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From within the milieu of race and identity fatigue emerges "Crash." Winner of three Academy Awards, including Best Picture, "Crash" addresses how the fluidity of identity is pooled, ebbed, blocked, directed, dammed up. How identity and subjectivity are dammed up and mediated through the force of the anxieties, fears, and frustrations of people haunted by the interpellations, seductions, and requirements of everyday living. As a public pedagogy, "Crash" produces effects not limited to moviegoers or film aficionados. From chat rooms, newspapers, and classrooms to town hall meetings and Oprah, "Crash" tapped into a social reservoir that recognizes how race and ethnicity continue to scaffold and structure space, politics, passions, and life possibilities. In this article, the author first discusses the advantage of situating the movie as a form of public pedagogy, locating "Crash" as a multiple site that is simultaneously generative/productive on one register while being complicit in the very racism it critiques on another register. Such a gesture compels students to go beyond understanding film and other cultural productions as mere sites of pleasure that can be grasped through reductive like-dislike logic. Next, and more specifically, he analyzes how "Crash" productively registers heterogeneity within African American culture without denying the significance of race a la the creators of "Grey's Anatomy"; how it disrupts myopic and monolithic notions of race and ethnicity; and how it produces an ethos of tolerance, by excavating fears driving inter- and intraethnic conflict and by humanizing its primary antagonist and protagonist. The essay concludes with the implications of "Crash" for discourses and pedagogies of race and ethnicity.

Background: The optimal postoperative rehabilitation regimen following total knee arthroplasty (TKA) is not clearly defined. The advent of telerehabilitation offers potential for increased patient convenience and decreased cost, while maintaining similar outcomes to traditional physical therapy (PT). Therefore, we evaluated a novel, home-based, clinician-controlled, multi-modal evaluation and therapy device with telerehabilitation functionality for TKA.Methods: A total of 135 consecutive TKA patients receiving standard therapy protocol (STP) were compared to 135 consecutive patients receiving a home-based clinician-controlled therapy system (HCTS). Outcomes were assessed at 2, 6, and 12 weeks, including visual analog scale (VAS) for pain, knee injury and osteoarthritis outcome score JR (KOOS JR), and knee range of motion (ROM) measured by the same certified physical therapists.Results: Postoperative knee ROM was greater in the HCTS group at all time points throughout the study period (P < .001 at 2, 6, and 12 weeks). VAS and the KOOS JR functional scores were statistically better (P < .001) in the HCTS group at all time points and exceeded the threshold for minimal clinically important difference (MCID) for both VAS and KOOS JR. There were significantly fewer cases of arthrofibrosis requiring manipulation under anesthesia (MUA) in the HCTS group (1.48 versus 4.44%).Conclusion: Following TKA, a novel, home-based, clinician-controlled, multi-modal therapy device was superior to standard PTduring the first 12 weeks postoperatively for ROM, KOOS JR, and VAS (with all scores exceeding the MCID) and had substantially fewer manipulations for arthrofibrosis. [ABSTRACT FROM AUTHOR]

Cementless total knee arthroplasty (TKA) is thought to facilitate durable, biological fixation between the bone and implant. However, the 4-12 weeks required for osseointegration coincides with the optimal timeframe to perform a manipulation under anesthesia (MUA) if a patient develops postoperative stiffness. This study aims to determine the impact of early MUA on cementless fixation by comparing functional outcomes and survivorship of cementless and cemented TKAs. A consecutive series of patients who underwent MUA for postoperative stiffness within 90 days of primary, unilateral TKA at 2 academic institutions between 2014 and 2018 were identified. Cases involving extensive hardware removal were excluded. Cementless TKAs undergoing MUA (n = 100) were propensity matched 1:1 to cemented TKAs undergoing MUA (n = 100) using age, gender, body mass index, and year of surgery. Both groups had comparable baseline Knee Injury and Osteoarthritis Outcome Scores (KOOS), Short Form (SF)-12 Physical, and SF-12 Mental scores. MUA-related complications as well as postoperative KOOS and SF-12 scores were compared. MUA-related complications were equivalently low in both groups (P =.324), with only 1 patella component dissociation in the cementless group. No tibial or femoral components acutely loosened in the perioperative period. Postoperative KOOS (P =.101) and SF-12 Mental scores (P =.380) were similar between groups. Six-year survivorship free from any revision after MUA was 98.0% in both groups (P = 1.000). Early postoperative MUA after cementless TKA was not associated with increased MUA-related complications or worse patient-reported outcomes compared to cemented TKA. Short-term survivorship was also comparable, suggesting high durability of the bone-implant interface. [ABSTRACT FROM AUTHOR]

BACKGROUND Although literacy rates in India have improved for both men and women, less is known about the evolution of gender disparities across different levels of educational attainment. OBJECTIVE The goal is to determine whether gender gaps in schooling outcomes have narrowed, widened, or remained unchanged across birth cohorts. METHODS With a multinomial logit specification, we compare six education outcomes for people born to the 1956-1960, 1961-1965, ..., and 1986-1990 cohort groups. Our empirical tests indicate whether the gender gaps have narrowed, widened, or remained unchanged across the cohort groups. RESULTS We find evidence of narrowing gender gaps for some but not all education outcomes. The gender gaps narrow for not attending school, attending primary school, and primary school completion, but they persist for secondary school completion, attending college, and college completion. CONCLUSIONS Although we observe improvements in the gender gaps in schooling outcomes toward the lower end of the education spectrum, gender inequities associated with higher levels of schooling persist across cohort groups. It is important to understand the causes of these patterns, as there are likely important policy considerations for India as it grapples with the interactions among technological change, a relatively young workforce, and persistent gendered norms and attitudes. CONTRIBUTION The paper makes two noteworthy contributions. First, we show that gender progress in schooling outcomes is not uniform across different levels of educational attainment. Second, our cohort study framework provides a simple test for progress (or lack thereof) in education and other settings. [ABSTRACT FROM AUTHOR]

The purpose of this preliminary analysis was to determine if there are relationships between anthropometric characteristics (arm length, torso length, thigh length, and shank length) and conventional deadlift (CDL) kinematics and kinetics during a 5 sets of 5 repetitions (5 x 5) CDL routine in resistance-trained males. Eleven males who had experience with the deadlift exercise were included in this analysis (age: 21.5 ± 1.4 y; height: 180.7 ± 5.7 cm; body mass: 89.9 ± 16.0 kg). Anthropometrics were measured by a 3-dimensional optical scanner. The participants underwent a 5 x 5 CDL workout using a self-selected load corresponding to a rating of perceived exertion (RPE) of 8 out of 10. Performance outcomes were measured synchronously using a 3-dimensional 12-camera motion capture system and two force platforms. Outcomes were averaged across all sets and analyzed using multiple linear regression. The selected anthropometric variables were not significantly related to the CDL performance outcomes, except for concentric ankle work. However, in the overall model, anthropometric predictors did not significantly predict ankle concentric work (p = 0.11; R² = 0.67; R²adj = 0.45). Independently, thigh length significantly correlated with ankle concentric work (p = 0.03). In this model, thigh length accounted for 55% of the normalized variance in ankle concentric work. The results from this preliminary study suggest that arm length, torso length, and shank length may not play a clear role in the examined CDL outcomes, but thigh length may be positively correlated with ankle concentric work during a 5 x 5 CDL routine in resistance-trained males. [ABSTRACT FROM AUTHOR]

Slower psychomotor speed is very common in patients with type 1 diabetes mellitus (T1D), but the underlying mechanisms are not clear. We propose that hyperglycemia is associated with slower psychomotor speed via disruption of brain activation. Eighty-five adults (48% women, mean age: 49.0 years, mean duration: 40.8) with childhood onset T1D were recruited for this cross-sectional study. Median response time in seconds (longer = worse performance) and brain activation were measured while performing a psychomotor speed task. Exposure to hyperglycemia, measured as glycosylated hemoglobin A1c, was associated with longer response time and with higher activation in the inferior frontal gyrus and primary sensorimotor and dorsal cingulate cortex. Higher activation in inferior frontal gyrus, primary sensorimotor cortex, thalamus, and cuneus was related to longer response times; in contrast, higher activation in the superior parietal lobe was associated with shorter response times. Associations were independent of small vessel disease in the brain or other organs. In this group of middle-aged adults with T1D, the pathway linking chronic hyperglycemia with slower processing speed appears to include increased brain activation, but not small vessel disease. Activation in the superior parietal lobe may compensate for dysregulation in brain activation in the presence of hyperglycemia.

As the number and diversity of high school graduates increase, secondary school systems and colleges must work together to prepare students for the demands of higher education and the labor force. This document describes a partnership between Montgomery College (Maryland) and Montgomery County Public School district that is focused on student success. (PGS)

Background: End-stage ankle arthritis is a debilitating condition often necessitating total ankle replacement (TAR). Tendo-Achilles lengthening (TAL) and gastrocnemius recession (GR) are commonly performed with TAR to improve ankle dorsiflexion (DF). No studies to date have radiographically analyzed tibiopedal motion to guide surgical management. The purpose of this study is to determine the effect of a TAL or GR during TAR on radiographic tibiopedal range of motion (ROM). Methods: A retrospective review of a prospectively maintained database was conducted followed by a propensity score–matched analysis of 110 patients who underwent TAL (n = 26), GR (n = 29), or no lengthening procedure (n = 55) with TAR. Minimum of 1-year ROM radiographic follow-up was required. Exclusion criteria included (1) calcaneal osteotomies, (2) simultaneous or previous hindfoot or midfoot arthrodesis, (3) prior ankle arthrodesis, or (4) revision TAR. Demographic data were extracted from the TAR database. Radiographic assessment included tibiopedal dorsiflexion (DF) and plantarflexion (PF). Results: DF improved by 2.8 degrees (P =.0286) and by 6.0 degrees (P <.0001) in the TAL and GR cohorts, respectively, with no difference in the control group (+0.7 degrees, P =.3764). PF was decreased by 4.5 degrees (P =.0152) and by 7.2 degrees (P =.0002) in the TAL and GR cohorts, respectively, with no difference in the control group (–0.2 degrees, P =.8546). Minimal differences were observed for total arc of motion for all 3 groups (control 0.5 degrees, GR –1.2 degrees, TAL –1.7 degrees), all of which were nonsignificant (all P >.05). There was no between-group difference in the change in overall arc of motion between the groups (P =.3599). GR resulted in a greater increase in DF (6.0 vs 2.8 degrees; P =.1074), with a reciprocal greater decrease in PF (7.2 vs 4.5 degrees; P =.2416) compared with the TAL cohort. Conclusion: Both TAL and GR increased postoperative DF; however, this was accompanied by a reciprocal loss in PF. Minimal differences were observed for total arc of motion. Patients should be counseled that concomitant procedures performed to increase DF will do so at the expense of PF. Level of Evidence: Level III, retrospective review of prospectively collected data. [ABSTRACT FROM AUTHOR]

Background: A study was performed to measure metal ions present in the knee joint after performing a total knee arthroplasty (TKA) with standard cobalt chromium (CoCr) components as well as with "nickel-free" oxidized zirconium femoral and titanium tibial (OxZr/Ti) components.Methods: Knee joint fluid was collected prior to arthrotomy, and on postoperative day one to determine the amount of metal debris generated when performing a TKA with standard instrumentation from consecutive cases with CoCr components (n = 24) and OxZr/Ti components (n = 16).Results: CoCr implant patients had statistically higher levels of nickel (Ni) (29.7%, P = .033), cobalt (Co), (1,100.7%, P < .0001) and chromium (Cr) (118.9%, P < .0001) postoperatively. The cutting blocks and sawblades do not contain Co, which therefore must have come from the components. The metal ions generated from the sawblades and cutting blocks, therefore, could be discerned from the OxZr/Ti whose components don't contain Co, Cr, or Ni. The OxZr patients had significantly higher Cr (9.5×, P < .001) and Ni (5.1×, P < .001) post-TKA vs pre-TKA; Co levels were not significantly different as expected with the absence of Co in the components (P = .60). The Ni levels generated in performing an Oxinium TKA was 3.3 times higher than when performing a CoCr TKA (1.37 vs. 41 ppb, P < .001).Conclusions: The substantial degree of Ni generation resulting from performing a hypoallergenic "nickel-free" TKA calls into questions the rationale of utilizing more expensive lower Ni components on the basis of known or suspected Ni or Cr allergy. [ABSTRACT FROM AUTHOR]

Background: In cases of large osteochondral lesions of the talus (OLTs), fresh structural or bulk osteochondral allograft transplantation has yielded favorable outcomes in several retrospective and few prospective case series. The purpose of this study was to prospectively evaluate patients who received fresh structural allograft transplantation of the talar shoulder. Methods: A prospective evaluation of patients who received a fresh structural allograft of an OLT was performed. Preoperative imaging included magnetic resonance imaging (MRI) and/or computed tomography (CT) with plain radiographs. The following patient-reported outcomes questionnaires were administered preoperatively and yearly after surgery: 36-Item Short-Form Health Survey (SF-36), visual analog scale (VAS) for pain, and the Short Musculoskeletal Functional Assessment (SMFA). Preoperative and postoperative imaging were evaluated for allograft assimilation, evidence of arthritic changes, or functional range of motion abnormalities. Results: Thirty-one patients with a mean age of 41.4 years (±14.1, range 18-69) underwent structural fresh osteochondral allograft transplantation to the talar shoulder and were included in this study. The mean follow-up was 56.2 months (±36.1, range 24-142). The majority of patients were female (n=17, 54.8%), reported some history of prior ankle trauma (n=21, 67.7%), and underwent prior ankle surgery (n=23, 74.2%). The mean lesion size on CT scan was 1879 mm3 (n = 27) compared to the mean lesion size of 3877 mm3 (n = 21) on MRI. There was a significant improvement in the mean preoperative VAS score (P <.0001), SF-36 score (P <.0005), SMFA bother index (P <.0015), and the SMFA function index (P <.0001) at final follow-up. A total of 15 (48.4%) patients underwent an additional surgery following their osteochondral allograft transplant, most commonly arthroscopic debridement or removal of hardware, performed at an average of 25.2 (±13.0) from their index procedure. There was one failure that required a total ankle replacement. The overall graft survival rate was 96.8%. Conclusion: Fresh, structural allograft transplantation resulted in significant improvement in patient-reported postoperative pain and function in patients suffering from OLTs. The graft survival rate was 96.8% at a mean of 56.2 months follow-up, with half of patients requiring a second procedure. Level of Evidence: Level IV, prospective case series. [ABSTRACT FROM AUTHOR]