bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a provincial feline onychectomy ban on cat intake and euthanasia in a British Columbia animal shelter system
Authors: Ellis Alexandre , van Haaften Karen , Protopopova Alexandra , Gordon Emilia
Published: September 2021

Objectives

The aim of this study was to determine whether there was an increase in cat relinquishment for destructive scratching behavior, a change in overall feline surrender intake and euthanasia, or a change in average length of stay in a British Columbia shelter system after provincial legislation banning elective onychectomy.

Methods

Records of cats admitted to the British Columbia Society for the Prevention of Cruelty to Animals in the 36 months prior to (1 May 2015–30 April 2018, n = 41,157) and after (1 May 2018–30 April 2021, n = 33,430) the provincial ban on elective onychectomy were reviewed. Total intake numbers, euthanasia and length of stay were descriptively compared between periods. Proportions of cats and kittens surrendered for destructive scratching, as well as the proportion of cats and kittens surrendered with an owner request for euthanasia, were compared using two-sample z-tests of proportions.

Results

Destructive behavior was found to be an uncommon reason for surrender (0.18% of surrendered cats) during the study period. There was no statistically significant difference in the number of cats surrendered for destructive scratching behavior ( z = −1.89, P >0.05) after the provincial ban on elective onychectomy. On the contrary, the proportion of owner-requested euthanasias decreased after the ban ( z = 3.90, P <0.001). The total number of cats surrendered, the shelter live release rate and average length of stay all remained stable or improved following the ban, though causation could not be determined.

Conclusions and relevance

The findings in this study suggest that legislation banning elective onychectomy does not increase the risk of feline shelter relinquishment – for destructive behavior or overall – and is unlikely to have a significant effect on shelter euthanasia or length of stay.
Young People’s Rights and Mental Health During a Pandemic: An Analysis of the Impact of Emergency Legislation in Scotland
Authors: McMellon Christina , MacLachlan A.
Published: September 2021

Emerging evidence indicates that the COVID-19 pandemic and government measures put in place in response to this have had a detrimental impact on young people’s mental health. A children’s human rights-based approach was taken to examine the impact of the legislative and policy measures that were implemented in Scotland in response to the pandemic on children’s rights related to their mental health. Key concerns were identified around children’s rights to access mental health services and information, participation in decision-making and non-discrimination of vulnerable groups. Although the analysis focussed on Scotland, recommendations to protect these rights are likely to be relevant to other countries following similar approaches as lockdown restrictions are eased, or in the event that stricter local or national measures are required again to curb rising infection rates or subsequent wave(s).
Triumph and concession? The moral and emotional construction of Ireland's campaign for abortion rights
Authors: O’Shaughnessy Aideen Catherine
Published: September 2021

In March 2018, the Irish government confirmed that a referendum would be held on 25 May, allowing for the Irish public to vote on the legalisation of abortion. The same month, Together for Yes – the national civil society campaign advocating for a ‘Yes’ vote in the referendum – was launched. This article draws upon findings from 27 in-depth interviews conducted in December 2019 and January 2020 with Irish abortion activists, to explore the moral and emotional construction of abortion within the ‘Yes’ campaign. This research suggests that the ‘Yes’ campaign, which secured 66% of the votes cast in the referendum, framed abortion as a negative affective object and constructed the moral permissibility of abortion along rather conservative lines. Data from the first year of abortion provision in the Republic of Ireland reveals that abortion seekers still face huge obstacles in accessing services in the State. The legislation introduced in January 2019 allows abortion on request only until 12 weeks, whilst issues remain in relation to the refusal of care. This article, therefore, concludes that by framing abortion in conservative terms, the pro-choice campaign has not yet succeeded in destigmatising abortion in Ireland – an issue now translated into limited legislation and inadequate provision of services.
An auto-ethnographic narrative of corporate intercultural training: Insights from the genealogical reordering of the material
Authors: Mahadevan Jasmin
Published: September 2021

Intercultural training is common practice in many organizations. By cross-cultural management scholars, intercultural training is often critiqued as overly simplistic. The argument is that intercultural trainers lack sophisticated cross-cultural management knowledge. Based on 6 years of ethnographic and auto-ethnographic research, I argue that such a categorical rejection of intercultural training practice as inferior functions as a closure mechanism towards higher scholarly relevance: The problem is not that intercultural training practice is overly simplistic but rather that cross-cultural management scholars fail to consider the actual processes of how intercultural training emerges in a certain (simplistic) and not in another (sophisticated) shape. What is required, is thus an investigation of the actual contexts, actors and chains of events, and of the power-relations underlying them, that bring a certain reality into being. To achieve this goal, I propose a practice approach to genealogy (based on Foucault) which I apply to rich auto-ethnographic and ethnographic material. In doing so, I work with ethnographic material in novel ways and move beyond a previously held, more structuralist, archival and textual approach to genealogy. Exemplifying the benefits of genealogy, I show how intercultural training is implicated by other, more intertwined and local, power-effects than those considered by academia, such as intersections of gender (women trainers), job precariousness, dominant male professionalism, organizational pressures and personal agendas. In walking the reader through the construction of a sample genealogy, I provide academics with a concrete approach of how to challenge taken-for-granted scholarly assumptions and make more impactful contributions to practice.
Using environmental evaluation systems and their contribution to sustainable development
Authors: Larsson Magnus
Published: September 2021

Drawing on previous research into evaluation use and sustainable development, this article investigates to what extent and how a national evaluation system can advance sustainable development. The data comprise interviews with key actors, observations at seminars where evaluations were discussed, and analysis of evaluation reports. The actors were divided into three categories (i.e. central, proximal, and peripheral) to indicate their closeness to the national policy cycle. The results indicate that the evaluations were used mainly by central and proximal actors, primarily because the evaluation knowledge met most of their knowledge needs, and very little used by peripheral actors, such as environmental and business organizations. The evaluation system’s main influence was to consolidate environmental work and provide guidance on the environmental dimension of sustainable development at the national level. The evaluation system also served as a recurring reminder for stakeholders about the national objectives, their achievement, and everyone’s responsibility for their implementation.
Prognostic value of signs and symptoms in heart failure patients using remote telemonitoring
Authors: Gingele Arno Joachim , Brandts Lloyd , Vossen Kjeld , Knackstedt Christian , Boyne Josiane , Brunner-La Rocca Hans-Peter
Published: September 2021

Introduction

Heart failure is a serious burden on health care systems due to frequent hospital admissions. Early recognition of outpatients at risk for clinical deterioration could prevent hospitalization. Still, the role of signs and symptoms in monitoring heart failure patients is not clear. The heart failure coach is a web-based telemonitoring application consisting of a 9-item questionnaire assessment of heart failure signs and symptoms and developed to identify outpatients at risk for clinical deterioration. If deterioration was suspected, patients were contacted by a heart failure nurse for further evaluation.

Methods

Heart failure coach questionnaires completed between 2015 and 2018 were collected from 287 patients, completing 18,176 questionnaires. Adverse events were defined as all-cause mortality, heart failure- or cardiac-related hospital admission or emergency cardiac care visits within 30 days after completion of each questionnaire. Multilevel logistic regression analyses were performed to assess the association between the heart failure coach questionnaire items and the odds of an adverse event.

Results

No association between dyspnea and adverse events was observed (odds ratio 1.02, 95% confidence interval 0.79–1.30). Peripheral edema (odds ratio 2.21, 95% confidence interval 1.58–3.11), persistent chest pain (odds 2.06, 95% confidence interval 1.19–3.58), anxiety about heart failure (odds ratio 2.12, 95% confidence interval 1.44–3.13), and extensive struggle to perform daily activities (odds ratio 2.23, 95% confidence interval 1.38–3.62) were significantly associated with adverse outcome.

Discussion

Regular assessment of more than the classical signs and symptoms may be helpful to identify heart failure patients at risk for clinical deterioration and should be an integrated part of heart failure telemonitoring programs.
Statecraft and incremental change: Explaining the success of pension reforms in the United Kingdom
Authors: Massala Thomais , Pearce Nick
Published: September 2021

How were comprehensive pension reforms in the UK successfully developed, enacted and implemented from 2002 to 2015, despite changes in government composition and the financial crisis? Why were they not subject to policy conflict, electoral competition and policy reversal? Drawing on actor-centred historical institutionalism and thirty interviews with key actors, we demonstrate the critical role played by a limited number of politicians and policy entrepreneurs and their ideas and agency. Institutional continuity with the Beveridgean policy legacies of the pension system and the United Kingdom’s `growth regime’ enabled a coalition space to open up for policy agreement. between the government and Opposition parties, and for partisan electoral competition over the reforms to be `bracketed’. The incremental and interlocking nature of the reform package reduced interest group opposition and enabled a centralisation of decision-making power. A long-term timeframe for reform cemented the formation of an elite coalition and buttressed political control. Cross-party support for the reform package, coupled with judicious phasing of the implementation of auto-enrolment and fiscal reforms, enabled it to withstand the impact of the financial crisis and the austerity that followed it, and to minimise opposition among the critical electoral constituency of older voters. The dominance of the reform process by political actors and policy entrepreneurs in the UK nonetheless came at a price, as institutional continuity and incrementalism foreclosed alternative reforms. We demonstrate the importance of political statecraft and policy entrepreneurship in the UK pensions’ reform process, but within boundaries set by its institutional context.
Recommendations for ethnic equity in health: A Delphi study from Denmark
Authors: Smith Jervelund Signe , Vinther-Jensen Kirsten , Ryom Knud , Villadsen Sarah Fredsted , Hempler Nana Folmann
Published: September 2021

Aims

A key issue in public health is how to approach ethnic inequities. Despite an increased focus on the health of people from ethnic minorities in the last 15 years, significant ethnic health inequities still exist in Denmark. These arise during pregnancy and are exacerbated by higher rates of exposure to health risks during the life course. This study aimed to formulate recommendations on both structural and organisational levels to reduce ethnic health inequities.

Methods

Nine decision-makers – representing municipalities, regions, the private sector and voluntary organisations in Denmark – participated in the formulation of recommendations inspired by the Delphi method. The consensus process was conducted in three rounds during spring 2020, resulting in eight overall recommendations, including suggestions for action.

Results

The recommendations address both structural and organisational levels. They aim to strengthen: 1) health policies and strategies related to the needs of people from ethnic minorities, including health literacy, linguistic, cultural and social differences; 2) health-promoting local initiatives developed in co-creation with people from ethnic minorities; 3) health promotion and prevention from a life course perspective with a focus on early intervention; 4) cross-sectoral and interdisciplinary collaborations that facilitate transitions and coordination; 5) competencies of professionals in terms of cultural knowledge, awareness, reflexivity and skills; 6) access to healthcare services by increasing information and resources; 7) interpreting assistance for, and linguistic accessibility to, healthcare services; 8) documentation and intervention research.

Conclusions

To reduce ethnic health inequities, it is crucial that Danish welfare institutions, including their strategies, approaches and skills of employees, are adapted to serve an increasingly heterogeneous population.
Social inequalities in the self-management of type 1 diabetes: A serial multiple mediation analysis
Authors: Wagner Sabina , Olesen Kasper
Published: September 2021

Aims

Diabetes requires complex self-management. Due to this complexity, social disparities exist in the self-management of type 1 diabetes. Various pathways to describe associations between socio-economic factors and health outcomes have been suggested. We sought to elucidate the potential of health literacy and social support to reduce social disparities in diabetes self-management.

Methods

Questionnaire responses were linked to data from electronic medical records, yielding a study population of 1186 people with type 1 diabetes. Mediation analyses using adjusted linear regressions were used to establish pathways between self-reported educational attainment, social support, functional health literacy and clinically obtained measures of glycaemic control.

Results

We found evidence of an association between education and glycated haemoglobin, partially mediated by functional health literacy and social support. However, the direct association between social support and glycaemic control was not statistically significant.

Conclusions

Whilst both functional health literacy and social support play a role in glycaemic control, our findings did not explain the main impact of social disparities on glycaemic control. Interventions to reduce disparities in glycaemic control related to educational attainment should focus beyond functional health literacy and social support.
‘Answer in any way you want’: Discursive tensions in conversations of a citizen participation process
Authors: Sjögren Maria
Published: September 2021

This paper contributes to empirical knowledge of citizen participation as a communicative event, by analyzing discursive tensions in interviews between civil servants and citizen-parents, that are part of a participatory process on how to mitigate violence in a suburban area in Sweden. Citizen participation events are increasingly initiated by public institutions in Western societies. Research, however, shows that goals of participatory processes often conflict with formal decision-making structures and institutional boundaries. Yet, how such tensions play out on the level of interaction is little researched. This study therefore analyzes discursive practices deployed by civil servants and how these construct characteristic tensions for the interviews. Three practices are identified: (1) pursuing the initial question, (2) cueing an institutional frame, and (3) epistemic positioning of the parents. These practices, being guided by an institutional agenda, create tensions both to the parents’ lifeworld and for the ideals of the participatory method itself.
Association Between the Visual N1-P2 Complex and Neuroticism
Authors: Xiu Bowen , Andanty Christopher , Dai Nasia , Zai Clement C. , Graff Ariel , McNeely Heather , Daskalakis Zafiris J. , De Luca Vincenzo
Published: September 2021

Neuroticism is a personality trait associated with impaired attention, memory, and error detection. Thus, the present study investigated the visual N100 and P200 event-related potentials components associated with attention using a 2-back working memory task in healthy neurotic and nonneurotic participants, evaluated using the Neuroticism, Extraversion, Openness Five Factor Inventory. A total of 35 healthy participants were asked to perform the 2-back task while recording electroencephalographic activity from 64 electrodes on the scalp. Analysis of the N100 and P200 amplitude and latency in high neuroticism and low neuroticism subjects showed an increased P200 amplitude and latency for high neuroticism subjects in the frontal and parietal regions, respectively. However, there were no significant performance differences between the high and low neuroticism subjects for the 2-back working memory task. Therefore, the results suggest that neuroticism is associated with the P200 component elicited in the context of a working memory task.
Comparison of 3- and 6-Month Outcomes of Combined Oral L-Carnitine Fumarate and Acetyl-L-Carnitine Therapy, Included in an Antioxidant Formulation, in Patients with Idiopathic Infertility
Authors: Szymański Marek , Wandtke Tomasz , Wasilow Karolina , Andryszczyk Marek , Janicki Radosław , Domaracki Piotr
Published: September 2021

The male factor is responsible for infertility in about 35–40% of all cases. Idiopathic oligo- and/or astheno- and/or therato-zoospermia is one of the most common male fertility disorders and remains a significant therapeutic challenge. The primary cause of idiopathic male infertility remains unknown but seems to be associated with oxidative stress. Objective: The use of antioxidative formulation to improve qualitative and quantitative deficiencies in the male gametes.

In total, 78 subjects were treated with a combination of 1,725 mg L-carnitine fumarate, 500 mg acetyl-L-carnitine, 90 mg vitamin C, 20 mg coenzyme Q10, 10 mg zinc, 200 µg folic acid, 50 µg selenium, and 1.5 µg vitamin B12 (Proxeed® Plus, Sigma-Tau, Italy) for 6 months; the preparation was taken twice daily from the time idiopathic infertility was diagnosed. Basic seminal parameters were evaluated by a European Society of Human Reproduction and Embryology (ESHRE) -certified embryologist following the fifth edition of the World Health Organisation (2010) guidelines at three time points: at baseline and 3 and 6 months of treatment.

Improvements in semen parameters (differing in terms of dynamics) were evident at 3 months and gradually improved over the 6 months of treatment. Each parameter: sperm concentration, total sperm count, sperm total and progressive motility improved significantly after treatment except for the percentage of sperm of abnormal morphology and ejaculate volume.

Proxeed Plus was effective for patients with idiopathic infertility; however, a long treatment period is needed to achieve optimal results.
Long-term results and comparison of flow re-direction endoluminal device and pipeline embolization device in endovascular treatment of intracranial carotid aneurysms
Authors: Gündoğmuş Cemal A , Sabet Soheil , Baltacıoğlu Nurten A , Türeli Derya , Bayri Yaşar , Baltacıoğlu Feyyaz
Published: September 2021

Objective

This study aims to compare the efficacy, safety, and long-term outcomes of two flow diverters, i.e., pipeline embolization device and flow re-direction endoluminal device, in the treatment of distal carotid aneurysms.

Methods

A total of 138 patients with 175 aneurysms were included from February 2012 to September 2019. Ninety-nine aneurysms were treated with flow re-direction endoluminal device and 76 with pipeline embolization device. Angiographic follow-ups were at the 6th, 12th, 24th, 36th, and 60th months; the O’Kelly-Marotta grading scale was used to assess aneurysms occlusion. Outcomes of two devices were compared; possible associations regarding patient characteristics, aneurysm properties, treatment details, and adverse events were evaluated.

Results

The mean follow-up period was 33 months, with 10 patients lost to follow-up. Occlusion rates at the 6th and 12th months and during the last follow-up were similar for flow re-direction endoluminal device (81%, 84%, and 90%) and pipeline embolization device (82%, 85%, and 93%). Occlusion rates were also similar after stand-alone use without coiling. There was no significant difference regarding adverse event rates with a 10.9% overall complication rate, 3.6% mortality, and 0.7% permanent morbidity. All the mortality and morbidity were related to hemorrhagic complications. Device deployment failure was observed with five flow re-direction endoluminal devices and two pipeline embolization devices, whereas two severe in-stent stenoses occurred with each device.

Conclusions

Both flow re-direction endoluminal device and pipeline embolization device are feasible and effective in flow diversion of distal internal carotid artery aneurysms, with similar adverse events rates and aneurysm occlusion success. Aneurysm occlusion rates increase with time, while the presence of an integrated branch significantly decreases treatment success.
Acute intracranial stenting with mechanical thrombectomy is safe and efficacious in patients diagnosed with underlying intracranial atherosclerotic disease
Authors: Hassan Ameer E , Ringheanu Victor M , Preston Laurie , Tekle Wondwossen G , Qureshi Adnan I
Published: September 2021

Objective

To investigate whether significant differences exist in recanalization rates and primary outcomes between patients who undergo mechanical thrombectomy alone versus those who undergo mechanical thrombectomy with acute intracranial stenting.

Methods

Through the utilization of a prospectively collected endovascular database at a comprehensive stroke center between 2012 and 2020, variables such as demographics, co-morbid conditions, symptomatic intracerebral hemorrhage, mortality rate at discharge, and good/poor outcomes in regard to modified thrombolysis in cerebral infarction score and modified Rankin Scale were examined. The outcomes between patients receiving acute intracranial stenting + mechanical thrombectomy and patients that underwent mechanical thrombectomy alone were compared.

Results

There were a total of 420 acute ischemic stroke patients who met criteria for the study (average age 70.6 ± 13.01 years; 46.9% were women). Analysis of 46 patients from the acute stenting + mechanical thrombectomy group (average age 70.34 ± 13.75 years; 37.0% were women), and 374 patients from the mechanical thrombectomy alone group (average age 70.64 ± 12.92 years; 48.1% were women). Four patients (8.7%) in the acute stenting + mechanical thrombectomy group experienced intracerebral hemorrhage versus 45 patients (12.0%) in the mechanical thrombectomy alone group ( p = 0.506); no significant increases were noted in the median length of stay (7 vs 8 days; p = 0.208), rates of modified thrombolysis in cerebral infarction 2B-3 recanalization ( p = 0.758), or good modified Rankin Scale scores ( p = 0.806).

Conclusion

Acute intracranial stenting in addition to mechanical thrombectomy was not associated with an increase in overall length of stay, intracerebral hemorrhage rates, or any change in discharge modified Rankin Scale. Further research is required to determine whether mechanical thrombectomy and acute intracranial stenting in acute ischemic stroke patients is unsafe.
O2–O3 chemodiscolysis: How much, how long? Retrospective outcome evaluation of different treatment sessions in partially-responder patients
Authors: Bruno Federico , Carboni Nicola , Palumbo Pierpaolo , Arrigoni Francesco , Varrassi Marco , Izzo Antonio , Catallo Nadia , Di Cesare Ernesto , Masciocchi Carlo , Splendiani Alessandra , Giovagnoni Andrea , Barile Antonio
Published: September 2021

Purpose

To retrospectively evaluate the clinical and instrumental outcome of different treatment sessions of oxygen–ozone (O2–O3) chemodiscolysis in patients with lumbar disc herniation

Methods

We evaluated 73 patients partially responders to a single session of oxygen–ozone (O2–O3) chemodiscolysis and submitted to multiple injections sessions. All patients completed a pre- and post-treatment clinical (VAS and modified McNab score) and instrumental MRI follow-up. Imaging evaluation included assessment of intervertebral disc area (IDA). Pre- and post-treatment differences were compared to evaluate differences in variation between groups. Correlation analysis was used to evaluate the relationship between morphological and clinical parameters.

Results

Based on the type and number of treatments performed, patients were divided into three groups: Group A) patients submitted to an additional periradicular anaesthetic/steroid injection; Group B) patients submitted to an additional session of intradiscal O2–O3 injection; Group C) patients submitted to two further sessions of intradiscal O2–O3 injection. The results showed an improvement of pain scores in all groups, and a smaller disc area change in group B. Comparing the differences between pre- and post-treatment features among the three different groups of patients, we did not find any statistically significant difference. Correlation analysis did not show any statistically significant correlation between the morphological changes of the intervertebral disc and the clinical output scores.

Conclusions

In our retrospective observation of partially responder patients, multiple intradiscal ozone injections were not associated with a higher disc shrinkage nor superior clinical outcome compared to a single intradiscal O2–O3 application with an additional periradicular injection session.
Postoperative cognitive dysfunction after endovascular treatments for unruptured intracranial aneurysms: A pilot study
Authors: Ishii Daizo , Zanaty Mario , Roa Jorge A , Li Luyuan , Lu Yongjun , Allan Lauren , Samaniego Edgar A , Torner James C , Tranel Daniel , Hasan David M
Published: September 2021

Objective

Post operative cognitive dysfunction (POCD) has been widely observed after major surgery, particularly in elderly patients with general anesthesia (GA). However, a specific unanswered question is whether different approaches to anesthetic managements are associated with different cognitive outcomes after endovascular treatments for unruptured intracranial aneurysms (UIAs). The purpose of this study is to assess the correlation of POCD with GA versus monitored anesthesia care (MAC).

Methods

We performed a pragmatic, prospective study to assess the association between different anesthetic approaches and POCD. We compared the pre- and post-procedural Montreal Cognitive Assessment (MoCA) scores in patients with normal cognition who underwent treatments of UIAs with various endovascular methods, using either GA or MAC.

Results

A total of 23 patients with UIAs were enrolled in the study. Seven (30.4%) and sixteen (69.6%) UIAs were treated without perioperative complications under GA or MAC, respectively. There was a significant decline in the post-procedural MoCA score under GA (mean difference  =  1.14; 95% confidence interval  =  [0.42–1.87], P < 0.01). By contrast, there was no significant difference of MoCA score between pre- and post-procedure under MAC (mean difference  =  0.19; 95% confidence interval  =  [−0.29–0.67], P  =  0.59).

Conclusions

Treating UIAs using MAC was associated with a decrease in POCD as compared to GA in patients undergoing endovascular treatments for UIAs with normal cognition. Larger randomized studies are needed to confirm these findings.
Transradial access for pediatric teenage neurointervention: A single-center case series
Authors: Cox Pablo , Riveros Rodrigo , Torres Francisco , Venegas Alejandro , Carvajal Yuri
Published: September 2021

Transradial access is widely used in cardiological adult interventions and less in pediatrics. In recent years, this access has become more popular in the neuroradiological community in adult patients since it has fewer complications and is more comfortable for the patient after the procedure. We present a single-center case series of 52 transradial access neurointerventions (43 angiographies and 9 therapeutic procedures) in pediatric patients, with a failure of 4 cases (7.7%) in which we could not puncture the artery, crossing over to transfemoral access. Since in five cases we did angiography followed by therapeutic intervention, thus doing only one puncture access for both procedures, then our access failure rate was 10.6%. The 34 successful transradial access solely angiographies had a median radiation exposure of 887 mGy (interquartile range 628–1352), median fluoroscopy time of 9.5 min (interquartile range 7.5–15.3), and median procedure time of 28 min (interquartile range 24–33 min) Therapeutic procedure diagnosis were: one ruptured saccular aneurysm, two juvenile nasopharyngeal angiofibromas, and five arteriovenous malformations. The transradial access neurointerventions for pediatric population older than 11 years is safe and feasible, having previous experience in adults. Younger population should be considered on a case-to-case basis, depending on ultrasound measurement of the arterial diameter and the materials available.
Safety and efficacy of intravenous tirofiban for stent-assisted coiling in acutely ruptured intracranial aneurysms: A single center experience
Authors: Ma Yihui , Jia Chenguang , Zhang Tingbao , Feng Yu , Chen Xinjun , Zhao Wenyuan
Published: September 2021

Background

There have been few reports on the use of tirofiban in ruptured intracranial aneurysms and the results were conflicting. However, the safety and efficacy of optimal dosage and the reasonable treatment course of tirofiban have not been determined.

Objective

To determine the safety and efficacy of a new protocol for its prophylactic tirofiban application during the endovascular treatment of ruptured intracranial aneurysms with no oral antiplatelet medications.

Methods

This retrospective study was based on 105 patients with ruptured aneurysms who underwent stent-assisted coiling at our institution between August 2017 and July 2020. Intravenous tirofiban was administered to patients after stent deployment. Tirofiban was administered as an intravenous bolus (5 µg/kg) over a 3 min period immediately after stent deployment, followed by a 0.06–0.08 µg/kg/min maintenance infusion for 12–24 h. Dual oral antiplatelet therapy was overlapped with half the tirofiban dose 2 h before the cessation of the tirofiban infusion. Cases of intracranial hemorrhage or thromboembolism were recorded.

Results

This study included a total of 105 patients with ruptured intracranial aneurysms, who underwent stent-assisted coiling. In terms of clinical severity, a presenting Hunt–Hess clinical-grade I was observed in 47 (44.8%) cases, grade II in 19 (18.1%) cases, grade III in 30 (28.6%) cases, grade IV in 6 (5.6%) cases, and grade V in 3 (2.9%) cases. None of the patients showed a newly developed tirofiban-related intracerebral hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, or ventriculostomy-related hemorrhage. There were 3 (2.8%) patients who had thromboembolic complications.

Conclusions

We have determined a new protocol for prophylactic intraoperative tirofiban during the endovascular treatment of ruptured intracranial aneurysms with no oral antiplatelet medications. In our study, tirofiban showed a low risk of hemorrhagic or thromboembolic complications. Tirofiban appears to be a safe and alternative during the stent-assisted coiling of ruptured intracranial aneurysms.
Dynamic recrystallization behavior of 6082 aluminum alloy during hot deformation
Authors: Lin Hai-bo
Published: September 2021

The dynamic recrystallization behaviors of 6082 aluminum alloy in the temperature range of 623–773 K and strain rate range of 0.01–5 s−1 were studied by electron back scattered diffraction (EBSD) and transmission electron microscopy (TEM). According to the experimental results, dynamic recrystallization occurs during hot deformation of 6082 aluminum alloy, although the true stress-strain curve has no obvious single peak characteristic, and the degree of dynamic recrystallization is closely related to the Z parameter. Hot compression with lnZ = 24.9014 (723 K, 0.1 s−1) gives rise to the highest recrystallization fraction of 38.6%. The initial critical strain of dynamic recrystallization was determined by the work hardening rate. The quantitative relationship between the critical strain and Z parameters was established: [Formula: see text]. Based on the EBSD analysis and measurement results, dynamic recrystallization kinetics models of 6082 aluminum alloy during hot deformation were deduced. Microstructure analysis showed that the subgrain structure formed in the original grain is coarsened by grain boundary migration, and the orientation difference increases continuously until a large-angle grain boundary forms, resulting in dynamic recrystallization of grains. The likely mechanism is continuous dynamic recrystallization.
Examining physical activity and quality of life in adults with autism spectrum disorder and intellectual disability
Authors: Tomaszewski Brianne , Savage Melissa N , Hume Kara
Published: September 2021

Adults with autism and co-occurring intellectual disability engage in low levels of physical activity and are at increased risk of developing secondary health conditions attributed to physical inactivity compared to adults in the general population. Few studies have examined the use of objective measures to characterize physical activity levels for adults with autism and intellectual disability. The current study aimed to examine the relationship between physical activity, using an activity tracker, and quality of life in adults with autism and intellectual disability. In the current study, 38 adults with autism and intellectual disability, ages 18–55, wore a Fitbit Flex 2® activity tracker for 1 week, and completed the Quality of Life Questionnaire. The relationship between average daily step count quality of life was examined. Most adults in the sample were overweight and taking fewer daily steps than recommended guidelines. Increased average daily step count was significantly associated with quality of life.
In Between: British and American Melodrama and Modernity
Authors: Buckley Matthew
Published: September 2021

This essay assesses the current state of scholarship on British and American melodrama and introduces the cluster of articles on that topic that follow. It suggests that recent advances in the field have made evident the trans-cultural, trans-medial and reproductive nature of melodrama as an art, re-focusing critical attention on melodrama's performance, production and formal evolution not within but among, and by movement between, the different cultures, media, creators, audiences, forms and works it involved. Drawing attention to British and American melodrama's critical role in this vast, largely unrecovered history of relational, migrational and reiterative creation, and noting the immediate challenges such a history presents to critical understanding and study, the essay describes the manner in which each of the cluster's articles responds to those new challenges and the ways in which, both individually and as a group, they have begun to lend that history more clarity.
‘Don’t let the bastards grind you down’: Feminist resilience/resilient feminism in The Handmaid’s Tale (Hulu, 2017–)
Authors: Gorton Kristyn
Published: September 2021

This article explores the tension that lies in the construction of resilience, which is at once, hopeful and inspiring and yet also in danger of positioning the individual as responsible for the lack of welfare and support that is available. In articulating these contradictory readings, I treat The Handmaid’s Tale as a ‘site where the meaning of feminism(s) is produced and contested’ (Ferreday and Harris, 2017: 240) and as a television text whose storytelling techniques reflect what Jason Mittell (2015) refers to as ‘narrative complexity’.
DSP rs2076295 variants influence nintedanib and pirfenidone outcomes in idiopathic pulmonary fibrosis: a pilot study
Authors: Doubkova Martina , Kriegova Eva , Littnerova Simona , Schneiderova Petra , Sterclova Martina , Bartos Vladimir , Plackova Martina , Zurkova Monika , Bittenglova Radka , Lostaková Vladimira , Siskova Lenka , Lisa Pavlina , Suldova Hana , Doubek Michael , Psikalova Jana , Snizek Tomas , Musilova Pavlina , Vasakova Martina
Published: September 2021

Background:

The antifibrotic drugs nintedanib and pirfenidone are used for the treatment of idiopathic pulmonary fibrosis (IPF). We analysed the association of common profibrotic polymorphisms in MUC5B (mucin 5B, rs35705950) and DSP (desmoplakin, rs2076295) on antifibrotic treatment outcomes in IPF.

Methods:

MUC5B rs35705950 and DSP rs2076295 were assessed in IPF patients ( n = 210, 139 men/71 women) from the Czech EMPIRE registry and age- or sex-matched healthy individuals ( n = 205, 125 men/80 women). Genetic data were collated with overall survival (OS), acute exacerbation episodes, worsening lung function and antifibrotic treatment.

Results:

We confirmed overexpression of the MUC5B rs35705950*T allele (55.2% versus 20.9%, p < 0.001) and the DSP rs2076295*G allele (80.4% versus 68.3%, p < 0.001) in IPF compared with controls. On antifibrotic drugs, lower mortability was observed in IPF patients with DSP G* allele ( p = 0.016) and MUC5B T* allele ( p = 0.079). Carriers of the DSP rs2076295*G allele benefitted from nintedanib treatment compared with TT genotype by a longer OS [hazard ratio (HR) = 7.99; 95% confidence interval (CI) = 1.56–40.90; p = 0.013] and a slower decline in lung function (HR = 8.51; 95% CI = 1.68–43.14; p = 0.010). Patients with a TT genotype (rs2076295) benefitted from treatment with pirfenidone by prolonged OS ( p = 0.040; HR = 0.35; 95% CI = 0.13–0.95) compared with nintedanib treatment. Both associations were confirmed by cross-validation analysis. After stratifying by MUC5B rs35705950*T allele carriage, no difference in treatment outcome was observed for nintedanib or pirfenidone ( p = 0.784). In the multivariate model, smoking, age, forced vital capacity (FVC) and DLCO (diffuse lung capacity) at the IPF diagnosis were associated with survival.

Conclusion:

Our real-world study showed that IPF patients with MUC5B T* allele or DSP G* allele profit from antifibrotic treatment by lower mortability. Moreover, carriers of the DSP rs2076295*G allele benefit from treatment with nintedanib, and TT genotype from treatment with pirfenidone. MUC5B rs35705950 did not impact the outcome of treatment with either nintedanib or pirfenidone. Our single-registry pilot study should be confirmed with an independent patient cohort.
Chemical Components and Antimicrobial Activities of Tea Tree Hydrosol and Their Correlation With Tea Tree Oil
Authors: Li Xiaoxue , Shen Dan , Zang Qiushuang , Qiu Yan , Yang Xuedong
Published: September 2021

Tea tree hydrosol (TTH) is the aqueous phase of the distillate from the steam distillation process of the twigs and leaves of Melaleuca alternifolia. In this study, the chemical components of TTH were analyzed by gas chromatography–mass spectrometry (GC–MS) and gas chromatography–flame ionization detector (GC-FID). The major components were terpenoids (1.53 mg/mL), including monoterpenoids and sesquiterpenoids. The antibacterial activity of TTH was assessed by paper disc agar diffusion and broth dilution methods. Terpinen-4-ol (MIC: 0.31-0.62 mg/mL), 2- endo-hydroxy-1,8-cineole (MIC: 1.25-2.50 mg/mL) and p-menth-3-ene-1,2-diol (MIC: 0.62-2.50 mg/mL) were the main antibacterial components of TTH. The results showed that the major components of TTH and tea tree oil (TTO) had the same parent structures, but different degrees of oxidation. Terpinen-4-ol was the most abundant component in both TTH (624.2 μg/mL) and TTO (35-48%), and played a major role in antibacterial activities. This is the first report on the chemical components and antibacterial activities of TTH and their correlation with TTO, which demonstrates the potential application of TTH as a natural antimicrobial agent in health care products.
The doors they choose: Solutions to “The Lady or the Tiger”
Authors: Lucey Thomas A , Lorsbach Anthony W
Published: September 2021

We consider the extent that elementary preservice teachers enrolled in a social studies methods course expressed empathy for story characters when solving the story’s emotionally ladened problem. We believe that the manner by which these students resolved one character’s dilemma informs about the nature of their own emotions. Participants read Frank Stockton’s story, “The Lady and the Tiger” toward the beginning and at the conclusion of the semester. The data represented all student responses to the prompt, “Read the short story at the following link. To what door do you think the princess directed the accused? What is the reason for your choice?” Forty-two students completed both reflections of the reading. The analysis found that in their initial reflections, a solid majority of students selected the tiger. At the end of the course, this percentage decreased to a smaller majority. Analysis of the six students who changed their perspectives of the princess’s decision found that five referenced course experiences in their explaining the reason for change. This paper fills a gap in social studies research about emotions and decision-making. Additional research needs to interpret the specific nature of these emotions and the conditions that influence them.
Political mobilization and its impact on voter turnout: A survey experiment in Iraq
Authors: Yamao Dai , Hamanaka Shingo
Published: September 2021

This article clarifies how political mobilization affects voter turnout in a post-conflict society by analyzing the Iraqi case using survey data. Voter turnout was high in post-war Iraq. However, the voter turnout in the fourth election, held in May 2018, declined by 20 percentage points from the previous one in 2014, mainly because of widespread political distrust due to corruption among political elites and their embezzlement of public funds, neglect of the people, and the breakdown of social services after the intensive operation against the so-called Islamic State (IS). Political mobilization during electoral campaigns usually encourages voters to go to polling stations. Notwithstanding, amid widespread political distrust in a post-conflict society, how does political mobilization affect voters’ behavior in elections? To answer this research question, we conducted a survey experiment during the 2018 electoral campaign to scrutinize the effects of political mobilization on voters in Iraq. Through quantitative analysis of the survey data, we demonstrated that voters are more likely to refrain from visiting polling stations if they are mobilized by political parties during a campaign. Thus, political mobilization discourages voters from participating in elections when there is extensive political distrust.
Combined score of C-reactive protein level and neutrophil-to-lymphocyte ratio: A novel marker in distinguishing children with exacerbated asthma
Authors: Zhu Xuming , Zhou Lina , Li Qingqing , Pan Ruilin , Zhang Jian , Cui Yubao
Published: September 2021

Background

Both C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) are commonly elevated in patients with asthma. It is necessary to develop a novel marker, the combined score of CRP level and NLR (C-NLR score) based on cutoff points of CRP and NLR, and apply it in asthma diagnosis. The aim of this study was to explore whether C-NLR could distinguish children with exacerbated asthma.

Methods

Children suffering from exacerbated asthma were regarded as the asthmatic group ( n = 86), which was divided into three groups: mild ( n = 54), moderate ( n = 17), and severe ( n = 15). The control group consisted of children without any allergic disease and infection ( n = 38). To compare CRP level and NLR between the asthmatic group and control group, a receiver-operating characteristic curve was constructed to determine area under the curve (AUC) and optimal cutoff point. Thereafter, the C-NLR score was classified as follows: C-NLR score of 2 with an elevated CRP level and high NLR, a C-NLR score of 1 with one of these abnormalities, and a C-NLR score of 0 with a normal CRP level and low NLR. The C-NLR score was then compared among different asthma groups.

Results

In the control group, the CRP level and NLR were 1.9 (0.5–2.6) mg/L and 1.01 (0.69–1.31), respectively. In the asthmatic group, the CRP level and NLR were 7.3 (3.2–14.2) mg/L and 3.08 (1.73–5.34), respectively, which were higher than those in the control group ( p < 0.001 for CRP and p < 0.001 for NLR). The AUC of CRP was 0.86, and the optimal cutoff point was 3.6 mg/L. The AUC of NLR was 0.86, and the optimal cutoff point was 1.72. The AUC of the C-NLR score was 0.94, and the optimal cutoff point was 1.

Conclusions

C-NLR, a novel inflammatory marker, was applied here for the exacerbated asthma for the first time. Our study has shown C-NLR is a promising marker to distinguish children with exacerbated asthma from healthy children.
Treatment patterns in women seeking care for endometriosis at an endometriosis center
Authors: Linder Katharine E , Burnett Tatnai L , Weng Chia-Sui , Khan Zaraq , Mara Kristin , Cope Adela G
Published: September 2021

Objective:

To determine the clinical characteristics and prior medical and surgical treatments in women undergoing surgical excision of endometriosis for pelvic pain at a single institution.

Methods:

In this retrospective cohort study we identified 140 women with pathology-proven endometriosis who completed a preoperative standardized pain form and underwent surgery at an endometriosis center. Women were stratified into three groups for analysis: no prior surgery, 1 prior surgery, and 2+ prior surgeries.

Results:

The most common treatments used prior to seeking care were hormonal contraceptives (51.6%) and surgery (46.1%). More than half of women were diagnosed with pelvic floor dysfunction at time of presentation or prior to consultation. There was a significant relationship between an increasing number of surgeries (none vs 1 vs 2+) and gonadotropin-releasing hormone (GnRH) agonist use (19.0% vs 27.5% vs 56.0%, p = 0.003). Though not significant, a trend was noted between increasing surgeries and opioid use (20.6% vs 30.0% vs 40.0%, p = 0.17). There was a statistically significant relationship between multiple surgeries and illicit drug use ( p < 0.001).

Conclusion:

Patients with pelvic pain and endometriosis who have undergone multiple surgeries are more likely to have used GnRH agonists and report illicit drug use prior to presenting to specialized care.