Major Rupture Research Articles

Development and external validation of a nomogram for individualized adjuvant imatinib duration for high‐risk gastrointestinal stromal tumors: A multicenter retrospective cohort study

IntroductionThe main emphasis of the research about adjuvant imatinib for high‐risk gastrointestinal stromal tumors (GISTs) is prolonging the treatment duration and ignores the heterogeneous that 10‐year recurrence rates ranged from about 20%–100%. Thus, this study evaluated the effect of different durations of adjuvant imatinib on outcomes in high‐risk GISTs to explore the feasibility of individual treatment.MethodsWe analyzed 855 high‐risk GIST patients from three centers who underwent macroscopically complete resection between December 2007 and September 2020. The patients were divided into training (n =564) and two validation cohorts (n = 238 and53) based on their source. Recurrence‐free survival (RFS) was the primary point. Cox multivariate analysis was used to develop the nomogram. C‐index, time‐dependent area under the curves, and calibration plots were used to assess the performance of the nomogram.ResultsUnivariate analysis showed that longer adjuvant imatinib was significantly associated with better 5‐year RFS (p < 0.0001). Further investigation identified that the same high‐risk patients with lower tumor‐associated recurrence risk benefitted little from prolonged treatment and that the recommended adjuvant imatinib duration was insufficient for those with higher recurrence risk. A nomogram for predicting 2‐, 3‐, and 5‐year RFS based on different treatment durations and four major risk factors, namely, tumor site, size, mitotic count, and rupture status, was built and validated, with a C‐index of 0.82, 0.74, and 0.70 in training and two external validation cohorts, respectively. An online dynamic nomogram was further developed for clinical applications (https://ruolinliu666.shinyapps.io/GIST/), offering predictive recurrence rates based on different treatment durations and tumor features.ConclusionsWe developed a nomogram to predict the recurrence risk for high‐risk patients according to tumor features and treatment durations of imatinib to help physicians on decision‐making for individualized treatment duration.

Multi-tier analysis of the medical equipment supply chain network: empirical analysis and simulation of a major rupture

PurposeWhile a global supply network can provide stability to address localized interruptions, however, the recent global pandemic materialized many concerns and risks associated with the global supply network. Considering the short-term and long-term effects of changes in the global supply chain, this research explores how the location characteristics of the firms across the supply chain affect their performance.Design/methodology/approachUsing the mined data from five tiers of the backward supply chain of medical equipment, the authors constructed a large supply chain network consisting of close to 160,000 dyadic connections. The authors used various network centrality and clustering algorithms to measure the influence of each firm across the supply chain structure. Furthermore, the authors ran a scenario to simulate the elimination of Chinese firms from the global supply chain and recalculated all centralities. Regression analysis was used to measure the effect of supply chain network centralities on firms' performance across the supply chain with and without Chinese firms.FindingsThe complexity of global purchasing across global tiers of supply networks had been recognized as a source of uncertainty before the COVID-19 pandemic. This pandemic was the black swan that the medical supply chain professionals had noted its threat in recent years. While a global supply network can provide stability to address localized interruptions, however, the recent global pandemic materialized many concerns and risks associated with the global supply network. Considering the short-term and long-term effects of changes in the global supply chain, this research explores how the location characteristics of the firms across the supply chain affect their performance.Research limitations/implicationsThis research has three main implications. First, it provides a benchmark for manufacturing firms and distributors around the world operating in the post-COVID-19 business environment to better understand the relationship of their supply chain strategy and firms' financial performance. Second, investors and asset managers can evaluate their portfolios in light of the changing relationship as a result of possible protectionism initiatives. Finally, policymakers can apply the research methodology of this work in various industries while reevaluating post-COVID-19 international relations and trades policies at the firm, industry and country levels.Practical implicationsPolicymakers working on global connection can utilize the outcome of this research to explore the consequences of local and global policies on trade patterns, organizational performance as well as individuals' movements. Another implication of this study for policymakers is that it provides a powerful simulation and analytical tool to launch or combat the global ruptures, including trade wars and natural disasters stemming from natural events (e.g. climate change) and human-made events (e.g. wars, supply-chain interruptions, sanctions).Originality/valueTo the best of our knowledge, this is the first large-scale empirical study that measures the effect of supply chain structure across multiple (five) tiers of the global supply chain on firms' performance. The present study uses the original supply chain network data mined by the authors from financial publications.

Frictional controls on the seismogenic zone: Insights from the Apenninic basement, Central Italy

Crustal seismicity is in general confined within the seismogenic layer, which is bounded at depth by processes related to the brittle-ductile transition (BDT) and in the shallow region by fault zone consolidation state and mineralogy. In the past 10-15 years, high resolution seismological and geodetic data have shown that faulting within and around the traditional seismogenic zone occurs in a large variety of slip modes. Frictional and structural heterogeneities have been invoked to explain such differences in fault slip mode and behaviour. However, an integrated and comprehensive picture remains extremely challenging because of difficulties to properly characterize fault rocks at seismogenic depths. Thus, the central-northern Apennines provide a unique opportunity because of the integration of deep-borehole stratigraphy and seismic reflection profiles with high resolution seismological data and outcrop studies. These works show that seismic sequences are limited within the sedimentary cover (depth < 9-10 km), suggesting that the underlaying basement plays a key-role in dictating the lower boundary of the seismogenic zone.Here we integrate structural data on exhumed outcrops of basement rocks with laboratory friction data to shed light on the mechanics of the Apenninic basement. Structural data highlight heterogeneous and pervasive deformation where foliated and phyllosilicate-rich rocks surround more competent quartz-rich lenses up to hundreds of meters in thickness. Phyllosilicate horizons deform predominantly by folding and foliation-parallel frictional sliding whereas quartz-rich lenses are characterized by brittle signatures represented by extensive fracturing and minor faulting. Laboratory experiments revealed that quartz-rich lithologies have relatively high friction, μ≈0.51, velocity-strengthening to neutral behaviour, and elevated healing rates. On the contrary, phyllosilicate-rich (muscovite and chlorite) lithologies show low friction, 0.23 <μ < 0.31, a marked velocity strengthening behaviour that increases with increasing sliding velocity and negligible rates of frictional healing.Our integrated approach suggests that in the Apenninic basement deformation occurs along shear zones distributed on thickness up-to several kilometres, where the frictionally stable, foliated, and phyllosilicate-rich horizons favour aseismic deformation and therefore confine the depth of major earthquake ruptures and the seismogenic zone.

COVID-19 Ruptures And Disruptions on Grieving And Mourning Within an African Context: Lessons For Social Work Practice.

Losing a significant other through death is a tragic experience worsened by the novel coronavirus disease 2019 (COVID-19). To curb this massive increase of deaths, the South African government introduced various rules to regulate the burial process. However, these COVID-19 regulations have caused major ruptures and disruptions on how bereaved families observe and practice cultural rites and customs following death within an African context. Consequently, many bereaved family members, particularly Black Africans, struggle with adhering to the regulations and funerals have been coined ‘super spreaders’ of the virus. The concerns raised in this article are twofold, namely, the impact of the Covid-19 regulations on how Black Africans grieve and mourn, as well as the involvement of social workers in formulating regulations that ought to be adhered to. This article explores the fissures and bricolages brought about by COVID-19, ultimately suggesting possible ways of dealing the losses ascribed to the pandemic.

Pectoralis Major Rupture: Evaluation and Management.

Pectoralis major tendon ruptures are being reported with increasing frequency and primarily occur in young, high demand, male patients. The injury results from an eccentric contracture of the muscle most commonly while performing the bench press maneuver during weight training. In the setting of both acute and chronic injury, physical examination is critical for a timely and accurate diagnosis. During physical examination, comparison with the opposite side is imperative, and findings may include swelling, ecchymosis, loss of the anterior axillary fold, and a decreased pectoralis major index. Surgical treatment of acute ruptures is superior to nonsurgical treatment and results in improved functional outcomes and high levels of return to work and sport. Repair of chronic tears is more challenging and may require reconstruction with autograft or allograft tissue. Despite advances in surgical technique, tendon rerupture, persistent pain, and wound infection remain a concern.

Deep Transitions: Towards a comprehensive framework for mapping major continuities and ruptures in industrial modernity

The world is confronted by a socio-ecological emergency, requiring rapid and deep decarbonization of a broad range of socio-technical systems. A recent Deep Transitions framework argues that this fundamentally unsustainable trajectory has been generated by the co-evolutionary dynamics of multiple systems during the last 250 years. Altering this direction requires transformation in industrial modernity – a set of most fundamental ideas, institutions, and practices characterizing every industrial society to date. Although the proponents of the framework suggest that this shift has been unfolding since the 1960s, no attempts have been made to operationalize the concept of industrial modernity and to assess this claim. This paper develops a comprehensive multi-dimensional and multi-domain approach for the measurement of industrial modernity. As such it seeks to provide empirical evidence of long-term continuities and emerging ruptures in the dominant ideas, institutions, and practices of industrial societies along the domains of environment and technology. Using a methodologically novel approach where the text mining of newspapers is combined with data from various databases the paper provides results from three countries – Australia, Germany, Soviet Union/Russia – between 1900 and 2020. Despite considerable country-level differences the results show shifts in public environmental discourse from the 1960s, followed by institutional changes from the 1980s but with only a modest change in practices. We also observe some change in the direction of innovative activities and their regulation coupled with a resurgent optimism in technology-environment discourse. The findings tentatively suggest that industrial modernity might be in the process of hollowing out along ideational and institutional dimensions in the environmental domain but less so in the domain of technology and innovation.

Effect of Boric Acid Solubility in Steam on the Process of Mass Transfer during Emergency Cooling of VVER-1200 Nuclear Reactor

The mechanisms of boric acid mass transfer in a VVER-1200 reactor core are studied in this work in the event of a major circulatory pipeline rupture and loss of all AC power. The VVER-1200's passive core cooling technology is made up of two levels of hydro accumulators. They use boric acid solution with a concentration of 16 g H3BO3/kg H2O to control the reactivity. Because of the long duration of the accident process, the coolant with high boron content starts boiling and steam with low concentration of boric acid departs the core. So, conditions could arise in the reactor for possible accumulation and subsequent crystallization of boric acid, causing the core heat removal process to deteriorate. Calculations were carried out to estimate the likelihood of H3BO3 build-up and subsequent crystallization in the core of the VVER reactor. According to the calculations, during emergency the boric acid concentration in the reactor core is 0.153 kg/ kg and 0.158 kg/kg in both the events of solubility of steam and without solubility of steam respectively and it does not exceed the solubility limit which is about 0.415 kg/kg at water saturation temperature. No precipitation of boric acid occurs within this time during the whole emergency process. Therefore, findings of the study can be used to verify whether the process of decay heat removal is affected or not.

The 'Cruciform Test': A diagnostic tool to detect pectoralis major rupture.

Pectoralis major (PM) rupture is a severe injury that untreated can lead to a profound functional deficit. Early surgical repair can greatly improve outcomes and give a more predictable timetable for recovery, making this the goal of current treatment. Surgical intervention is also essential to return professional athletes to their previous level of competition. However, there is no single, reliable and easily reproducible test that can be used to establish the diagnosis. We describe 'The Cruciform Test'; a method of identifying PM rupture that can be used for initial diagnosis either in clinic or a pitch-side environment, or to assess restoration of normal anatomy and function post-operatively. We studied a series of 14 patients who underwent open PM repair in order to evaluate this method of assessment. All patients had a positive test pre-operatively. 5 were formally tested at post-operative follow-up and all had a negative result. The Cruciform Test is a simple and reproducible diagnostic tool that has potential as a clinical indicator of both PM rupture and successful repair. It can therefore contribute to earlier diagnosis, prompt surgical intervention and facilitate return to play at the earliest opportunity.

Metal accumulation induces oxidative stress and alters carbonic anhydrase activity in corals and symbionts from the largest reef complex in the South Atlantic ocean

We evaluated the influence of metal accumulation on the oxidative status [lipid peroxidation (LPO) and total antioxidant capacity (TAC)] and carbonic anhydrase (CA) activity in host and symbionts of the coral Mussismilia harttii and the hydrocoral Millepora alcicornis collected in Abrolhos Reef Banks (Northeast Brazil), potentially impacted by a major mine dam rupture. Considering metal levels measured in reefs worldwide, Abrolhos corals had higher Fe and Mn levels than expected for preserved offshore reefs. Increasing concentrations of arsenic (As), chromium (Cr) and manganese (Mn) drove inhibition of CA and increased oxidative damage in the hydrocoral M. alcicornis. The impairment of enzymatic activity in the symbiotic algae of M. alcicornis may be related to the oxidative stress condition. The hydrocoral M. alcicornis was more affected by metals than the coral M. harttii, which did not show the expected CA inhibition after metal exposure. Our results suggest that CA activity can be applied as a complementary biomarker to evaluate the physiological impacts of environmental metal contamination in reefs. Also, the metal levels and biochemical biomarkers reported in the present study may provide reference data to monitor the health of reefs impacted by a relevant dam rupture.

Segmentation and Holocene Behavior of the Middle Strand of the North Anatolian Fault (NW Turkey)

AbstractThe North Anatolian Fault (NAF) in the Marmara region is composed of three parallel strands all separated by ∼50 km. The activity of the middle strand, which borders the southern edge of the Marmara Sea, is much debated because of its present‐day very low seismicity. This contrasts with historical, archeological and paleoseismological evidence, which suggest several destructive earthquakes have occurred during the last 2000 years. Our study aims to better constrain seismic hazard on the middle strand by exploring its Holocene paleoseismicity. For this, we mapped 148 km of the eastern part of the middle strand, using high‐resolution satellite imagery. A series of landforms offset by the middle strand activity have been systematically measured to recover the past ruptures. Three Late Pleistocene‐Holocene terraces have been dated with the terrestrial cosmogenic nuclide method, constraining a horizontal slip rate of mm/yr. The statistical analysis of the offsets evidences several major ruptures preserved in the landscape, with coseismic lateral displacements ranging between 3 and 6.5 m. This corresponds to Mw ∼7.3 earthquakes able to propagate along several fault segments. Historical seismicity and paleoseismology data suggest that the last large earthquakes along the middle strand of the NAF (MNAF) happened in 1065 CE and between the 14th and 18th centuries CE. Since then, the MNAF may have accumulated enough stress to generate a destructive rupture.

Reviewing the characteristics of slip behaviour for megathrust earthquake at Sumatera using vertical derivative of GOCE satellite gravity field

The review of the seismogenic zone characteristics associated with the earthquake rupture process in the Sumatra Subduction Zone has been carried out by various methods. This zone has experienced several major earthquakes; Aceh 2004 Mw=9,1, Nias-Simeulue 2005 Mw=8,6, Bengkulu 2007 Mw=8,5, and Enggano 2000 Mw=7,9. This study focuses on the relationship between density contrast analysis based on gravity data from the GOCE satellite and the slip distribution in four major earthquake rupture zones. Satellite gravity data processing is carried out to obtain data for Gravity disturbance (Gd) and vertical gravity derivatives (Tzz), corrected by topography and sediment effects with different spectrum decomposition to get gravity maps with different depths. Based on the Tzz analysis, the maximum slip of the earthquake rupture is correlated with the minimum Tzz pattern and low-density contrast. In contrast, the rupture ends at the maximum Tzz pattern and high-density contrast. Tzz pattern and Gravity disturbance can describe the barrier and asperity of the Sumatra subduction zone. The schematic maps portray the seismic segmentation of Sumatra Subduction, which have asperities zone along the subduction strike associated with the minimum Tzz and associated with the forearc zone, as well as the barrier related to the maximum Tzz, which is a manifestation of structures (fracture zone and seamount) that are subducted to the oceanic plate.

Transit for a better and more equitable urbanity

Nordic welfare states once sought to provide their citizens with affordable and healthy housing conditions by planning compact residential areas. For a variety of reasons, this model is now in a major rupture. Strong domestic and international migration to 4-6 urban regions transforms Finland’s spatial setup. The entire process entails major challenges for urban design. Expanding urban structures constitute a massive source of greenhouse gases and are often deemed dysfunctional for reaching goals such as social sustainability, better public health or even individually perceived quality of life. Transit-oriented development (TOD) is one of the attempts to tackle these challenges. It holds a major promise for better and more equitable urbanity, but this assumes that the entire dynamics of urban development and how transit and better accessibility are related to it will be re-thought. This paper is based on case-study data from Tampere city region and its on-going light rail transit (LRT) construction process as an example of the current TOD thinking. It also makes references to comparable or otherwise interesting international LRT processes as discussed in planning journals or based on the authors’ own observations and fieldwork.

Safety assessment of the small welded pipe system by the test and FEA

Failures of small pipe systems continue to occur frequently at nuclear power plants and aerospace equipment resulting in degraded systems and unscheduled downtime. Currently, there is a lack of detailed technical requirements and evaluation criteria for the small pipe in the existing design codes. In the design code, if referring to the general fatigue evaluation method for metal parts, the results may be too conservative. It has been shown that fatigue tests based on structural parts can significantly extend the component life by recently studies. At the same time, for the small pipe, the influence of the crack propagation stage on the fatigue life (S–N curve) is usually ignored in the existing evaluation process. On the other hand, fatigue-related failures are generally detected as small cracks or leaks before major pressure boundary ruptures occur, so the “Leak-Before-Break” (LBB) can be also applied for the small pipe. This study is undertaken to improve the understanding of the fatigue life of the small pipe (comparing the pipe test results with the data in the code) and the characteristics of fatigue crack propagation. Also, the applicability of the LBB concept is discussed. The results show that the S–N curve obtained by the pipe test is higher than that gained by the standard specimen. The crack propagation life accounts about 3% of the fatigue life in the study case. The critical failure mode is dominated by the plastic collapse; it is therefore shown that the plastic collapse load or critical crack size can be increased by increasing the tensile strength of the materials. A safety factor of 9.25 for the LBB assessment is contained in the case; therefore, it is also useful to warn the final fracture of the pipe by installing a leak detection system.

Heterogeneous material properties—as inferred from seismic attenuation—influenced multiple fault rupture and ductile creep of the KaikouraMw 7.8 earthquake, New Zealand

SUMMARYThe 2016 Mw 7.8 Kaikoura, New Zealand, earthquake occurred along the eastern margin of the transition region between active subduction in the North Island and oblique collision in the South Island. To infer crustal properties, we imaged Q (1/seismic attenuation) by combining selected M &amp;gt; 3.5 aftershocks with data from previous Q models. For 158 distributed aftershocks, we fit spectral decay on temporary stations and all Geonet stations, providing 6194 t*p and 19 497 t*s. Considering the varied rheology and faults, we also used 2.5-D numerical models to study ductile strain development. The complex earthquake ruptured an ∼180-km-long zone of multiple faults, which involved jumping around the complicated eastern end of the Hope fault, without significant slip on the Hope fault. The Qs and Qp results show features in the upper and lower crust which correlate to the distribution and types of fault rupture. This earthquake involved numerous faults over a region of greywacke crust, where the underlying high Q Cretaceous slab is about 30-km depth. It initiated with ∼5-m slip on the Humps fault in a region of background seismicity and low Q lower crust, adjacent to the Hope fault. The central region near Kaikoura shows a high Q crustal block, which appears to have inhibited rupture; as the rupture progressed over several small faults to jump offshore of the apparently strong block. Underlying the Kaikoura greywacke crust, below 20-km depth, there is a 40-km-long region of increased Vp, Qs and gravity, which likely represents an intraplate plutonic complex emplaced into the Hikurangi Plateau, forming an elevated section which influences deformation. In the northern section, in a region with relatively uniform moderate to low Q, the earthquake evolved into the relatively continuous ∼80-km-long major rupture along the Jordan, Kekerengu and Needles faults, with ∼6–20 m dextral slip at depth and surface displacements of ∼10 m dextral and ∼2 m vertical. The northern progression of the rupture stopped when it approached an abrupt change to high Q crust across Cook Strait. At 20–30-km depth northwest of the rupture, deeper zones with low Q are consistent with regions of distributed ductile shear and creep where the observed afterslip may have occurred, where the underlying slab is 25–40 km deep. The numerical model shows that ductile deformation localizes in this area of lower crust above the relatively strong slab, connecting outer faults (Kekerengu) to inland faults (Clarence, Awatere, Wairau), and demonstrates that no subduction thrust is required under the Marlborough region.

Large Holocene ruptures on the Cañada David detachment, Baja California, Mexico; implications for the seismogenesis of low-angle normal faults

We present the results of detailed mapping and paleoseismic investigations along a section of the complex fault scarp array associated with the Cañada David detachment, a low-angle oblique normal fault that controls the southwestern flank of the Sierra El Mayor, Baja California, Mexico. We used high-resolution unmanned aerial vehicle imagery to map portions of a sequence of alluvial fans that comprise a bajada that flanks the southwestern range front. Their ages are distinguished based on a regional soil chronosequence. Three paleoseismic trenches were excavated across active surface faults that root into the Cañada David detachment at depth. Fine-grained stratigraphic units in the trenches were dated by optically stimulated luminescence techniques. The three trenches in this study show strong evidence for four large (Mw≥7) Holocene earthquakes at or just prior to about 1.7, 4.3–6.1, 7.7–7.6 and 8.4–10.7 ka, as well as weak to moderate evidence for two additional late Pleistocene earthquakes at or just prior to 12.7–14.1 ka and 15.2 ka, indicating an average recurrence of such events of ∼3 ka. This earthquake recurrence interval is slightly longer than that for the Laguna Salada fault to the north that flanks the Sierra Cucapah. The regular recurrence of major surface ruptures strongly suggests that severely-misoriented low-angle normal faults like the Cañada David detachment have a mechanical behavior that is very similar to other more optimally oriented faults suggesting that earthquakes on such faults should be common and may be difficult to recognize from seismologic methods due rolling-hinge ramps and/or multifault ruptures.

Navigating the Time of Arab Jerusalem: A Perspective from Within

For many Palestinians, the colonial denial of Palestinian self-determination in an independent nation-state has rendered futile the very notion of a future. But it is imperative to challenge the colonial logics that produce the native’s future as always already failed, unachievable, or impossible. This essay examines snippets of the life of Arab Jerusalem between the two major ruptures of 1948 and 1967 to deconstruct colonial and nationalist epistemologies of time and to challenge the persistently violent present and its domination of Palestinian pasts and futures. Using as its lens the memories and attachments of Jerusalemites who lived, worked, and struggled in the city, the essay examines the ways in which they thought of, imagined, produced, fulfilled, or were deprived of a future—in other words, how Jerusalemites shaped futurity. Such a nonlinear unfolding of time challenges dominant perceptions of the Nakba as constituting a clean break between past and present.

Renal Involvement in Retroperitoneal Fibrosis: Prevalence, Impact and Management Challenges.

Retroperitoneal fibrosis (RPF) is a rare disorder consisting of idiopathic and various secondary forms and characterized by chronic inflammatory infiltrates and marked fibrosis in the retroperitoneal space. In idiopathic RPF (IRPF), 35–60% of cases have been reported to be IgG4-related RPF, the retroperitoneal lesions of IgG4-related disease (IgG4-RD). IRPF can frequently lead to renal insufficiency mediated by urinary tract obstruction and hydronephrosis irrespective of being IgG4-related or not. Clinical pictures, laboratory and imaging findings, and location of the urinary tract obstruction are generally similar in IgG4-related and non-IgG4-related IRPF although multiple organ involvement and serum IgG4 elevation may be characteristic of the IgG4-related forms. Periaortic/periarterial lesions are the most frequent cause of renal insufficiency. Although the response to glucocorticoids is generally good, relapse does occur in a considerable proportion of patients, and may require an additional immunosuppressive agent and/or urological intervention in cases with multiple relapses or refractory obstructive uropathy. In general, the prognosis of patients with IRPF is good, but careful attention needs to be paid to chronic kidney disease as a major complication and rupture of the affected aorta/artery as a life-threatening one. Further studies are necessary to better understand the pathogenesis of the disease and to establish the optimal diagnostic and therapeutic strategies for it.

A Significant Increase in Interplate Seismicity near Major Historical Earthquakes Offshore Martinique (FWI)

ABSTRACT Understanding the processes that may be at the origin of major earthquakes in subduction zones is highly challenging, especially in the case of slowly converging areas such as the Lesser Antilles subduction zone. Our study reveals a recorded increase in seismicity rate and cumulative seismic moment over the last two decades offshore Martinique island and, particularly, in the presumed rupture area of the major historical 1839 earthquake. This sustained seismicity is shared between extensive intermediate depth activity since the 2007 Mw 7.4 earthquake that occurred about 20 km north of Martinique and a compressive seismic cluster located in the seismogenic zone of the subduction zone. We also observe a downward migration of the seismicity along the plate interface up to a 60–65 km depth and a recorded increase in the magnitudes of the earthquakes. All these observations may indicate ongoing changes along the plate boundary interface near the area of the historical major rupture of 1839, although more detailed statistical studies and additional data are necessary to confirm this trend.

Pectoralis Major Ruptures in the National Football League: Incidence, RTP, and Performance Analysis.

Background:While pectoralis major (PM) tears are rare injuries in National Football League (NFL) athletes (previous study reported only 10 PM ruptures between 2000 and 2010), the incidence of these injuries has increased over the past decade. The impact these injuries have on a player’s performance after return has not been measured.Purpose/Hypothesis:To identify player characteristics that may predispose to PM tears and to determine the impact of this injury on return to play and performance. We hypothesized that there would be no difference in performance between the year before and after their injury.Study Design:Descriptive epidemiology study.Methods:NFL players who experienced PM tears between the years 2010 and 2018 were identified using publicly available reports. Several individual player characteristics were identified and recorded, and the return-to-play rates after injury were determined for each position. The pre- and postinjury Pro Football Focus grades of players who met inclusion criteria were compared. A paired t test analysis of the change in player performance was used for analysis.Results:In this study, 63 ruptures were identified between 2010 and 2018. Linebackers had the highest incidence of PM tear compared with any other position. Of all injuries, 79.3% were sustained by defensive players. The majority of PM tears occurred during games. Only 6.9% of players who sustained the injury were suspended for performance-enhancing drug use during their professional career. A total of 85.7% of players returned to play in the NFL after injury. Among those who returned to play there were no significant changes in player performance from pre- to post-injury.Conclusion:NFL players demonstrated 85.7% return-to-play rates and no significant drop-off in performance after PM ruptures. During the time period studied, there was an increase in incidence of PM ruptures compared with the previous decade. Further investigation is needed to determine potential causes for the increased incidence of PM ruptures in NFL players.

On dependencies and opportunities: Examining networks of scholars in exile

We present a qualitative network analysis (QNA) of fourteen scholars from Turkey, Syria and Yemen in exile in Germany. The QNA examined the strength and importance of the exiled scholars’ networks on their careers and modes of communication. While international mobility is typical in an academic career, an analysis of the networks of exiled scientists revealed major ruptures and changes in the networks of the investigated scholars due to their forced relocation. The analyses showed strong dependency of the researchers on the host nation, leading many to feel marginalized in their host country while having to sever relations with their home country, concurrently. Nonetheless, others were able to strengthen their position in their host nation by exploiting their previously built transnational and newly formed connections. We explore the vulnerability of the scholars’ networks in exile.