A great deal of ink has been spilled over attempts to increase trust in government. Surprisingly, the impact of social equity on trust in government has received relatively little attention. ...Particularly, insufficient attention has been paid to empirically connect the linkage between a country-level social equity and an individual-level trust in government. The purpose of this study is to examine the impacts of social equity on citizen trust in government. This study uses a multilevel analysis to take into account macro-country level social equity. The findings from analyzing the World Values Survey and the Rule of Law Index reveal that social equity in administrative processes is positively associated with trust in the courts and the police. It is imperative to consider social equity in public administration to get a better understanding of developing citizen trust in government.
New Public Management posed challenges to governments by emphasizing the flexibility of workforce, innovation, and the role of supervisors in running public sector organizations. However, there is ...debate over whether job insecurity and organizational innovativeness contribute to organizational performance in the public sector. Furthermore, despite the growing awareness of the importance of supervisors, the issue of public sector employees’ trust in their supervisors has received relatively little attention. The purpose of this article is to examine the impacts of job insecurity, innovation, and employees’ trust in supervisors on organizational performance in order to explain these inconsistencies and fill the void in past research. It develops a structural equation model, built on two sets of Korean public employee survey data, whose results show that job insecurity is negatively related to performance, while employees’ trust in supervisors and organizational innovativeness are positively associated with performance. In addition, employees’ trust in supervisor is positively related to innovativeness.
Due to air pollution and energy shortages in the contemporary world, weight lighting for transportation vehicles and energy conservation, as well as emission reductions, are necessary to achieve ...carbon neutrality and fuel conservation ...
Study Design: Retrospective cohort study. Objective: The purpose of this study is to characterize the relationship between preoperative MCS and surgical outcomes after lumbar spine surgery including ...inpatient complications, length of stay, readmissions, and reoperations. Summary of Background Data: As the prevalence of mental health disorders in the United States increases, it is important to identify risks associated with poor mental health status in the surgical spine patient. The mental health component summary (MCS) of the Short Form-12 has been used extensively as an indication of a patient’s mental health status and psychological well-being. Methods: Adult patients older than or equal to 18 years who underwent primary one to three level lumbar fusion surgery at our academic medical institution from 2017 to 2021 were retrospectively identified. Preoperative MCS score was used to analyze outcomes in patients based on a cutoff (<45.6). A score >45.6 indicated better preoperative mental health and a score < 45.6 indicated worse preoperative mental health. Results: Patients with lower preoperative MCS scores had longer hospital stays (3.86 + 2.16 vs. 3.55 + 1.42 days, P =0.010) and were more likely to have inpatient renal complications (3.09% vs. 7.19%, P =0.006). Patients with lower preoperative MCS scores also had lower Activity Measure for Post-Acute Care (AM-PAC) scores (17.1 + 2.85 vs. 17.6 + 2.49, P =0.030). Ninety-day surgical readmissions, medical readmissions, and reoperations were not significantly different between groups ( P >0.05). Conclusion: Our study suggests that patients with lower preoperative mental health scores (MCS < 45.6) were independently more likely to experience more renal complications and longer length of stay after primary lumbar fusion. Additionally, higher MCS scores may correlate with better postoperative mobility and daily activity scores. Nevertheless, long-term outcomes are not significantly different between patients of better or worse preoperative mental health.
A noninvasive and selective therapy, photodynamic therapy (PDT) is widely researched in clinical fields; however, the lower efficiency of PDT can induce unexpected side effects. Mitochondria are ...extensively researched as target sites to maximize PDT effects because they play crucial roles in metabolism and can be used as cancer markers due to their high transmembrane potential. Here, a mitochondria targeting photodynamic therapeutic agent (MitDt) is developed. This photosensitizer is synthesized from heptamethine cyanine dyes, which are conjugated or modified as follows. The heptamethine meso‐position is conjugated with a triphenylphosphonium derivative for mitochondrial targeting, the N‐alkyl side chain is modified for regulation of charge balance and solubility, and the indolenine groups are brominated to enhance reactive oxygen species generation (ROS) after laser irradiation. The synthesized MitDt increases the cancer uptake efficiency due to the lipo‐cationic properties of the triphenylphosphonium, and the PDT effects of MitDt are amplified after laser irradiation because mitochondria are susceptible to ROS, the response to which triggers an apoptotic anticancer effect. Consequently, these hypotheses are demonstrated by in vitro and in vivo studies, and the results indicate strong potential for use of MitDts as efficient single‐molecule‐based PDT agents for cancer treatment.
Mitochondria targeting photodynamic therapeutic agents (MitDt) including triphenylphosphonium, which can be guided to mitochondrial membranes, are devised. Among them, the brominated indolenine structure can boost reactive oxygen species production after near‐infrared (NIR) laser irradiation, which elicits outstanding cellular apoptotic death in vitro and in vivo. Therefore, MitDt suggests a promising therapeutic probe for cancer therapy.
The relationship between research productivity in training and future productivity as an attending spine surgeon is not well-established in the literature nor has the effect of geographic location of ...training institutions on future academic success been investigated. The aim of our study was to (1) summarize characteristics of academically productive spine surgeons, (2) assess predictors of long-term academic productivity, and (3) establish the effect of geographic location on long-term academic productivity.
A query was conducted of the 2021 to 2022 North American Spine Society Spine Fellowship Directory of all orthopaedic and neurosurgical spine fellowship selection committee members for each institution participating in the spine fellowship match. The attending publication rate and h- index were determined. A multivariate linear regression model was developed. P value was set to <0.05.
We identified 310 orthopaedic and neurosurgical spine surgeons, representing 76 fellowship programs. Multivariate linear regression analysis identified that the publications during residency ( P < 0.001) and during fellowship ( P < 0.001) were significant predictors of an increased publication rate as an attending surgeon. By contrast, the preresidency publication rate ( P = 0.729) was not significantly predictive of the attending publication rate. Multivariate analysis of h- index found that residency publication rate had a positive correlation ( P = 0.031) compared with preresidency ( P = 0.579) or fellowship ( P = 0.257) rates. Attendings who had attended residency in the Northeast and currently practicing in the Northeast had a higher publication rate ( P < 0.001 and P = 0.004, respectively).
A higher number of publications in residency and fellowship were markedly predictive of an increased publication rate as an attending spine surgeon. By contrast, preresidency publications may not be indicative of future academic productivity as an attending. Location may also contribute to attending publication rate and favor those who undergo residency training and ultimately practice in the Northeast.
To evaluate the (1) 90-day surgical outcomes and (2) 1-year revision rate of robotic versus nonrobotic lumbar fusion surgery.
Patients >18 years of age who underwent primary lumbar fusion surgery at ...our institution were identified and propensity-matched in a 1:1 fashion based on robotic assistance during surgery. Patient demographics, surgical characteristics, and surgical outcomes, including 90-day surgical complications and 1-year revisions, were collected. Multivariable regression analysis was performed. Significance was set to
< 0.05.
Four hundred and fifteen patients were identified as having robotic lumbar fusion and were matched to a control group. Bivariant analysis revealed no significant difference in total 90-day surgical complications (
= 0.193) or 1-year revisions (
= 0.178). The operative duration was longer in robotic surgery (287 + 123 vs. 205 + 88.3,
≤ 0.001). Multivariable analysis revealed that robotic fusion was not a significant predictor of 90-day surgical complications (odds ratio OR = 0.76 0.32-1.67,
= 0.499) or 1-year revisions (OR = 0.58 0.28-1.18,
= 0.142). Other variables identified as the positive predictors of 1-year revisions included levels fused (OR = 1.26 1.08-1.48,
= 0.004) and current smokers (OR = 3.51 1.46-8.15,
= 0.004).
Our study suggests that robotic-assisted and nonrobotic-assisted lumbar fusions are associated with a similar risk of 90-day surgical complications and 1-year revision rates; however, robotic surgery does increase time under anesthesia.
Objectives: The objectives of our study were to (1) determine if physical therapy (PT) impacts patient-reported outcomes (PROMs) after lumbar decompression surgery and (2) determine if PT impacts ...postsurgical readmissions or reoperations after lumbar decompression surgery.
Methods: Patients >18 years of age who underwent primary one- or two-level lumbar decompression at our institution were identified. Patient demographics, surgical characteristics, surgical outcomes (all-cause 90 days readmissions and 90 days surgical readmissions), and patient-reported outcomes (PROMs) were compared between the groups. Multivariate linear regression was utilized to determine the individual predictors of 90 days readmissions and PROMs at the 1-year postoperative point. Alpha was set at P < 0.05.
Results: Of the 1003 patients included, 421 attended PT postoperatively. On univariate analysis, PT attendance did not significantly impact 90-day surgical reoperations (P = 0.225). Although bivariate analysis suggests that attendance of PT is associated with worse improvement in physical function (P = 0.041), increased preoperative Visual Analogue Scale leg pain (0 = 0.004), and disability (P = 0.006), as measured by the Oswestry Disability Index, our multivariate analysis, which accounts for confounding variables found there was no difference in PROM improvement and PT was not an independent predictor of 90-day all-cause readmissions (P = 0.06). Instead, Charlson Comorbidity Index (P = 0.025) and discharge to a skilled nursing facility (P = 0.013) independently predicted greater 90-day all-cause readmissions.
Conclusions: Postoperative lumbar decompression PT attendance does not significantly affect clinical improvement, as measured by PROMs or surgical outcomes including all-cause 90 days readmissions and 90-day surgical readmissions.
Purpose The Great Recession that began around 2008 hit hard on Greece and Italy. During a period of extreme economic distress, the two countries suffered the loss of government performance and ...citizen trust in government. The purpose of this study is to describe how government performance and citizen trust in government had been altered in the context of the Great Recession. Design/methodology/approach This study conducts a case study on France and Germany. These in-depth case studies afford a lens for diagnosing how the Great Recession affected macro and micro-performance in practice. Findings Comparative case studies of Greece and Italy provide evidence that government performance in Greece and Italy was diminished to a large extent as a result of the Great Recession. In addition, citizen trust in both countries was impaired during the Great Recession period. Social implications It is a matter of grave concern how the government responds to crises. During the crisis, some states implemented stringent austerity measures. This case brings out the careful point that austerity measures could diminish government performance as well as the state’s fundamental potential. Originality/value Due to its significance, the Great Recession has been widely investigated, with the explanations often concentrating on economic and political repercussions. Nonetheless, how the economic crisis transformed into public administration and policy has largely gone unheeded. The case studies of Greece and Italy newly identify and help to explain how the Great Recession contributes to governments and citizens in a multitude of aspects.
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