations. We conclude by proposing a simple tool based on voice pitch for assessing levels of implicit occupational-gender stereotyping in children.

RAP1-RAC1 Signaling Has an Important Role in Adhesion and Migration in HNSCC

Cell-cell adhesion is a key mechanism to control tissue integrity and migration. In head and neck squamous cell carcinoma (HNSCC), cell migration facilitates distant metastases and is correlated with poor prognosis. RAP1, a ras-like protein, has an important role in the progression of HNSCC. RAC1 is an integrin-linked, ras-like protein that promotes cell migration. Here we show that loss of cell-cell adhesion is correlated with inactivation of RAP1 confirmed by 2 different biochemical approaches. RAP1 activation is required for cell-matrix adhesion confirmed by adhesion to fibronectin-coated plates with cells that have biochemically activated RAP1. This effect is reversed when RAP1 is inactivated. In addition, RAP1_GTP-mediated adhesion is only facilitated through α5β1 integrin complex and is not a function of either α5 or β1 integrin alone. Moreover, the inside-out signaling of RAP1 activation is coordinated with RAC1 activation. These findings show that RAP1 has a prominent role in cell-matrix adhesion via extracellular matrix molecule fibronectin-induced α5β1 integrin and supports a critical role for the RAP1/RAC1 signaling axis in HNSCC cell migration.

Coupling between Exciton-Polariton Corner Modes through Edge States

Recently realized higher order topological insulators have taken a surge of interest among the theoretical and experimental condensed matter community. The two-dimensional second order topological insulators give rise to zero-dimensional localized corner modes that reside within the band gap of the system along with edge modes that inhabit a band edge next to bulk modes. Thanks to the topological nature, information can be trapped at the corners of these systems, which will be unhampered even in the presence of disorder. Being localized at the corners, the exchange of information among the corner states is an issue. Here we show that the nonlinearity in an exciton polariton system can allow the coupling between the different corners through the edge states based on optical parametric scattering, realizing a system of multiple connectible topological modes.

Physiological and perceptual correlates of masculinity in children's voices

Low frequency components (i.e. a low pitch (F0) and low formant spacing (ΔF)) signal high salivary testosterone and height in adult male voices and are associated with high masculinity attributions by unfamiliar listeners (in both men and women). However, the relation between the physiological, acoustic and perceptual dimensions of speakers' masculinity prior to puberty remains unknown. In this study, 110 pre-pubertal children (58 girls), aged 3 to 10, were recorded as they described a cartoon picture. 315 adults (182 women) rated children's perceived masculinity from the voice only after listening to the speakers' audio recordings. On the basis of their voices alone, boys who had higher salivary testosterone levels were rated as more masculine and the relation between testosterone and perceived masculinity was partially mediated by F0. The voices of taller boys were also rated as more masculine, but the relation between height and perceived masculinity was not mediated by the considered acoustic parameters, indicating that acoustic cues other than F0 and ΔF may signal stature. Both boys and girls who had lower F0, were also rated as more masculine, while ΔF did not affect ratings. These findings highlight the interdependence of physiological, acoustic and perceptual dimensions, and suggest that inter-individual variation in male voices, particularly F0, may advertise hormonal masculinity from a very early age.

Human Articular Chondrocytes Retain Their Phenotype in Sustained Hypoxia While Normoxia Promotes Their Immunomodulatory Potential

OBJECTIVE

To assess the phenotype of human articular chondrocytes cultured in normoxia (21% O2) or continuous hypoxia (2% O2).

DESIGN

Chondrocytes were extracted from patients undergoing total knee replacement (n = 5) and cultured in ~21% (normoxic chondrocytes, NC) and 2% (hypoxic chondrocytes, HC) oxygen in both monolayer and 3-dimensional (3D) pellet culture and compared with freshly isolated chondrocytes (FC). Cells were assessed by flow cytometry for markers indicative of mesenchymal stromal cells (MSCs), chondrogenic-potency and dedifferentiation. Chondrogenic potency and immunomodulatory gene expression was assessed in NC and HC by reverse transcription quantitative polymerase chain reaction. Immunohistochemistry was used to assess collagen II production following 3D pellet culture.

RESULTS

NC were positive (>97%, n = 5) for MSC markers, CD73, CD90, and CD105, while HC demonstrated <90% positivity (n = 4) and FC (n = 5) less again (CD73 and CD90 <20%; CD105 <40%). The markers CD166 and CD151, indicative of chondrogenic de-differentiation, were significantly higher on NC compared with HC and lowest on FC. NC also produced the highest levels of CD106 and showed the greatest levels of IDO expression, following interferon-γ stimulation, indicating immunomodulatory potential. NC produced the highest levels of CD49c (>60%) compared with HC and FC in which production was <2%. Hypoxic conditions upregulated expression of SOX9, frizzled-related protein (FRZB), fibroblast growth factor receptor 3 (FGFR3), and collagen type II (COL2A1) and downregulated activin receptor-like kinase 1 (ALK1) in 3 out of 4 patients compared with normoxic conditions for monolayer cells.

CONCLUSIONS

Hypoxic conditions encourage retention of a chondrogenic phenotype with some immunomodulatory potential, whereas normoxia promotes dedifferentiation of chondrocytes toward an MSC phenotype with loss of chondrogenic potency but enhanced immunomodulatory capacity.

Children can control the expression of masculinity and femininity through the voice

Pre-pubertal boys and girls speak with acoustically different voices despite the absence of a clear anatomical dimorphism in the vocal apparatus, suggesting that a strong component of the expression of gender through the voice is behavioural. Initial evidence for this hypothesis was found in a previous study showing that children can alter their voice to sound like a boy or like a girl. However, whether they can spontaneously modulate these voice components within their own gender in order to vary the expression of their masculinity and femininity remained to be investigated. Here, seventy-two English-speaking children aged 6-10 were asked to give voice to child characters varying in masculine and feminine stereotypicality to investigate whether primary school children spontaneously adjust their sex-related cues in the voice-fundamental frequency (F0) and formant spacing (ΔF)-along gender stereotypical lines. Boys and girls masculinized their voice, by lowering F0 and ΔF, when impersonating stereotypically masculine child characters of the same sex. Girls and older boys also feminized their voice, by raising their F0 and ΔF, when impersonating stereotypically feminine same-sex child characters. These findings reveal that children have some knowledge of the sexually dimorphic acoustic cues underlying the expression of gender, and are capable of controlling them to modulate gender-related attributes, paving the way for the use of the voice as an implicit, objective measure of the development of gender stereotypes and behaviour.

The role of sex-related voice variation in children's gender-role stereotype attributions

In the absence of clear sex differences in vocal anatomy, the expression of gender in pre-pubertal children's voices has a strong behavioural dimension. However, whether children are sensitive to this gender-related variation in the voice and use it to make inferences about their peers' masculinity and femininity remains unexplored. Using a cross-modal matching task, thirty-one 7- to 8-year-olds and forty-two adults were asked to associate prototypical voices of boys and girls, and their re-synthesized masculinized and feminized versions, to fictional stereotypically masculine, gender-neutral, and stereotypically feminine child characters. We found that listeners spontaneously associated stereotypically masculine and feminine descriptors of a child character with masculinized voices and feminized voices, respectively. Adults made overall more stereotypical associations and were less influenced by character sex than children. Our observations highlight for the first time the contribution of acoustic cues to gender stereotyping from childhood, and its potential implications for the gender schema literature. Statement of contribution What is already known on this subject? Research on stereotyping shows children's schematic processing of the visible aspects of gender expression Psychoacoustic research shows that variation in children's voices affects adults' judgments of their masculinity What does this study add? Children and adults linked voice variation to gender-stereotypical characterizations of child characters Adults made overall more stereotypical associations than children and were less influenced by character's sex Our results highlight the existence of a vocal component in children's and adults' gender schemas.

Reference range of liver corrected T1 values in a population at low risk for fatty liver disease-a UK Biobank sub-study, with an appendix of interesting cases

Purpose

Corrected T1 (cT1) value is a novel MRI-based quantitative metric for assessing a composite of liver inflammation and fibrosis. It has been shown to distinguish between non-alcoholic fatty liver disease (NAFL) and non-alcoholic steatohepatitis. However, these studies were conducted in patients at high risk for liver disease. This study establishes the normal reference range of cT1 values for a large UK population, and assesses interactions of age and gender.

Methods

MR data were acquired on a 1.5 T system as part of the UK Biobank Imaging Enhancement study. Measures for Proton Density Fat Fraction and cT1 were calculated from the MRI data using a multiparametric MRI software application. Data that did not meet quality criteria were excluded from further analysis. Inter and intra-reader variability was estimated in a set of data. A cohort at low risk for NAFL was identified by excluding individuals with BMI ≥ 25 kg/m² and PDFF ≥ 5%. Of the 2816 participants with data of suitable quality, 1037 (37%) were classified as at low risk.

Results

The cT1 values in the low-risk population ranged from 573 to 852 ms with a median of 666 ms and interquartile range from 643 to 694 ms. Iron correction of T1 was necessary in 36.5% of this reference population. Age and gender had minimal effect on cT1 values.

Conclusion

The majority of cT1 values are tightly clustered in a population at low risk for NAFL, suggesting it has the potential to serve as a new quantitative imaging biomarker for studies of liver health and disease.

Isolation and Purification of a Coagulant from Snake Venom of the Species Bothrops jararaca and the Study of its Properties

1. A material active in coagulating fibrinogen has been purified thirty-fold from crude venom of the species Bothrops jararaca. This material exhibits clotting and esterase activities, but no measurable proteolytic activity if measured by its ability to digest denatured hemoglobin.

2. The clotting activity of the purified material (but not its esterase activity) is greatly enhanced by the addition of 2—3 μM of calcium ion; no other divalent metallic ion can duplicate the accelerating effect of Ca++ ion.

3. The purified material is stable to dialysis, standing at room temperature for 18—20 hours, or heating at 50° C for 10 minutes; it loses both its clotting and esterase activities if heated at 70° C for 25 minutes or at 80° C for 10 minutes

4. Although the powerful proteolytic enzyme inhibitors ovomucoid and soyabean trypsin inhibitor can block the clotting and esterase activities of thrombin, they are ineffective with respect to these properties of venom-coagulin. DFP, an inhibitor of far less specificity, can prevent the actions both of thrombin and of venom-coagulin

5. An amount of heparin sufficient to block the clotting activity of thrombin is unable to prevent the action of venom-coagulin on fibrinogen; a much higher concentration of heparin is needed. In both cases the addition of 2—3 μM of Ca++ ion necessitates the introduction of considerably more heparin in order to block the actions of thrombin and venom-coagulin.

6. While the antithrombin contained in serum can neutralize the clotting and esterase activities of thrombin, it has no effect on the actions of venom-coagulin.

ANITA-An active vibration cancellation system for scanning probe microscopy

The high sensitivity of scanning probe microscopes poses a barrier to their use in noisy environments. Vibrational noise, whether from structural or acoustic sources, can manifest as relative motion between the probe tip and sample, which then appears in the probe position ("Z") feedback as it tries to cancel this motion. Here we describe an active cancellation process that nullifies the appearance of this vibration by adding a drive signal into the existing Z-feedback loop. The drive is digitally calculated from accelerometer-based vibration measurements. By transferring the vibration cancellation effort to this drive signal, vibration-created noise is significantly reduced. This inexpensive and easy solution requires no major instrumental modifications and is ideal for those looking to place their microscopes in noisier environments, coupled, for example, to active refrigeration systems (e.g., pulse tube cryocoolers) or other high-vibration instruments.

Risk factors for diagnostic delay in Crohn's disease and their impact on long-term complications: how do they differ in a tuberculosis endemic region?

BACKGROUND

The diagnosis of Crohn's disease (CD) can be delayed in clinical practice. In tuberculosis endemic areas, empirical anti-tubercular therapy further delays treatment.

AIM(S)

To assess risk factors for diagnostic delay and its impact on the long-term complications of Crohn's disease in India where tuberculosis is endemic.

METHODS

Data from a large prospectively established inflammatory bowel disease registry were analysed retrospectively. The time from onset of symptoms to diagnosis (diagnostic delay) was calculated and categorised into two groups based on median diagnostic delay. The risk factors for delay including anti-tubercular therapy were analysed. Logistic regression analysis was done to assess impact of diagnostic delay on development of stenotic and fistular complications including need for surgery.

RESULTS

Seven hundred and twenty Crohn's disease patients (60.3% male, median: 28 years) were included. Main outcome measures were stenosis, fistula and need for surgery. Subjects with diagnostic delay >18 months (median) developed significantly higher stenotic complications and surgery (OR 4.12; 95% CI: 2.74-6.33, P < 0.001 and OR 2.41, 95% CI: 1.68-3.42, P < 0.001), respectively, compared to those ≤18 months. There was no difference in the development of fistulous complications. 193/720 (27%) received anti-tubercular therapy which significantly contributed to diagnostic delay (OR: 2.47; 95% CI: 1.76-3.47, P < 0.001) with 47% showing initial clinical response (Crohn's disease activity index- CDAI decrease >100). Moreover, the incidence of stenotic complications was significantly higher in patients who had received prior anti-tubercular therapy (55/193 (28.49%) vs 78/527 (14.8%), P < 0.001, OR: 2.60, 95% CI: 1.64-4.12).

CONCLUSIONS

Diagnostic delay in Crohn's disease is associated with significantly higher stenotic complications and need for surgery. Empirical anti-tubercular therapy is the single largest contributor to diagnostic delay in tuberculosis endemic areas. Despite initial clinical response to anti-tubercular therapy, long-term stenotic complications are higher.

Measurement of Hemodynamic and Anatomic Parameters in a Swine Arteriovenous Fistula Model

Purpose

Although arteriovenous fistulae (AVFs) are currently the preferred mode of permanent hemodialysis access they do have significant problems due to initial non-maturation and a later venous stenosis. These problems appear to have been exacerbated following a push to increase AVF prevalence in the US. The reasons for both AVF non-maturation and the later venous stenoses are unclear but are thought to be related to abnormal hemodynamic wall shear stress (WSS) profiles. This technical note aims to describe the successful development of measurement techniques that can be used to establish a complete hemodynamic profile in a pig model with two different configurations of AVF.

Methods and results

The curved and straight AVF configurations were created in an in vivo pig model. Flow and pressure in the AVFs were measured using the perivascular flow probes and Doppler flow wires while the pressure was recorded using a pressure transducer. The anatomical configuration was obtained using two different approaches: a) combination of intravascular ultrasound (IVUS) and angiograms, (b) 64 slice CT angiography. 3D models were reconstructed using image processing and computer modeling techniques. Numerical calculations were then performed by applying the measured flow and pressure data into the configurations to obtain the hemodynamic WSS profiles.

Conclusion

The described methodologies will allow the calculation and optimization of WSS profiles in animal models. This information could then be translated to the clinical setting where it would have a positive impact on improving the early maturation rates of AVFs as well as reducing the late venous stenoses.

Controversies in tuberculous infection among pediatric infectious disease specialists in North America

OBJECTIVE

To evaluate the extent to which advancements in the diagnosis and treatment of latent tuberculous infection (LTBI) have been integrated into practice by pediatric infectious disease (PID) specialists.

DESIGN

We conducted an online survey of the Infectious Diseases Society of America's Emerging Infections Network (EIN) membership.

RESULTS

Of the 323 members, 197 (61%) responded: 7% cared for ⩾5 children with TB disease and 34% for ⩾5 children with LTBI annually. We identified substantial variations in the use of interferon-gamma release assays (IGRAs) based upon age, immune status, and TB risk factors. In addition, tuberculin skin test (TST) use was three times more common in younger children. Variations existed in managing children with discordant TST and IGRA results. Less variation existed in LTBI treatment, with 86% preferring a 9-month course of isoniazid; few other, newer regimens were used routinely.

CONCLUSION

Substantial variations exist in LTBI management; uptake of newer diagnostic tools and treatment regimens has been slow. Variations in practice and the lag time to integrating new data into practice may indicate the relative infrequency with which providers encounter LTBI. Our findings reflect the need for increased visibility of existing TB guidelines and resources for expert consultation for scenarios not covered by guidelines.

Investigations on Blending and Foaming Behavior of Styrene-Ethylene-Butylene-Styrene/Polystyrene Blends

The interplay of screw speed and residence time during polymer blend extrusion profoundly influences blend properties. Herein, blends of styrene-ethylene-butylene-styrene (SEBS) and polystyrene (PS) containing 30% by weight PS were prepared at a constant feed rate but different screw speeds (50, 100, 200 and 300 min−1). The blend produced at 100 min−1 (B100) possessed a finer morphology, better mechanical and rheological properties, attributed to suitability of residence time and viscosity ratio. When batch foamed with carbon dioxide at 110°C and 100°C, all blends produced stable foams. B100 foams exhibited higher volume expansion ratio (VE) due to higher complex viscosity and storage modulus. When foaming was conducted at 35°C, all foams shrank. B100 foams possessed higher cell density, lower VE and showed faster shrinkage due to increased nucleation and hindered expansion by the finely dispersed stiff PS aggregates during selective foaming of the elastomeric phase.

Prevention and treatment of long-term social disability amongst young people with emerging severe mental illness with social recovery therapy (The PRODIGY Trial): study protocol for a randomised controlled trial

BACKGROUND

Young people who have social disability associated with severe and complex mental health problems are an important group in need of early intervention. Their problems often date back to childhood and become chronic at an early age. Without intervention, the long-term prognosis is often poor and the economic costs very large. There is a major gap in the provision of evidence-based interventions for this group, and therefore new approaches to detection and intervention are needed. This trial provides a definitive evaluation of a new approach to early intervention with young people with social disability and severe and complex mental health problems using social recovery therapy (SRT) over a period of 9 months to improve mental health and social recovery outcomes.

METHODS

This is a pragmatic, multi-centre, single blind, superiority randomised controlled trial. It is conducted in three sites in the UK: Sussex, Manchester and East Anglia. Participants are aged 16 to 25 and have both persistent and severe social disability (defined as engaged in less than 30 hours per week of structured activity) and severe and complex mental health problems. The target sample size is 270 participants, providing 135 participants in each trial arm. Participants are randomised 1:1 using a web-based randomisation system and allocated to either SRT plus optimised treatment as usual (enhanced standard care) or enhanced standard care alone. The primary outcome is time use, namely hours spent in structured activity per week at 15 months post-randomisation. Secondary outcomes assess typical mental health problems of the group, including subthreshold psychotic symptoms, negative symptoms, depression and anxiety. Time use, secondary outcomes and health economic measures are assessed at 9, 15 and 24 months post-randomisation.

DISCUSSION

This definitive trial will be the first to evaluate a novel psychological treatment for social disability and mental health problems in young people presenting with social disability and severe and complex non-psychotic mental health problems. The results will have important implications for policy and practice in the detection and early intervention for this group in mental health services.

TRIAL REGISTRATION

Trial Registry: International Standard Randomised Controlled Trial Number (ISRCTN) Registry.

TRIAL REGISTRATION NUMBER

ISRCTN47998710 (registered 29/11/2012).

A closer look at the in vitro electrochemical characterisation of titanium alloys for biomedical applications using in-situ methods

Titanium (Ti) and its alloys are widely used in several biomedical applications, particularly as permanent orthopaedic implants. Electrochemical testing provides a means to perform accelerated corrosion testing, however whilst results from polarisation testing for Ti and its alloys to date have been generally useful, they are also rather limited on the basis of several reasons. One reason is that the polarisation curves for Ti and its alloys in simulated body fluids all appear rather similar, and they do not present a classical 'breakdown' or pitting potential, making discrimination between alloys difficult. Of practical relevance however, are two key issues; (1) how do Ti alloys respond to a breakdown event? (i.e. do they readily 'repassivate'?), and, (2) what is that actual rate of Ti ion loss from exposure to physiological conditions? The answers to these questions are probed herein. Several Ti alloys of either unique composition or different fabrication method were studied, including commercially pure Ti (cp-Ti), Ti-6Al-4V, Ti-29Nb-13Ta-4.5Zr (TNTZ), selective laser melted Ti-6Al-4V, direct laser deposited cp-Ti, Ti-35Nb-15Zr, and Ti-25Nb-8Zr. Results reveal that both fabrication method and alloying influence 'repassivation' behaviour. Furthermore, atomic emission spectroelectrochemistry as applied to cp-Ti indicated actual dissolution currents of ∼2-3μA/cm^-2 (i.e. ∼9μm/yr) in the range of the corrosion potential, also revealing such dissolution is persistent, even with cathodic polarisation, and definitively revealing that the presence of hydrogen peroxide and albumin activate anodic dissolution of Ti.

STATEMENT OF SIGNIFICANCE

We believe the paper makes a significant and important contribution to the field of permanent implant biomaterials. Whilst we concede that the paper does not include any in vivo work, the timeliness of the work, and the completely new nature of the findings, we believe carries the impact required for Acta Biomaterialia. Key highlights include:All of the above combine to produce a manuscript that we believe has wide appeal, and can be used as both a port of reference to those working with Ti biomaterials, and also those wishing to apply useful characterisation techniques to their own work (with two very novel methods demonstrated herein, along with the unique information they provide).