bluuebunny/crossref_metadata_2025 huggingface dataset:
Careers advancement of women: Applying a multi-level relational perspective in the context of Turkish banking organisations
Authors: Taser-Erdogan Didem
Published: February 2021

This article investigates the question of why women remain underrepresented in management positions despite their increasing presence in the Turkish banking sector context. By using an integrative framework that brings together the relational and institutional perspectives, this article seeks to understand how macro-level contextual influences reflect on meso-organisational processes and practices, which in turn influence women’s micro-individual career trajectories. This article explores the careers experiences of 49 female banking professionals from three distinct banking organisations (Turkish, western and Islamic).

The findings reveal that women’s limited representation at managerial level is an outcome of the interplay between macro-, meso- and micro-level issues. At the macro-level, the article highlights religion-based fragmented social structure as a key factor in the socio-cultural context of Turkey. At the meso-level, the analysis of the three different cases identifies factors relevant to both western and Middle Eastern societal contexts. At the micro-level, the analysis highlights how women’s perceptions of macro-level barriers change depending on their organisational context, emphasising the interrelatedness between these three levels. The article contributes to women’s career literature by providing the Turkish perspective and introducing novel insights into the interplay between societal forces, organisational practices and individuals’ perceptions.
Relational Exchange in Non-union Firms: A Configurational Framework for Workplace Dispute Resolution and Voice
Authors: Avgar Ariel C.
Published: February 2021

For much of the 20th century, a sizeable proportion of the workforce in the United States had access to a combination of dispute resolution and voice options through the union grievance process. The vast majority of today’s workforce, however, no longer does. The focus of this article is the proliferation of alternative relational exchange models developed in non-union firms. The author develops a theoretical framework proposing variation in the overarching non-union models employed by firms as a function of distinct organizational features and strategies. These models are the product of distinct configurations of voice and dispute-resolution strategies. The author proposes five alternative non-union models, discusses the internal and external characteristics associated with them, and evaluates distinct employer and worker outcomes.
On the Stability of Social Preferences in Inter-Group Conflict: A Lab-in-the-Field Panel Study
Authors: Böhm Robert , Fleiß Jürgen , Rybnicek Robert
Published: February 2021

Despite the omnipresence of inter-group conflicts, little is known about the heterogeneity and stability of individuals’ social preferences toward in-group and out-group members. To identify the prevalence and stability of social preferences in inter-group conflict, we gather quota-representative, incentivized data from a lab-in-the-field study during the heated 2016 Austrian presidential election. We assess social preferences toward in-group and out-group members one week before, one week after, and three months after the election. We find considerable heterogeneity in individuals’ group-(in)dependent social preferences. Utilizing various econometric strategies, we find largely stable social preferences over the course of conflict. Yet, there is some indication of variation, particularly when the conflict becomes less salient. Variation is larger in social preferences toward in-group members and among specific preference types. We discuss the theoretical implications of our findings and outline potential avenues for future research.
Complaint Publicization in Social Media
Authors: Golmohammadi Alireza , Havakhor Taha , Gauri Dinesh K. , Comprix Joseph
Published: February 2021

Firms are increasingly turning to social media platforms for complaint handling. Previous research and practitioners’ reports highlight the benefits of complaint handling on social media, urging firms to provide prompt and detailed responses to complaints. However, little research has explored the possible drawbacks of such practices, especially when responses inadvertently further publicize complaints. Utilizing two unique data sets in a series of observational and quasiexperimental analyses, this research provides the first evidence of “complaint publicization” in social media, a phenomenon in which firm responses to complaints on popular social media platforms increase the potential public exposure of complaints. This negative effect can outweigh any positive customer care–signaling impact from firm responses. The authors show that a response strategy that engenders a high level of complaint publicization (e.g., providing detailed responses through multiple communication exchanges with a complainant) could negatively impact perceived quality and firm value, diminish the positive impact of a firm’s own posts, and increase the volume of future complaints. Additional analyses reveal that these adverse impacts are stronger for firms that are targeted by retail investors. The authors also uncover specific response strategies and styles that could mitigate these effects.
Do Animated Line Graphs Increase Risk Inferences?
Authors: Kim Junghan , Lakshmanan Arun
Published: February 2021

This article shows that animated display of time-varying data (e.g., stock or commodity prices) enhances risk judgments. We outline a process whereby animated display enhances the visual salience of transitions in a trajectory (i.e., successive changes in data values), which leads to transitions being utilized more to form cognitive inferences about risk. In turn, this leads to inflated risk judgments. The studies reported in this article provide converging evidence via eye tracking (Study 1), serial mediation analyses (Studies 2 and 3), and experimental manipulations of transition salience (graph type; Study 3) and utilization of transitions (global trend; Study 4 and investment goals; Study 5) and, in the process, outline boundary conditions. The studies also demonstrate the effect of animated display on consequential investment decisions and behavior. This article adds to the literature on salience effects by disambiguating the role of inference making in how salience of stimuli causes biases in judgments. Broader implications for visual information processing, data visualization, financial decision making, and public policy are discussed.
The Mediating Effects of Self-Esteem on Anxiety and Emotion Regulation
Authors: Fernandes Blossom , Newton Jack , Essau Cecilia A.
Published: February 2021

Individuals with anxiety disorders maladaptively appraise interpersonal threat cues leading to inaccurate interpretations of the self and others. However, little is known about the factors that mediate this association, therefore, the main aim of this study was to examine the relationship between state and trait anxiety, self-esteem, and emotion regulation strategies: reappraisal and suppression. Young adults aged between 18–26 years participated in the study. They completed a set of self-reports measuring emotion regulation, self-esteem, state-trait anxiety, and positive and negative attributes. Participants also completed an experimental task, using the dot-probe paradigm, which measures threat bias and response inhibition. The findings showed that trait and state anxiety predicted suppression, reappraisal, and internalising problems, and is linked to response inhibition. Importantly, low self-esteem, significantly mediated the relationship between increased anxiety and suppression. Taken together, these results show specific associations between emotion regulation and anxiety, highlighting the significant impact of self-esteem in young adults.
The Contribution of Individual Differences to L2 Pronunciation Learning: Insights from Research and Pedagogical Implications
Authors: Suzukida Yui
Published: February 2021

Adult second language (L2) learning often exhibits great variability in its rate and outcome. Although research shows that learning trajectories are partly shaped by social and contextual factors (e.g. Larson-Hall, 2008), certain learner factors play an important role in enhancing L2 pronunciation learning by helping L2 learners notice and process input efficiently, whereas certain learner factors may impede L2 pronunciation learning by impairing attention control or slowing down L2 input processing. Therefore, in order for language teachers to provide effective instruction and help students improve their L2 pronunciation proficiency, it is beneficial for them to understand the differential impact of learner characteristics on L2 learning and adapt such understanding to their instruction and learning activities.

The aim of the current article is to provide a review of existing studies that have explored individual differences (IDs) in relation to L2 pronunciation acquisition and to present implications for effective L2 pronunciation teaching. The article begins with an introduction of the paradigm shift in L2 pronunciation research and the conceptual framework of IDs proposed by Dörnyei (2009). This is followed by a summary of the processes involved in L2 pronunciation learning. The third section focuses on the characteristics of four IDs that have been found to influence the development of L2 pronunciation. Those IDs include foreign language learning aptitude (e.g. Saito and Hanzawa, 2016), musical aptitude (e.g. Milovanov et al., 2010), L2 learning motivation (e.g. Moyer, 1999), and anxiety (e.g. Baran-Łucarz, 2016). Based on the discussion in the third section, the last section will offer various applications of IDs research findings to L2 pronunciation instruction (e.g. instructional approaches, feedback, and pronunciation syllabi) for successful L2 pronunciation teaching.
Agonism, Democracy, and the Moral Equality of Voice
Authors: White Stephen K.
Published: February 2021

Agonism emerged three decades ago as an assault on the overemphasis in political theory on justice and consensus. It has now become the norm. But its character and relation to core values of democracy are not as unproblematic today as is often thought, an issue that becomes more pressing as contemporary politics increasingly seem locked into notions of unrelenting conflict between “friends” and “enemies.” This essay traces alternative ontological roots and ethical implications of agonism, distinguishing between “imperializing” and “tempered” modes. The former, exemplified in the popular Schmitt-Mouffe formulation, is shown to be fundamentally flawed in its failure to conceive politics in a fashion that does not allow the dynamic of friend–enemy to imperially trump appeals to democratic norms. In a world of insurgent white nationalism in democratic polities, this is no small fault. “Tempered” agonists, such as William Connolly and Bonnie Honig, offer ontologies where democratic norms can gain traction. Despite the admirable qualities of these alternatives, their formulations are nevertheless not fully persuasive. The difficulty lies in their underarticulated accounts of equality. I suggest an alternative formulation of agonism that embraces a central role for the idea of the moral equality of voice, a value that resides in the seam between notions of difference, resistance, and conflict emphasized by agonists, on the one hand, and the idea of fairness emphasized by notions of democratic justice, on the other.
Comparison of Trauma Symptoms Among Nonpartner Sexual Violence Victims and Nonvictims in Urban Haiti’s Cité Soleil Neighborhood
Authors: Joshi Manisha , Rahill Guitele J. , Rhode Sarah
Published: February 2021

Women in resource-constrained, postdisaster, urban enclaves, such as Haiti’s Cité Soleil, are at risk for nonpartner sexual violence (NPSV) by multiple perpetrators, and subsequently, psychological trauma and sexually transmitted infections (STIs), including HIV/AIDS. These biopsychosocial risks suggest that NPSV victims may benefit from an adapted evidence-based intervention for sexually transmitted infection (EBI-STI) that includes a trauma component. Yet there is a dearth of knowledge on trauma symptoms experienced by victims in Haiti. We administered a Haitian Kreyòl version of Trauma Symptom Checklist (TSC-40), including its subscales (depression, dissociation, anxiety, sexual problems, sleep disturbance, sexual abuse trauma) to women in Cité Soleil, comparing victims’ scores ( n = 54) with those of nonvictims ( n = 179). After controlling for child sexual abuse, arrest, transactional sex, and sociodemographics, being a victim was associated with higher scores on the full TSC-40, and subscales of anxiety and sexual abuse trauma index. These increased scores of victims underscore the need to incorporate trauma in adaptation of EBI-STI for Haitian NPSV victims like our sample.
Implementation of Evidence-Based Practices in Intergenerational Programming: A Scoping Review
Authors: Jarrott Shannon E. , Scrivano Rachel M. , Park Cherrie , Mendoza Angela N.
Published: February 2021

Evidence-based intergenerational practices are sought by practitioners interested in the potential value of intergenerational programs. These are often difficult to identify as intergenerational program research frequently consists of small samples and pre-post analyses of attitudinal data with little attention to implementation characteristics. We systematically identified evidence-based intergenerational practices linked to program outcomes from peer-reviewed journal articles ( n = 21) published between 2000 and 2019. Scoping reviews facilitate synthesis of available evidence-based practices and identification of gaps in the literature. Fifteen evidence-based intergenerational practices were identified; each was coded in at least five articles. The practices informed program content (e.g., using technology), program considerations (e.g., environmental modifications), facilitator and participant preparation (e.g., training), and quality interactions among participants (e.g., incorporating mechanisms of friendship). While these identified practices reflect extant theory and research, rigorous implementation research is needed to advance evidence-based intergenerational practice as policymakers and practitioners advocate for intergenerational program growth.
Maternal education and early childhood education across affluent English-speaking countries
Authors: Crosnoe Robert L. , Johnston Carol Anna , Cavanagh Shannon E.
Published: February 2021

Women who attain more education tend to have children with more educational opportunities, a transmission of educational advantages across generations that is embedded in the larger structures of families’ societies. Investigating such country-level variation with a life-course model, this study estimated associations of mothers’ educational attainment with their young children’s enrollment in early childhood education and engagement in cognitively stimulating activities in a pooled sample of 36,400 children ( n = 17,900 girls, 18,500 boys) drawn from nationally representative data sets from Australia, Ireland, U.K., and U.S. Results showed that having a mother with a college degree generally differentiated young children on these two outcomes more in the U.S., potentially reflecting processes related to strong relative advantage (i.e., maternal education matters more in populations with lower rates of women’s educational attainment) and weak contingent protection (i.e., it matters more in societies with less policy investment in families).
Parental incarceration affects children’s emotional and behavioral outcomes: A longitudinal cohort study of children aged 9 to 13 years
Authors: Bradshaw Daragh , Creaven Ann-Marie , Muldoon Orla T.
Published: February 2021

Parental incarceration (PI) is negatively associated with emotional, educational, and psychological child outcomes. However, few studies explore potential mechanisms through which these outcomes are transmitted or the means by which prosocial outcomes might develop. This study used data from two waves of a population cohort study of children aged 9 years and followed up aged 13 years living in Ireland. Children and parents ( N = 8,568) completed measures of PI, primary caregiver (PCG) depression, PCG-child relationship quality, and child behavioral adjustment. We then conducted a secondary analysis on this national longitudinal study of children in Ireland. Using sequential mediation models, we observed a mediated indirect effect of PI on prosocial outcomes via PCG depression and PCG-child relationship quality. PI at age 9 was associated with increased difficulties and reduced prosocial behavior at age 13. Additionally, PI at age 9 affected PCG depression and the PCG-child relationship quality. Additionally, child prosocial outcomes, and emotional and behavioral difficulties were less apparent where PI had a weaker effect on PCG depression and the quality of PCG-child relationship. Supports that can mitigate the impact of PI for vulnerable caregivers and children are discussed.
‘The rumble of continuing life’: Kozintsev’s Hamlet and its distorted reception
Authors: Assay Michelle
Published: February 2021

This article challenges central tenets of the Western reception of Grigori Kozintsev’s 1964 screen adaptation of Hamlet. Adding new information derived from published and unpublished archival materials and insights from the film director’s son, it argues that Kozintsev’s intentions were more universal than contemporary political. It serves as a call for caution and for the reconsideration of certain articles of received wisdom, in particular with respect to the film’s supposedly anti-Stalinist language.
Divorce Ideation and “Deal Breakers” among Married Gay Men and Lesbians: A Qualitative Exploration
Authors: Hoy Aaron , Diiriye Anfa , Gunderson Emily
Published: February 2021

Regardless of whether married individuals are actively pursuing divorce, at all stages of marriage, individuals can experience thoughts of divorce, which are often termed “divorce ideation” in the literature. However, with same-sex marriage only being legalized in 2015, the literature has yet to explore divorce ideation among individuals married to a same-sex partner. In this article, we used semi-structured, in-depth interviews with 28 married gay men and lesbians to explore how and under what circumstances gay men and lesbians think about divorce. We find that although a slight majority of participants had never considered divorce, many had, especially during periods of marital conflict. In addition, nearly all participants indicated that they would be willing to consider divorce under certain circumstances such as infidelity, the loss of trust and/or intimacy, and unhappiness with the relationship. We conclude by discussing the limitations of our research and directions for future research.
Reinsurance and Financial Performance of Non-life Insurance Companies in Ghana
Authors: Andoh Charles , Yamoah Susana Adobea
Published: February 2021

The study examines how premiums ceded to a reinsurer affect the profitability of non-life insurance companies in Ghana. Secondary data on reinsurance ceded, combined ratio, assets, liabilities and return on assets for 20 non-life insurance companies over the period 2008–2018 were sourced from National Insurance Commission whilst interest and exchange rates variables were obtained from the Bank of Ghana. Panel regression model was employed for the analysis of the data collected.

The results show that purchasing high levels of reinsurance alone does not affect the profitability of non-life insurance companies, but the combined effect of reinsurance and solvency ratio significantly impact their profitability. Managers of non-life insurance companies in Ghana should increase their ability to repay all financial obligations in the short, medium and long term in combination with reinsurance. This will enable insurers to stabilize growth, earn profits and meet their obligations to policyholders in a timely fashion.

JEL Code: G22
The association between plant-based diet indices and metabolic syndrome in Iranian older adults
Authors: Amini* Mohammad Reza , Shahinfar Hossein , Djafari Farhang , Sheikhhossein Fatemeh , Naghshi Sina , Djafarian Kurosh , Clark Cain CC , Shab-Bidar Sakineh
Published: February 2021

Background:

We investigated the association between plant-based diets indices – an overall plant-based diet index; a healthful plant-based diet index; and an unhealthful plant-based diet index – and metabolic syndrome among Iranian older adults.

Aim:

We aimed to examine the relationship between plant-based diet indices and metabolic syndrome.

Methods:

This cross-sectional study included 178 older adults (51 men and 127 women), with a mean age of 67.04 (60–83) who were referred to health centers in Tehran, Iran. Blood and urine samples were collected to measure serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. We created an overall plant-based diet index, healthful plant-based diet index, and unhealthful plant-based diet index from semi-quantitative food-frequency questionnaire data. Anthropometric measures were done.

Results:

Our crude model results showed that triglycerides, systolic and diastolic blood pressure, fasting blood sugar, high-density lipoprotein cholesterol, and waist circumference did not significantly differ between tertiles of plant-based diet index and healthful plant-based diet index; also triglycerides, systolic and diastolic blood pressure, fasting blood sugar, and waist circumference did not significantly differ between tertiles of unhealthful plant-based diet index, but high-density lipoprotein cholesterol significantly differed between tertiles of unhealthful plant-based diet index. After adjusting for confounders the results remained non-significant for plant-based diet index but high-density lipoprotein cholesterol was significant for healthful and unhealthful plant-based diet indices. There was also no significant association between plant-based diet index (OR: 1.11; 95% CI: 0.53–2.33), healthful plant-based diet index (OR: 0.81; 95% CI: 0.39–1.68), and unhealthful plant-based diet index (OR: 0.81; 95% CI: 0.38–1.72) with metabolic syndrome, even after adjustment for confounders.

Conclusions:

Our findings showed that plant-based diets are not significantly associated with risk of metabolic syndrome in older adults. To confirm the veracity of these findings, more studies should be conducted.
Prediction of Human Lethal Doses and Concentrations of MEIC Chemicals from Rodent LD50 Values: An Attempt to Make Some Reparation
Authors: Dearden John C. , Hewitt Mark
Published: February 2021

The prediction of human toxicities from animal toxicity tests is often poor, and is now discouraged and in some cases banned, especially those involving the LD50 test. However, there is a vast number of historical LD50 data in both public and in-house repositories that are being put to little use. This study examined the correlations between human lethality (doses and concentrations) of 36 MEIC chemicals and the median values of a large number of mouse and rat LD50 values obtained for four different routes of administration. The best correlations were found with mouse and rat intraperitoneal LD50 values (r2 = 0.838 and 0.810 for human lethal dose, and r2 = 0.753 and 0.785 for human lethal concentration). The results show that excellent prediction of human lethal dose and concentration can be made, for this series of chemicals at least, by using uncurated rodent LD50 values, thus offering some reparation for the millions of rodent lives sacrificed in LD50 testing.
Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: first results and outcomes of a newly established ECPR program in a large population area
Authors: Djordjevic Ilija , Gaisendrees Christopher , Adler Christoph , Eghbalzadeh Kaveh , Braumann Simon , Ivanov Borko , Merkle Julia , Deppe Antje-Christin , Kuhn Elmar , Stangl Robert , Lechleuthner Alex , Miller Christian , Pfister Roman , Mader Navid , Baldus Stephan , Sabashnikov Anton , Wahlers Thorsten
Published: February 2021

Objectives:

Out-of-hospital cardiac arrest (OHCA) is associated with excessively high mortality rates. Recent studies suggest benefits from extracorporeal cardiopulmonary resuscitation (ECPR) performed in selected patients. We sought to present the first results from our interdisciplinary ECPR program with a particular focus on early outcomes and potential risk factors associated with in-hospital mortality.

Methods:

Between January 2016 and December 2019, 44 patients who underwent ECPR selected according to our institutional ECPR protocol were retrospectively analyzed regarding pre-hospital, in-hospital, and early outcome parameters. Patients were divided into survivors (S) and non-survivors (NS). Statistical analysis of risk factors regarding in-hospital mortality of the patient cohort analyzed was performed.

Results:

The mean age of the population was 53 ± 12 years, with most patients being male ( n = 40). The leading cause of cardiac arrest (CA) was myocardial infarction ( n = 24, 55%). The median hospital stay was 1 (1;13) day. Twenty-three percent of patients ( n = 10) were discharged from hospital including eight patients (18%) with CPC 1–2. Survivors showed a trend toward shorter pre-hospital CPR duration (60 (59;60) min (S) vs 60 (55;90) min (NS), p = 0.07).

Conclusion:

Establishing ECPR programs in large population areas offers the option to improve survival rates for OHCA patients. Stringent compliance of institutional criteria (mainly age, witnessed arrest, and time of pre-hospital resuscitation) and providing ECPR to strictly selected patients seems to be a vital factor for such programs’ success. Pre-clinical settings and therapeutic measures must be adjusted in this regard to improve outcomes for this highly demanding patient cohort.
Extrapolating Parametric Survival Models in Health Technology Assessment Using Model Averaging: A Simulation Study
Authors: Gallacher Daniel , Kimani Peter , Stallard Nigel
Published: February 2021

Previous work examined the suitability of relying on routine methods of model selection when extrapolating survival data in a health technology appraisal setting. Here we explore solutions to improve reliability of restricted mean survival time (RMST) estimates from trial data by assessing model plausibility and implementing model averaging. We compare our previous methods of selecting a model for extrapolation using the Akaike information criterion (AIC) and Bayesian information criterion (BIC). Our methods of model averaging include using equal weighting across models falling within established threshold ranges for AIC and BIC and using BIC-based weighted averages. We apply our plausibility assessment and implement model averaging to the output of our previous simulations, where 10,000 runs of 12 trial-based scenarios were examined. We demonstrate that removing implausible models from consideration reduces the mean squared error associated with the restricted mean survival time (RMST) estimate from each selection method and increases the percentage of RMST estimates that were within 10% of the RMST from the parameters of the sampling distribution. The methods of averaging were superior to selecting a single optimal extrapolation, aside from some of the exponential scenarios where BIC already selected the exponential model. The averaging methods with wide criterion-based thresholds outperformed BIC-weighted averaging in the majority of scenarios. We conclude that model averaging approaches should feature more widely in the appraisal of health technologies where extrapolation is influential and considerable uncertainty is present. Where data demonstrate complicated underlying hazard rates, funders should account for the additional uncertainty associated with these extrapolations in their decision making. Extended follow-up from trials should be encouraged and used to review prices of therapies to ensure a fair price is paid.
What Type of Title Would You Put on Your Paintings?: The Impact on the Price of Artwork According to Its Title
Authors: Park JooYeon , Park JiHye , Park Ji Hyon
Published: February 2021

This paper investigated the impact of the type of title on the price of the artwork effects using the hammer price of the paintings auctioned in Korea during a two-year period from December 2017 to November 2019. The results of the analysis showed that a descriptive title had a negative effect on the prices fetched, whereas a more elaborate title had a positive effect on auction prices. Also, it was found that elaborate titles for abstract paintings had a significant positive impact on the hammer price. In the case of unknown artists, a descriptive title had a negative effect on the auction price, while the absence of a title had a positive impact. The findings of this study suggest that artists must make careful decisions when titling their work because the title of the work affects the purchase decisions of art collectors.
Pancreas preservation time as a predictor of prolonged hospital stay after pancreas transplantation
Authors: Mei Shengmin , Huang Zhichao , Dong Yinlei , Chen Zheng , Xiang Jie , Zhou Jie , Li Zhiwei , Zheng Shusen , Hu Zhenhua
Published: February 2021

Objective

Length of hospital stay is a sensitive indicator of short-term prognosis. In this retrospective study, we investigated how pancreas preservation time affects length of hospital stay after pancreas transplantation.

Methods

Patients receiving pancreas transplantation (1998.7–2018.6) were identified from the Scientific Registry of Transplant Recipients database and grouped according to pancreas preservation time. We analyzed the relationship of pancreas preservation time with graft and patient survival and prolonged length of stay (PLOS; i.e., hospital stay ≥20 days).

Results

We included 18,099 pancreas transplants in the survival analysis. Pancreas preservation time >20 hours had a significantly higher risk of graft failure than 8 to 12 hours. Pancreas preservation time was not significantly associated with patient survival. We included 17,567 pancreas transplants in the analysis for PLOS. Compared with 8 to 12 hours, pancreas preservation time >12 hours had a significantly higher PLOS risk, which increased with increased pancreas preservation time. In simultaneous pancreas–kidney transplantation, we also found that pancreas preservation time was positively associated with PLOS risk with pancreas preservation time >12 hours.

Conclusion

Pancreas preservation time is a sensitive predictor of PLOS. Transplant centers should minimize pancreas preservation time to optimize patient outcomes.
Acute diarrhea-induced shock during alcohol withdrawal: a case study
Authors: Zhao Tong , Gao XiaoLei , Huang GuangBiao
Published: February 2021

We present the case of a 54-year-old man with severe acute diarrhea during alcohol withdrawal, despite special feeding, correction of vitamin deficiencies, and protection of the gastrointestinal mucosa. Diarrhea is often overlooked, so we aim to draw attention to the risk of combined malnutrition, acute diarrhea, and alcohol withdrawal because this can lead to lethal complications. We recommend that patient’s bowel movements should be carefully observed during alcohol withdrawal, even during hospitalization.
Sudden sensorineural hearing loss during pregnancy: etiology, treatment, and outcome
Authors: Qian Yi , Kang Houyong , Hu Guohua , Zhong Shixun , Zuo Wenqi , Lei Yan , Xu Zhengyan , Chen Tao , Zeng Jihong
Published: February 2021

Objective

To analyze the etiologies, treatments, and outcomes of sensorineural hearing loss (SSNHL) during pregnancy.

Study design

Retrospective chart review of 25 pregnant patients treated for SSNHL between January 2012 and September 2019. Forty-nine age matched non-pregnant women with severe and profound hearing loss diagnosed with SSNHL during the same period served as controls. Data were recorded on age, symptoms, onset of hearing loss, audiometric results, treatments, and outcomes.

Results

The mean age was 29.6 years (range 23–38 years). Intratympanic steroids (ITS) were administered in 15 (60.0%) pregnant women with SSNHL. Three women were treated with postauricular steroids only, while another woman was treated with intravenous ginkgo leaf extract and dipyridamole. The remaining six women received no medications. More than half (8/15, 53.3%) of pregnant women with SSNHL receiving ITS experienced hearing improvement. Pregnant women with profound hearing loss who received no medication had no hearing improvement. Most pregnant women with SSNHL (12/15, 80.0%) had higher fibrinogen levels than controls (mean values 3.77±0.71 g/L and 2.54±0.48 g/L, respectively).

Conclusion

Fibrinogen could be a risk factor for SSNHL during pregnancy. ITS may benefit pregnant women with severe and profound SSNHL.
Idiopathic pleuroparenchymal fibroelastosis confirmed by pathology: a case report
Authors: Cao Min , Li Hui , Cai Hou-Rong
Published: February 2021

The case of a patient with cough and asthma after activity that each had a 1-month duration is reported. Chest high-resolution computed tomography (HRCT) showed visceral pleural thickening in both upper lungs (especially the right lung), which was accompanied by fibrous strips and patches near the pleura, and these were accompanied by distraction bronchiectasis. Idiopathic pleuropulmonary elastosis was confirmed by thoracoscopic lung biopsy. The patient was treated with acetylcysteine, but their asthma worsened after activity and their lung function decreased significantly after 10 months. Idiopathic pleuroparenehymal fibroelastosis is a rare new type of idiopathic interstitial pneumonia, which has no effective treatment except for lung transplantation.
Infrastructural nature
Authors: Nelson Sara H , Bigger Patrick
Published: February 2021

The assertion that ‘ecosystems are infrastructure’ is now common in conservation science and ecosystem management. This article interrogates that claim, which we argue underpins diverse practices of environmental investment focused on the strategic management of ecosystem functions to sustain and secure human life. We trace the genealogies and geographies of infrastructural nature as a paradigm of investment that coexists (sometimes in tension) with extractivist commodity regimes. We draw links between literatures on the political economy of ecosystem services and infrastructure and highlight three themes that hold promise for future research: labor, territory, and finance.
Migraine therapeutics differentially modulate the CGRP pathway
Authors: Bhakta Minoti , Vuong Trang , Taura Tetsuya , Wilson David S , Stratton Jennifer R , Mackenzie Kimberly D
Published: February 2021

Background

The clinical efficacy of migraine therapeutic agents directed towards the calcitonin-gene related peptide (CGRP) pathway has confirmed the key role of this axis in migraine pathogenesis. Three antibodies against CGRP – fremanezumab, galcanezumab and eptinezumab – and one antibody against the CGRP receptor, erenumab, are clinically approved therapeutics for the prevention of migraine. In addition, two small molecule CGRP receptor antagonists, ubrogepant and rimegepant, are approved for acute migraine treatment. Targeting either the CGRP ligand or receptor is efficacious for migraine treatment; however, a comparison of the mechanism of action of these therapeutic agents is lacking in the literature.

Methods

To gain insights into the potential differences between these CGRP pathway therapeutics, we compared the effect of a CGRP ligand antibody (fremanezumab), a CGRP receptor antibody (erenumab) and a CGRP receptor small molecule antagonist (telcagepant) using a combination of binding, functional and imaging assays.

Results

Erenumab and telcagepant antagonized CGRP, adrenomedullin and intermedin cAMP signaling at the canonical human CGRP receptor. In contrast, fremanezumab only antagonized CGRP-induced cAMP signaling at the human CGRP receptor. In addition, erenumab, but not fremanezumab, bound and internalized at the canonical human CGRP receptor. Interestingly, erenumab also bound and internalized at the human AMY1 receptor, a CGRP receptor family member. Both erenumab and telcagepant antagonized amylin-induced cAMP signaling at the AMY1 receptor while fremanezumab did not affect amylin responses.

Conclusion

The therapeutic effect of agents targeting the CGRP ligand versus receptor for migraine prevention (antibodies) or acute treatment (gepants) may involve distinct mechanisms of action. These findings suggest that differing mechanisms could affect efficacy, safety, and/or tolerability in migraine patients.
Tranexamic Acid in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis
Authors: Johns William L. , Walley Kempland C. , Hammoud Sommer , Gonzalez Tyler A. , Ciccotti Michael G. , Patel Nirav K.
Published: February 2021

Background:

Hemarthrosis after anterior cruciate ligament (ACL) reconstruction procedures can delay rehabilitation and have toxic effects on the cartilage and synovium. Tranexamic acid is widely used in adult reconstruction procedures; however, its use in ACL reconstruction is a novel topic of study.

Purpose:

To analyze the available literature on hemarthrosis, pain, functional outcomes, and complications after administration of tranexamic acid in ACL reconstruction procedures.

Study Design:

Meta-analysis.

Methods:

A literature search was performed to retrieve randomized controlled trials examining the use of tranexamic acid at the time of ACL reconstruction procedures. The studied outcomes included postoperative joint drain output, hemarthrosis grade, visual analog scale scores for pain, range of motion, Lysholm score, postoperative rates of deep venous thrombosis, and pulmonary embolism. Outcomes were pooled to perform a meta-analysis.

Results:

Five prospective randomized controlled trials met inclusion criteria for analysis. Four studies administered intravenous tranexamic acid in bolus or infusion form before ACL reconstruction, while 2 studies administered tranexamic acid via intra-articular injection. Specifically, tranexamic acid was administered intravenously (preoperative 15-mg/kg bolus 10 minutes before tourniquet inflation with or without 10 mg/kg/h for 3 hours postoperatively) or intra-articularly (10 mL [100 mg/mL] intraoperatively), and 1 study consisted of tranexamic acid administration in combined intravenous and intra-articular forms (15-mg/kg bolus 10 minutes before tourniquet inflation and intra-articular 3 g 10 minutes before tourniquet deflation). Tranexamic acid use in ACL reconstruction cases resulted in a mean reduction of 61.5 mL in postoperative drain output at 24 hours (95% CI, –95.51 to −27.46; P = .0004), lower hemarthrosis grade ( P < .00001), improved Lysholm scores, and reduction in visual analog scale scores for pain (−1.96 points; 95% CI, −2.19 to −1.73; P < .00001) extending to postoperative week 6. Range of motion was improved in the immediate postoperative period, and the need for joint aspiration within 2 weeks was reduced ( P < .001). There was no difference in venous thromboembolic event rate between the experimental and control groups.

Conclusion:

The use of intravenous tranexamic acid in ACL reconstruction surgery results in reduced joint drain output and hemarthrosis and improved pain scores and range of motion in the initial postoperative period without increased complications or thromboembolic events.
Magnetic Resonance Imaging 1 Year After Hamstring Autograft Anterior Cruciate Ligament Reconstruction Can Identify Those at Higher Risk of Graft Failure: An Analysis of 250 Cases
Authors: Putnis Sven E. , Oshima Takeshi , Klasan Antonio , Grasso Samuel , Neri Thomas , Fritsch Brett A. , Parker David A.
Published: February 2021

Background:

There is currently no analysis of 1-year postoperative magnetic resonance imaging (MRI) that reproducibly evaluates the graft of a hamstring autograft anterior cruciate ligament reconstruction (ACLR) and helps to identify who is at a higher risk of graft rupture upon return to pivoting sports.

Purpose:

To ascertain whether a novel MRI analysis of ACLR at 1 year postoperatively can be used to predict graft rupture, sporting level, and clinical outcome at a 1-year and minimum 2-year follow-up.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Graft healing and integration after hamstring autograft ACLR were evaluated using the MRI signal intensity ratio at multiple areas using oblique reconstructions both parallel and perpendicular to the graft and tunnel apertures. Clinical outcomes were assessment of side-to-side laxity and International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm, and Tegner activity level scores at 1 year. Repeat outcome measures and detection of graft rupture were evaluated at a minimum of 2 years.

Results:

A total of 250 patients (42.4% female) underwent MRI analysis at 1 year, and assessment of 211 patients between 1 year and the final follow-up (range, 24-36 months) detected 9 graft ruptures (4.3%; 5 in female patients). A significant predictor for graft rupture was a high signal parallel to the proximal intra-articular graft and perpendicular to the femoral tunnel aperture ( P = .032 and P = .049, respectively), with each proximal graft signal intensity ratio (SIR) increase by 1 corresponding to a 40% increased risk of graft rupture. A cutoff SIR of 4 had a sensitivity and specificity of 66% and 77%, respectively, in the proximal graft and 88% and 60% in the femoral aperture. In all patients, graft signal adjacent to and within the tibial tunnel aperture, and in the mid intra-articular portion, was significantly lower than that for the femoral aperture ( P < .001). A significant correlation was seen between the appearance of higher graft signal on MRI and those patients achieving top sporting levels by 1 year.

Conclusion:

ACLR graft rupture after 1 year is associated with MRI appearances of high graft signal adjacent to and within the femoral tunnel aperture. Patients with aspirations of quickly returning to a high sporting level may benefit from MRI analysis of graft signal. Graft signal was highest at the femoral tunnel aperture, adding further radiographic evidence that the rate-limiting step to graft healing occurs proximally.
The white mirror: Face to face with racism in group analysis part 1—mainly theory
Authors: Aiyegbusi Anne
Published: February 2021

Group analysis privileges the social and political, aiming to address individual distress and ‘disturbance’ within a representation of the context it developed and persists in. Reproducing the presence and impact of racism in groups comes easily while creating conditions for reparation can be complicated. This is despite considerable contributions to the subject of racism by group analysts. By focusing on an unconscious, defensive manoeuvre I have observed in groups when black people describe racism in their lives, I hope to build upon the existing body of work. I will discuss the manoeuvre which I call the white mirror.

I aim to theoretically elucidate the white mirror. I will argue that it can be understood as a vestigial trauma response with roots as far back as the invention of ‘race’. Through racialized sedimentation in the social unconscious, it has been generationally transmitted into the present day. It emerges in an exacerbated way within the amplified space of analytic groups when there is ethnically-diverse membership. I argue it is inevitable and even essential that racism emerges in groups as a manifestation of members’ racialized social unconscious including that of the conductor(s). This potentially offers opportunities for individual, group and societal reparation and healing. However, when narratives of racism are instead pushed to one side, regarded as a peripheral issue of concern only to minority black or other members of colour, I ask whether systems of segregation, ghettoization or colonization are replicated in analytic groups. This is the first of two articles about the white mirror. The second article which is also published in this issue highlights practice implications.
‘If you prick me, do I not bleed?’: Antisemitism, racism and group analysis —some thoughts
Authors: Bacha Claire , Einhorn Sue , Lieberman Sue
Published: February 2021

The Merchant of Venice contains some of the most powerful depictions of Jewish–Christian relations in an era when Christian antisemitism dominated European life. It is one of the most difficult plays for Jews to watch: not only for Shylock’s torment at the treatment he is subjected to, particularly in the Christian characters’ relentless contempt for him, but for the depiction of his gradual descent into violent revenge, as a result of which he himself is crushed.

The revenge part of Shylock’s speech is crucial. The anti-Semites in the play unconsciously fear their victim, especially after treating Shylock with cruelty and contempt. The racists then project hatred, consequently fearing that Shylock will hate them, that he will be filled with rage and seek a revenge even more cruel than that which has been perpetrated upon him. Shylock speaks the racist’s fear and then wants to carry it out. In Shakespeare’s play, Shylock becomes a justification for hatred. If we look at this as the unconscious of antisemitism, then Shakespeare is personifying this unconscious in the character of Shylock. Seen in this way, The Merchant of Venice is a dramatic depiction of the violent effects of antisemitism on the subjectivity and identity of both victims and perpetrators.

We know that racism creates trauma. Sue Lieberman’s work on transmitted trauma (Lieberman, 2015) and Earl Hopper’s work on massification and aggregation both explored unprocessed trauma (Hopper, 2003). However, the permeating trauma of both racism and antisemitism has festered without being addressed adequately. Our purpose in this article is to begin to look at this disturbing truth. We will address the historical relationship between antisemitism and racism. We will make links to the development of psychoanalysis and group analysis. That Foulkes, himself was a victim of racism has always been present but largely unspoken. Unspoken, it has created blind spots, including our own racism.