bluuebunny/crossref_metadata_2025 huggingface dataset:
One-Year Treatment Outcome of Profile Changes After Transcutaneous Maxillary Distraction Osteogenesis in Growing Children With Cleft Lip and Palate
Authors: Gao Wei-Ling , Lee Yi-Hao , Tsai Chi-Yu , Wu Te-Ju , Lai Jui-Pin , Lin Shiu-Shiung , Chang Yu-Jen
Published: April 2021

Objective:

To evaluate the long-term stability of LeFort I osteotomy followed by distraction osteogenesis with a transcutaneous rigid external device for the treatment of severe maxillary hypoplasia in patients with cleft lip and palate.

Patients and Methods:

Nine patients with cleft lip and palate underwent rigid external distraction after a LeFort I osteotomy for maxillary advancement. Lateral cephalometric films were analyzed for assessment of treatment outcome and stability in 1 month, 6 months, and 1 year after distraction.

Results:

Significant maxillary advancement was observed in the horizontal direction, with the anterior nasal spine (ANS) distance of the maxilla increasing by an average of 20.5 ± 5.1 mm after distraction. The ANS relapse rates in 6 months and 1 year were 8.7% and 12.8%, respectively. The mean inclination of upper incisors to the palatal plane was almost unchanged (before: 109.8° ± 6.6°; after: 108.9° ± 7.5°). The movement ratios at the nasal tip/ANS, soft tissue A point/A point, and the upper vermilion border/upper incisor edge were 0.36:1, 0.72:1, and 0.83:1, respectively.

Conclusion:

Considerable maxillary advancement was achieved with less change of incisors inclination after distraction. Moreover, the relapse rate after 1 year was minimal. The concave facial profile was improved as well as the facial balance and aesthetics.
Clinical Outcomes of Pulmonary Embolism in Mexican Patients With COVID-19
Authors: Bobadilla-Rosado Luis O. , Mier y Teran-Ellis Santiago , Lopez-Pena Gabriel , Anaya-Ayala Javier E. , Hinojosa Carlos A.
Published: April 2021

Coagulation abnormalities have been reported in COVID-19 patients, which may lead to an increased risk of Pulmonary Embolism (PE). We aimed to describe the clinical characteristics and outcomes of COVID-19 patients diagnosed with PE during their hospital stay. We analyzed patients with PE and COVID-19 in a tertiary center in Mexico City from April to October of 2020. A total of 26 (100%) patients were diagnosed with Pulmonary Embolism and COVID-19. We observed that 14 (54%) patients were receiving either prophylactic or full anticoagulation therapy, before PE diagnosis. We found a significant difference in mortality between the group with less than 7 days (83%) and the group with more than 7 days (15%) in Intensive Care Unit ( P = .004); as well as a mean of 8 days for the mortality group compared with 20 days of hospitalization in the survivor group ( P = .003). In conclusion, there is an urgent need to review antithrombotic therapy in these patients in order to improve clinical outcomes and decrease hospital overload.
The Role of Cultural Beliefs, Norms, and Practices in Nigerian Women’s Experiences of Sexual Abuse and Violence
Authors: Ajayi Chinyere Elsie , Chantler Khatidja , Radford Lorraine
Published: April 2021

This study aims to explore if and how cultural beliefs, norms, and practices might contribute to Nigerian women’s experiences of sexual abuse and violence. In-depth narrative interviews were conducted with 12 women of Nigerian origin living in the Northwest of England who had experienced sexual abuse and violence. Women’s accounts were analyzed thematically, and drawing upon a feminist-intersectional conceptual framework, analysis reveals that male privilege defined by gendered role and expectation, religious beliefs, rape myths, and bride-price with the associated practice of libation may have contributed to women’s experiences of sexual abuse and violence.
Connect to Consumers and Create Successful Advertising With Hitting the Sweet Spot – Again
Authors: Northfelt Peter
Published: April 2021

Hitting the Sweet Spot – Again: How Consumer Insights Can Inspire Better Marketing and Advertising (2020) includes 14 principles and six perspectives for introductory account planning students. The book, by Kim Bartel Sheehan and Charlie Robertson, is based on the classic text by Lisa Fortini-Campbell.

The principles guide new market researchers through classic strategies to discover consumer insights. The perspectives are more didactic and include tips for using creative briefs and how to become a better account planner.

There are few examples of great advertising using the book’s exact principles. As an introductory text, this textbook orients students to market research fundamentals in an accessible and open-ended way.
Neo-ECHOTIP: A structured protocol for ultrasound-based tip navigation and tip location during placement of central venous access devices in neonates
Authors: Barone Giovanni , Pittiruti Mauro , Biasucci Daniele G , Elisei Daniele , Iacobone Emanuele , La Greca Antonio , Zito Marinosci Geremia , D’Andrea Vito
Published: April 2021

Central venous access devices are often needed in neonates admitted to Neonatal Intensive Care Unit. The location of the tip of the central catheter is usually assessed by post-procedural X-ray. However, this strategy is inaccurate and time consuming. Recent guidelines strongly recommend intra-procedural methods of tip location, to increase the cost-effectiveness of the maneuver and to shorten the time between device placement and utilization. In this regard, real-time ultrasound represents the most promising tool for tip navigation and location in neonates. The aim of this paper is (a) to review all the evidence available about ultrasound-based tip navigation and tip location of central catheters in the neonatal population (b) to propose a novel protocol for tip navigation and location (Neo-ECHOTIP) based on such evidence.
Feelings of Quarantine: Allegories for the Lockdown
Authors: Guenther Linus Paul Frederic
Published: April 2021

This case study shows how allegories are a means to express the inexpressible and how Allegory Analysis can be a method to reveal it and bring out the subjective meaning making, life script ideology, and capability to deal with the ambivalent in critical life situations. From a cultural psychological perspective, the research is based on feelings during the quasi-quarantine period of the COVID-19 pandemic. The study tries to understand the coping strategies with which people deal with a psychological crisis in general concerning for the COVID-19 lockdown. It discusses further ways to deal with the ambivalences and subjective meaning making arousing through such a crisis. The case study analysis of Miss K. not only showed her meaning making processes and attitude of life but also showed how to deal with the uncertainty during the critical lockdown period. Through her allegories, she utters her current life script ideology that living nowadays means to function like a machine while being creative, self-reflective at the same time. Her meaning making process counterbalanced between the voice of being delivered to withdrawal or depression versus the voice of being able to learn, connect, and relax. Her coping strategy was bearing the ambivalence in a psychological crisis with faith.
Rethinking the relationship between reverse burdens and the presumption of innocence
Authors: Allen Jackson
Published: April 2021

Criminal lawyers regard burdens of proof placed on the accused with deep suspicion. Recently, this suspicion has spurred an interest in how to reconcile these so-called ‘reverse burdens’ with the rule that it is for the prosecution to prove guilt beyond a reasonable doubt in a criminal trial. Though views on this differ among commentators, all reach their conclusions by reference to the presumption of innocence (PoI). Unfortunately, such analysis frequently falls prey to a serious error. Namely, the existing literature fails to adequately distinguish the thin conception of the PoI (a trial rule) from a thick PoI (a general norm of the criminal law) or ignores the distinction entirely. In either case, failure to appreciate this distinction and attend to its consequences raises significant doubt that existing analyses of reverse burdens are sound. This article addresses this failure and offers a fresh approach to reconciling reverse burdens and the PoI.
Use of universally offered family planning services – a cohort study in the city of Vantaa, Helsinki metropolitan area, Finland
Authors: Saloranta Tuire , Gyllenberg Frida , But Anna , Gissler Mika , Laine Merja K. , Heikinheimo Oskari
Published: April 2021

Aims: Knowledge about the women reached by public family planning services is scarce. The means for provision of these services that are pivotal for women’s health and empowerment varies globally. In Finland, family planning services are offered free of charge, but often separately for different age groups. City of Vantaa offers these services for all female residents without age limit. The aim of this study was to describe the characteristics of the women using public family planning services. Methods: We assessed the sociodemographic and reproductive characteristics of women aged 15–44 using ( n = 11,790) and not using ( n = 42,931) these services in 2013–2014. We obtained adjusted odds ratios (AORs) and 95% confidence intervals (95%CIs) for service use by multivariate logistic regression. Results: Women under 35 years of age had higher odds of service use compared with those over 35 (AORs ranging from 2.79 [95%CI 2.54–3.07] for 15–19 year-olds to 1.81 [95%CI 1.69–1.95] for 30–34 year-olds). Women speaking a foreign native language used services less when aged under 30 and more when aged 35–44 compared with women speaking the national languages. Women with a history of delivery, induced abortion or sexually transmitted infections, or with a lower socioeconomic or educational status were more likely to use the services. Conclusions: Young women in general were more likely to use free-of-charge family planning services. In contrast, young women speaking a foreign native language were underrepresented among service users. It is important to recognise and actively reach underrepresented groups, such as young women with a foreign background, to optimise equal access to family planning services.
Neoliberalism’s influence on American universities: How the business model harms students and society
Authors: Morgan Hani
Published: April 2021

The influence of neoliberalism on colleges and universities leads to conditions that make it difficult for students from low-income families to profit from higher education. It contributes to a less rigorous learning environment and to other consequences that harm various groups of people. This article focuses on how the corporate model that neoliberal ideology promotes leads universities to implement practices that prevent marginalized groups from benefitting from the higher education system. In addition, it mentions how these practices contribute to a less-than-optimal learning environment for many students and to other negative outcomes. Finally, it offers examples of different kinds of activism that can reduce the deleterious effects of neoliberalism.
A novel composite cotton yarn with phase change and electrical conductivity functions
Authors: Ke Guizhen , Jin Xinya , Cai Guangming , Li Wenbin , Xu Anchang
Published: April 2021

PAN/PEG/CNT/cotton composite yarn (PPCCY) was fabricated by impregnating PEG2000–10000 into CNT/cotton yarn (CCY) and coating electrospun PAN around its surface. The effects of PEG type on the morphology, structure, electrical resistance and phase change behavior of the produced composite yarns were studied thoroughly by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), thermal gravimetric(TG), electrical resistance tester and infrared thermal images. The experimental results indicated that the resulting compound yarn consisted of conductive yarn within which the spacing between cotton fibers was fulfilled by PEG, rendering phase transition enthalpy from 126–150 Jg−1. The composite yarn exhibited adjustable temperature and thermal storage and electrical conductivity abilities. The composite yarn demonstrated good responsive properties to external electrical and thermal stimuli and had reversible heat conversion and storage, which shows a promise for applications in electrical wearable fabrics.
A Sum of Its Parts: Party Fit and Party Change in the U.S. House
Authors: Lee Daniel J. , Goff Sean M.
Published: April 2021

Previous research has noted the transformation of the American parties since the 1970s, as exhibited in their increased ideological polarization and transformation on social issues like civil rights, abortion, and the environment. We contribute to the literature on party change by theoretically stressing the decentralized and individualistic nature of American parties, while using a measure of party change that is based on legislative behavior beyond roll call voting. Our paper uses social network analysis to analyze the parties from the 93rd to 110th Congresses, utilizing bill cosponsorship to define connections between members. Our analysis illustrates how the core of the party, that is, who are most central in the cosponsorship network, has changed over time. We find evidence that party centrality influenced retirement decisions, thereby reinforcing and contributing to party change.
Progressive Multimedia Exposure for Specific Phobias: A Clinical Case of Claustrophobia and Acrophobia
Authors: Ruiz-García Antonio , Valero-Aguayo Luis
Published: April 2021

We present a multimedia exposure intervention for specific phobias using images and videos in a specific case of claustrophobia and acrophobia. The patient was a 47-year-old woman named “Jane” (anonymized name) who was diagnosed with fear of heights (acrophobia) and fear of confined spaces and enclosed areas (claustrophobia). The procedure was a single-case A-B design with several concurrent baselines, pre-post measurements, and two follow-ups (6 and 12 months). For the assessment, there were several questionnaires on anxiety and phobias and the continuous evaluation of anxiety and heart rate during treatment assays for each session. The treatment consisted of eight sessions of progressive multimedia exposure: images, videos, and in vivo settings. The results showed a decrease in the score for pre-post questionnaires ( Z = −4.196, p < .0010) and also a total decrease in anxiety in the different baselines (PND 100%). The benefits were maintained during 1 year of follow-up. After the treatment, “Jane” could be confronted with situations she previously feared, such as being on floors of different levels (up to ninth floor), in closed places, in crowded elevators, and traveling on buses and trains for long distances.
Differential Effects of Sound Intervention and Rest on Cardiovascular Parameters in Cancer Patients: A Randomized Cross-over Trial
Authors: Hohneck Anna , Reyser Christina , Merx Kirsten , Weingärtner Simone , Mavratzas Athanasios , Schumacher Gerhard , Linhuber Christoph , Hofmann Wolf-Karsten , Burkholder Iris , Hofheinz Ralf-Dieter
Published: April 2021

Background:

Music therapy or sound interventions were shown to confer beneficial effects in patients with cancer for instance in terms of pain or fear relief and improvement of other patient reported outcomes. Cardiovascular parameters, especially heart rate variability (HRV) were found to have prognostic implications in cancer patients. In this trial we aimed to investigate the effects of a sound intervention on cardiovascular parameters compared to rest in patients with cancer.

Methods and results:

Using a randomized cross-over design, 52 patients (male 13, female 39) with cancer were recruited to receive both a 15-minute sound intervention and a 15-minute rest intervention within 4 weeks with at least a one-week blanking period. Cardiovascular parameters (among others HRV, aortic pulse wave velocity [PWV], augmentation index [Aix], aortic blood pressure [BP], heart rate [HR]) were assessed immediately before (pre) and after (post) the intervention had taken place. HRV (Root mean square of successive RR interval differences [RMSSD, ms]) significantly increased, during sound intervention (median RMSSD pre 24 [range 5-112] vs post 22 [range 9-141], P = .03). Likewise, median PWV, as a direct marker of arterial stiffness, was significantly reduced by sound intervention ([m/s] pre 8.5 [range 5.6-19.6] vs post 8.3 [range 5.6-15.6], P = .04). For both parameters no statistically significant change during rest was observed. HR was lowered by both, rest ( P < .0001) and sound intervention ( P = .02), with a more pronounced effect by rest. A significant increase in systolic aortic blood pressure was shown by rest ([mmHg] median 101 [range 78-150] vs post median 103 [range 71-152], P = .04) but not during sound intervention ( P = .59), while rest intervention led to a decrease in resistance index (pre median 33 [range 13-92] vs post median 32 [11-84], P = .02).

Conclusion:

In comparison with rest, a single sound intervention in patients with cancer improved cardiovascular parameters commonly associated with increased stress levels. Studies with longer follow-up and multiple interventions are warranted.

Trial Registration:

ISRCTN registry 70947363.
The Utility of Duplex Ultrasonography Surveillance in Identifying Failing Aortobifemoral Grafts
Authors: Maloni Krystal , Calligaro Keith D. , Madden Nicholas , Troutman Douglas , Vani Kunal , Dougherty Matthew J.
Published: April 2021

Objective:

The Society for Vascular Surgery stated there are a lack of studies describing long-term surveillance for aortobifemoral (AoBF) bypasses. Our goal was to investigate the value of DU studies as a surveillance tool for AoBF bypasses.

Methods:

We retrospectively identified patients in our prospectively maintained database who underwent AoBF bypasses between 1995-2018. Surveillance was performed routinely with DU post-operatively, every 6 months for 1 year, and then annually. We considered “abnormal” DU findings to include peri-graft fluid, pseudoaneurysm or, peak systolic velocities (PSVs) > 350 cm/sec or PSV ratio > 3.5 anywhere from the proximal aortic to distal femoral anastomosis. If abnormalities were identified patients underwent intervention or shorter surveillance intervals.

Results:

Of 153 AoBF bypasses, 60 patients with 120 graft limbs fulfilled our post-operative surveillance protocol with a mean follow-up of 4.0 years (0.5-24 years). “Normal” DU surveillance studies were documented throughout follow-up in 112 (93%) limbs. Of these, 2 (1.7%) developed acute limb occlusion. Eight (6.7%) limbs had “abnormal” DU findings: 5 failing grafts with focal elevated PSVs, 2 with peri-graft fluid leading to a diagnosis of an infected graft, and 1 with a pseudoaneurysm (PSA). Contrast arteriography or CT-angiography confirmed > 75% diameter stenosis, fluid or PSA in all 8 limbs. Graft revision (5 endovascular, 2 surgical) was performed in 7 of the 8 limbs initially or after 2 successive “abnormal” DU studies within 6 weeks of each other; 1 patient refused intervention. Without surveillance, urgent or emergent treatment might have proved necessary in 7.5% (7 + 2 = 9/120) of cases instead of only 1.7% (2/120) of cases.

Conclusion:

Vascular surgeons should adopt DU as a useful surveillance tool to identify AoBF bypasses that are failing or have other problems not identified clinically. Persistence of “abnormal” DU findings should prompt operative or endovascular intervention.
Surgical Excision of a Functional Carotid Body Tumor Presenting Intraoperative Hypertensive Crisis: A Case Report and Literature Review
Authors: Gu Guangchao , Liu Zhili , Song Xitao , Zheng Yuehong
Published: April 2021

Carotid body tumor (CBT) is a rare neoplasm arising from the carotid bifurcation. Functional CBTs are extremely rare and are usually associated with elevated serum catecholamine and catecholamine-induced symptoms such as paroxysmal hypertension, palpitations, dizziness, flushing and tachycardia. We reported a 47-year-old female with a functional CBT that was biochemically silent and had no catecholamine-induced symptoms preoperatively, but experienced hypertensive crisis during surgical excision of the lesion. Postoperative pathology confirmed the diagnosis of CBT, and a functional tumor was considered due to the hypertensive crisis during surgical manipulation of the lesion. Under careful management of intraoperative blood pressure and close monitoring of vital sign along with adequate crystalloid infusion after surgery, the tumor was successfully excised and the patient recovered uneventfully during a follow-up period of 12 months. To the best of our knowledge, this is an unusual report of functional CBT presenting merely hypertensive crisis during surgery, with no elevated serum catecholamine or catecholamine-induced symptoms preoperatively. Clinicians should be aware of such lesions so that appropriate medication and gentle manipulation are given when encountering hypertensive crisis during surgical excision of CBTs, to prevent life-threatening cardiovascular complications. The appropriate management and recognition of functional CBTs were also discussed by means of a review of the literature.
Facilitation effect of incidental environmental context on the computer screen for paired-associate learning
Authors: Isarida Takeo , Isarida Toshiko K , Kubota Takayuki , Yin Yannan , Sakakibara Ibuki , Kato Daiki
Published: April 2021

Three experiments, in which a total of 198 undergraduates engaged, investigate whether the incidental environmental context on the computer screen influences paired-associate learning. Experiment 1 compared the learning of foreign- and native-language words between a constant context condition, where the stimulus and response pairs were presented twice on the same 5-s video background context, and a varied context condition, where the pairs were presented twice on different video contexts. Repetition in the same context resulted in better learning than in different contexts, evaluated with a paper-and-pencil test. Experiment 2 investigated learning of paired-associate foreign and native words in the same video contexts, or photograph contexts, or on a neutral grey background. Both the video and the photograph contexts equally facilitated the paired-associate learning compared with the grey background. Experiment 3 investigated whether the incidental environmental context similarly facilitated face–name paired-associate learning. We added a new condition of spot illustrations, and a second testing 1 day later. The repetition of face–name pairs within the same complex incidental environmental context on the computer screen (either video or photograph background) facilitated the paired-associate learning. There was no significant difference in learning performance between video and photograph background contexts, which were significantly better than grey or spot-illustration backgrounds which did not differ from each other. The retention interval did not interact with the effect of the background. The present results show that repetition within the same video or photograph context, covering the entire background of the video screen on which each item pair was superimposed, facilitates paired-associate learning.
Recasting Service Quality for AI-Based Service
Authors: Noor Nurhafihz , Rao Hill Sally , Troshani Indrit
Published: April 2021

Artificial intelligence service agents (AISA), such as chatbots and virtual assistants, are becoming increasingly pervasive in service. Research to date has not adequately addressed how the unique nature of AISA shape consumers’ service quality expectations. A deeper understanding of AISA service quality is important for their successful deployment in the service sector. To address this gap, we reviewed marketing and information systems literatures and conducted qualitative in-depth interviews with 37 informants, inclusive of 28 AISA users and nine AISA experts. We developed a conceptual framework for how consumers use and evaluate AISA. Twelve service quality dimensions emerged from the qualitative evidence representing AISA service quality, two of which align with AISA’s unique characteristics. The study extends the service quality theory to a new context and offers fresh insights for theory and practice. It culminates with a research agenda to advance research on AISA service quality.
Quantification of Training Load Relative to Match Load of Youth National Team Soccer Players
Authors: Szigeti Gyorgy , Schuth Gabor , Revisnyei Peter , Pasic Alija , Szilas Adam , Gabbett Tim , Pavlik Gabor
Published: April 2021

Background:

Previous studies have examined the training load relative to match load in club settings. The aims of this study were to (1) quantify the external training load relative to match load in days before a subsequent international game and (2) examine the cumulative training load in relation to match load of U-17 national team field soccer players.

Hypothesis:

Volume and intensity load parameters will vary between trainings; the farthermost trainings have the highest load gradually decreasing toward the match.

Study Design:

Prospective cohort study.

Level of Evidence:

Level 4.

Methods:

External training load data were collected from 84 youth national team players using global positioning technology between 2016 and 2020. In the national team setting, training load data were obtained from 3 days before the actual match day (MD-3, MD-2, MD-1 days) and analyzed with regard to the number of days up to the game. Volume and intensity parameters were calculated as a percentage of the subsequent match load.

Results:

Significant differences were found between MD-1 and MD-2, as well as between MD-1 and MD-3 for most volume parameters ( P < 0.01; effect sizes [ESs] 0.68-0.99) and high-intensity distance ( P < 0.002; ES 0.67 and 0.73) and maximum velocity ( P < 0.002; ES 0.82) as intensity parameters. Most cumulative values were significantly different from total duration ( P < 0.001, common language ES 0.80-0.96).

Conclusion:

The training volume gradually decreased as match day approached, with the highest volume occurring on MD-3. Intensity variables, such as maximum velocity, high-intensity accelerations, and meterage per minute were larger in MD-1 training relative to match load. Training volume was lowest in MD-1 trainings and highest in MD-3 trainings; intensity however varies between training days.

Clinical Relevance:

The findings of this study may help to understand the special preparational demands of international matches, highlighting the role of decreased training volume and increased intensity.
The Role of Personality in COVID-19-Related Perceptions, Evaluations, and Behaviors: Findings Across Five Samples, Nine Traits, and 17 Criteria
Authors: Zettler Ingo , Schild Christoph , Lilleholt Lau , Kroencke Lara , Utesch Till , Moshagen Morten , Böhm Robert , Back Mitja D. , Geukes Katharina
Published: April 2021

Individuals and institutions around the world have been affected by the coronavirus disease 2019 (COVID-19). Herein, we investigate the role of basic (Big Five and HEXACO) and specific (Dark Factor of Personality, Narcissistic Rivalry, and Narcissistic Admiration) personality traits for 17 criteria related to COVID-19, grouped into (i) personal perceptions in terms of risks and worries about the disease, (ii) behavioral adjustments in terms of following health recommendations and hoarding, and (iii) societal evaluations in terms of the appropriateness of different measures and feelings of social cohesion. (Internal) Meta-analytic results across five samples from two countries (overall N = 19,718) show—next to gender and age effects—the importance of several traits, including Emotionality/Neuroticism for personal perceptions and anti- or prosocial traits for behavior in line with health recommendations. The investigation highlights the importance of individual differences in uncertain and changing situations in general and during the COVID-19 pandemic in particular.
Regaining legitimacy after an information systems implementation failure: Case of a National Blood Bank Service
Authors: Saxena Deepak
Published: April 2021

This teaching case discusses the aftermath of an implementation failure and resultant legitimacy crisis in a national blood bank service. The implementation of the new blood bank system was abandoned after significant loss of public money. This was followed by a review with the Auditor General and a subsequent debate in the public accounts committee of the national parliament. The case follows how the organisation repaired its legitimacy after the implementation failure and how it gained further legitimacy when planning a new implementation. This case helps the students in understanding diverse assessment of legitimacy, appreciating the contextual influences on legitimacy claims, and being able to analyse how legitimacy is managed by the organisation in its institutional context.
Proteus syndrome: Rare cause of life-threatening haematuria
Authors: John Jeff , Sood Vishesh , Kesner Ken , Sinha Sunil
Published: April 2021

Proteus syndrome is an extremely rare sporadic hamartomatous condition characterized by random overgrowth of connective, epidermal and bony tissue. Involvement of the genitourinary system in PS is extremely rare and if present, are usually caused by enlarging cysts or neoplasms. Infrequent reports of testicular, renal and bladder involvement have been reported. The involvement of the bladder is predominantly due to vascular malformations with only three previous cases reported in literature. We report the fourth case – one of a 14-year-old male with known Proteus syndrome that presented to the emergency unit with life threatening haematuria. He appeared acutely ill in haemorrhagic shock with a haemoglobin of 4.3 g/dL on index presentation. Initial acute management involved aggressive resuscitation of the patient with intravenous fluids and blood transfusion. Cystoscopy revealed an actively-bleeding extensive venous anomalies of the bladder wall that were successfully-sealed with electrocautery.
Outcomes of minimally invasive nephroureterectomy in octogenarians: a single centre experience and review of literature
Authors: McCabe Gerard , Hendry Jane , Qureshi Khaver N , Oades Grenville , Umez-Eronini Nkem , Sahni Dhruv , Aboumarzouk Omar M
Published: April 2021

Introduction:

The gold standard treatment for high risk upper tract urothelial cancers is radical nephroureterectomy. Little evidence exists specifically directed for octogenarians with this disease, therefore we highlight our centre’s outcomes and compare to current literature.

Methods:

Demographic, operative and postoperative data were collected on all octogenarian patients who underwent minimally invasive radical nephroureterectomy between 2010 and 2018 in a single centre. Outcomes including intraoperative and postoperative complications, disease recurrence rates and survival data were analysed. A literature search was performed, with six included articles of cases series and retrospective cohort studies after screening of full manuscripts.

Results:

Twenty-three patients of average age 82.6 years (range 80–85) were included. Length of stay was median 10 days (range 5–53). Six patients (25%) had postoperative complications ranging from Clavien–Dindo classification 2–3. Eight patients were found to have recurrence, with median time to recurrence of 18 months. Of the 13 patients who died during a follow-up of median 38.4 months, five patients (22%) died of disease related to their original diagnosis (median survival 20 months).

Conclusions:

From this single centre case series results combined with a review of current literature, radical nephroureterectomy is safe for octogenarian patients for upper tract urothelial cancers when appropriately selected. Further work will need to be carried out to assess the role of lymphadenectomy and adjuvant chemotherapy in the older patient cohort.

Level of evidence

Level 4
The Association Between Problem Recognition, Race/Ethnicity, and Professional Help-Seeking Intentions Across Psychological Disorders
Authors: Chakawa Ayanda , Shapiro Steven K.
Published: April 2021

While 75% of mental health problems emerge by young adulthood, there is a strong reluctance during this developmental stage to seek professional help. Although limitations in mental health literacy, such as incorrect problem recognition, may hinder professional help-seeking intentions, the relationship between these variables has been understudied among young adults in the United States (U.S.) and racial/ethnic differences in help-seeking intentions for specific disorders have not been well explored. Using a vignette-based design, the current study examines the association between psychological disorder recognition and professional help-seeking intentions among 1,585 Black/African American and White/European American young adults. Correctly identifying a psychological disorder was significantly associated with intentions to seek professional help for several disorders and race/ethnicity significantly influenced intentions to seek professional help for some disorders. Implications for ways to address unmet mental health care needs, especially among racially/ethnically diverse young adults, and directions for future research are discussed.
The Impact of Personality Pathology Across Three Generations: Evidence From the St. Louis Personality and Intergenerational Network Study
Authors: Shields Allison N. , Oltmanns Thomas F. , Boudreaux Michael J. , Paul Sarah E. , Bogdan Ryan , Tackett Jennifer L.
Published: April 2021

Personality disorder (PD) symptoms in a parent generation may confer risk for problems in future generations, but intergenerational transmission has not been studied beyond parent–child effects. We examined the generational transfer of risk associated with PDs using structural models of grandparent personality pathology and grandchild psychopathology among 180 adults (mean age = 66.9 years), 218 of their children (mean age = 41.2 years), and 337 of their grandchildren (mean age = 10.5 years). We found evidence for general and heterotypic domain-specific transmission. Specifically, broad grandparent personality pathology was associated with broad grandchild psychopathology ( b = 0.15, 95% confidence interval [CI] = [−0.01, 0.31]); at the domain level, grandparent internalizing personality pathology was associated with grandchild externalizing psychopathology ( b = 0.06, 95% CI = [0.01, 0.12]). Neither association was significantly mediated by parental personality pathology. These findings indicate that personality pathology in one generation confers risk for psychopathology across subsequent generations. Such intergenerational transmission operates across broad rather than specific (i.e., individual disorder) psychopathology domains.
A Transdiagnostic Application of the Contrast-Avoidance Model: The Effects of Worry and Rumination in a Personal-Failure Paradigm
Authors: Jamil Nimra , Llera Sandra J.
Published: April 2021

The contrast-avoidance model (CAM) originally described emotion-regulation patterns in generalized anxiety disorder (GAD), proposing that chronic worry maintains negative emotionality, thus attenuating strong shifts into negative emotion (emotional contrasts) as a result of adverse events. Rumination may function similarly in depression, although this proposal requires further research. In this study, we aimed to (a) test the transdiagnostic applicability of the CAM and (b) enhance ecological validity of the CAM using personally relevant in vivo exposures. Participants were assigned to worry, rumination, relaxation, or neutral inductions, then engaged in a challenging task followed by false-negative performance feedback. Relative to baseline, worry and rumination both increased negative emotionality, which significantly reduced emotional contrast in response to failure feedback. Furthermore, participants in the GAD-analogue group experienced prior worry as helpful in coping with failure feedback, and participants in the MDD-analogue group reported rumination as helpful relative to comparison inductions. Overall, findings support the transdiagnostic application of CAM.
Land, Gender, and Class Relations in Ghana’s Cassava Frontier
Authors: Torvikey Gertrude Dzifa
Published: April 2021

Lands for domestic production in rural areas have increasingly shrunk and the rules of access have changed as corporate land grabs intensify in many parts of the Global South. These occurrences are outcomes of processes that are packaged in state policies that promote market intervention in agricultural production. In Ghana, state initiatives promote large-scale industrial cassava production in rural areas. This article discusses land grabs in cassava frontier communities, their impacts on land access rules, and social relations. It is argued that while land, gender, and class relations change as a result of competition over, and commodification of, land resources, community institutions, namely chiefs and families, play significant roles that legitimize dispossession of social groups whose land-use rights are derived from other hierarchies. The changes in production relations in the communities are linked to processes linked to older commodity production. Similar changes have occurred at the household level as circuits of commodity production integrate within domestic production. The article highlights different struggles by women and migrants to renegotiate their access rules and their local citizenship status.
Changes of Periodontal Tissues Because of Orthodontic Treatment: A Retrospective Study
Authors: Alzoman Hamad , Alamoud Khalid , Alomran Waad K. , Almudhi Abdullazez , Bindayel Naif A.
Published: April 2021

Aim:

To evaluate the periodontal status before and after orthodontic treatment and to analyze the confounding factors associated with it.

Materials and Methods:

The present retrospective study analyzed pre- and posttreatment records of a total of 60 patients. Intraoral digital photographs before and after the orthodontic treatment were used to measure the following three periodontal variables: (a) width of the keratinized gingiva, (b) gingival recession, and (c) the status of interdental papilla. The ImageJ 46 software imaging program was used to perform the required measurements. The clinical data were then analyzed in an association with the participants’ demographic data, the type of orthodontic tooth movement, and other confounding factors. The data obtained were manually entered into the statistical package and analyzed using a significance level set at P < .05. Descriptive statistics, paired t-tests, and Pearson’s correlation analysis were used to identify differences among the studied variables.

Results:

Among the 60 patients, the majority (66.7%) were females. Most cases of the treated malocclusion were Class II, and most patients underwent intrusion and retrusion movements. The width of keratinized gingiva increased for most sites of upper teeth. In contrast, the lower teeth showed a mix of improvement and compromised width of keratinized gingiva. As a measure of gingival recession, the difference of clinical crown height revealed the tendency toward a reduced clinical crown height for most sites. Upper left lateral incisors and canines showed significant values with regard to keratinized gingival width measurements and tooth movements such as extrusion and intrusion movements. Likewise, with regard to the clinical crown height, upper right central incisors showed significant differences when correlated with the interincisal angle, lower incisors to the mandibular plane, and upper incisors to the NA line. The upper lateral incisors also showed significant correlations to certain cephalometric measurements.

Conclusions:

The orthodontic treatment was found to exert a significantly positive impact on the surrounding periodontium, particularly in the upper canine areas. Likewise, various types of tooth movement were found to positively affect the periodontium.
Anatomic Differences in the Sagittal Knee Joint Are Associated With ACL Injury: Results From a Skeletally Immature Korean Population
Authors: Kwak Yoon Hae , Nam Ji-Hoon , Koh Yong-Gon , Park Byoung-Kyu , Kang Kyoung-Tak
Published: April 2021

Background:

Differences in tibiofemoral articular morphology are associated with risks of anterior cruciate ligament (ACL) injury.

Purpose:

To determine whether bony and cartilaginous morphological characteristics are related to ACL injury in pediatric patients and to investigate any differences according to sex.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 200 skeletally immature Korean patients from a single institution were included in this study; 100 patients had an ACL injury, and 100 had an intact ACL. Condylar morphology and tibial slopes were evaluated and compared between the groups, and differences between sexes were evaluated in the ACL-injured group.

Results:

The lateral femoral curvature was significantly greater and the lateral and medial tibial curvatures were significantly smaller in the ACL-injured group than in the intact group ( P < .01 for all). In addition, the lateral and medial femoral curvatures as well as the lateral tibial curvature were significantly smaller in female than in male patients ( P < .01 for all). Both the medial and lateral tibial slopes were greater in the ACL-injured versus intact group (medial slope, 5.5° vs 5.0°; lateral slope, 3.0° vs 1.3°, respectively); this difference was statistically significant for lateral tibial slope ( P = .026). No sex-based differences were found for medial or lateral tibial slope.

Conclusion:

Femoral and tibial curvatures as well as lateral tibial slope were significantly different between the ACL-injured and ACL-intact patients, and the lateral tibial curvature was significantly smaller in female than in male patients. Medial and lateral tibial slopes were not associated with a significant difference in ACL injury between male and female patients.
Migrant Detention and COVID-19: Pandemic Responses in Four New Jersey Detention Centers
Authors: Tosh Sarah R. , Berg Ulla D. , León Kenneth Sebastian
Published: April 2021

On March 24, 2020, a 31-year-old Mexican national in Bergen County Jail, New Jersey, became the first federal immigration detainee to test positive for the novel coronavirus (COVID-19). By April 10, 2020, New Jersey had more confirmed COVID-19 cases among immigration detainees than any other state in the nation. This article examines the relationship between COVID-19 and processes of migrant detention and deportation through a case study of New Jersey — an early epicenter of the pandemic and part of the broader New York City metro area. Drawing on publicly available reports and in-depth interviews with wardens, immigration lawyers, advocates, and former detainees, we describe the initial COVID-19 response in four detention facilities in New Jersey. Our findings suggest that migrant detention and deportation present distinct challenges that undermine attempts to contain the spread of COVID-19. We provide testimonies from migrant detainees who speak to these challenges in unsettling personal terms. Our interviews highlight the insufficient actions by Immigration and Customs Enforcement (ICE) to contain the spread of the pandemic and a troubling lack of due process in immigration court proceedings. Based on these findings, we argue that reducing the number of migrants detained in the United States is needed not only in the context of the COVID-19 pandemic but also as a preventative measure for future health crises. Reductions can be achieved, in part, by reforming federal immigration laws on “mandatory detention.”
Marriage and Divorce Decline during the COVID-19 Pandemic: A Case Study of Five States
Authors: Manning Wendy D. , Payne Krista K.
Published: April 2021

The decline in marriage and divorce was evident prior to the coronavirus disease 2019 pandemic, but it remains unknown whether these patterns have persisted during the pandemic. The authors compared monthly marriage and divorce counts for two years prior to the pandemic (2018 and 2019) and during the pandemic for the five states that published monthly vital statistics data for 2020 (Arizona, Florida, Missouri, New Hampshire, and Oregon). All five states witnessed initial declines in marriage. Counts of marriages in Arizona and New Hampshire rebounded. In contrast, marriage shortfalls occurred in Florida, Missouri, and Oregon. In the early pandemic months, divorces initially declined in all five states and rebounded in Arizona. In the remaining four states, divorce shortfalls have occurred. As more data become available, it will be important to acknowledge these state variations in response to the pandemic.
DNA Methylation at Birth is Associated with Childhood Serum Immunoglobulin E Levels
Authors: Han Luhang , Kaushal Akhilesh , Zhang Hongmei , Kadalayil Latha , Duan Jiasong , Holloway John W. , Karmaus Wilfried , Banerjee Pratik , Tsai Shih-Fen , Wen Hui-Ju , Arshad Syed Hasan , Wang Shu-Li
Published: April 2021

Immunoglobulin E (IgE) is known to play an important role in allergic diseases. Epigenetic traits acquired due to modification of deoxyribonucleic acid (DNA) methylation (DNAm) in early life may have phenotypic consequences through their role in transcriptional regulation with relevance to the developmental origins of diseases including allergy. However, epigenome-scale studies on the longitudinal association of cord blood DNAm with IgE over time are lacking. Our study aimed to examine the association of DNAm at birth with childhood serum IgE levels during early life. Genome-scale DNAm and total serum IgE measured at birth, 5, 8, and 11 years of children in the Taiwan Maternal and Infant Cohort Study were included in the study in the discovery stage. Linear mixed models were implemented to assess the association between cord blood DNAm at ~310K 5′-cytosine-phosphate-guanine-3′ (CpG) sites with repeated IgE measurements, adjusting for cord blood IgE. Identified statistically significant CpGs (at a false discovery rate, FDR, of 0.05) were further tested in an independent replication cohort, the Isle of Wight (IoW) birth cohort. We mapped replicated CpGs to genes and conducted gene ontology analysis using ToppFun to identify significantly enriched pathways and biological processes of the genes. Cord blood DNAm of 273 CpG sites were significantly (FDR = 0.05) associated with IgE levels longitudinally. Among the identified CpGs available in both cohorts (184 CpGs), 92 CpGs (50%) were replicated in the IoW in terms of consistency in direction of associations between DNA methylation and IgE levels later in life, and 16 of the 92 CpGs showed statistically significant associations ( P < .05). Gene ontology analysis identified 4 pathways (FDR = 0.05). The identified 16 CpG sites had the potential to serve as epigenetic markers associated with later IgE production, beneficial to allergic disease prevention and intervention.