bluuebunny/crossref_metadata_2025 huggingface dataset:
A tale of two citizens: The Brey-Dano proportionality gap in UK courts and tribunals
Authors: Hooton Victoria E.
Published: April 2021

The role of proportionality and individual assessments in EU residency and welfare access cases has changed significantly over the course of the last decade. This article demonstrates how a search for certainty and efficiency in this area of EU law has created greater uncertainty, more legal hurdles for citizens, and less consistency in decision-making at the national level. UK case law illustrates the difficulty faced by national authorities when interpreting and applying the rules relating to welfare access and proportionality. Ultimately, the law lacks the consistency and transparency that recent CJEU case law seeks to obtain, raising the question of whether the shift from the Court's previous, more flexible, case-by-case approach was desirable after all.
Endovascular treatment of concomitant innominate and subclavian artery injury with pseudoaneurysms from a gunshot wound in a polytrauma patient
Authors: Wannatoop Tongporn , Slisatkorn Worawong
Published: April 2021

Introduction

Injury of the innominate artery (IA) is associated with high mortality and morbidity, such as a major neurologic event. The aim of this case report was to describe an example of prioritization in polytrauma management by applying endovascular intervention in a difficult case with impending uncal herniation, extensive cerebral infarction, and large pseudoaneurysm from concomitant innominate and right subclavian artery injuries.

Case Report

A 34-year-old woman sustained a gunshot wound to her upper chest that lodged in the anterior triangle of her neck and presented with tension pneumothorax and cardiac arrest, which was successfully resuscitated. Subsequently she developed drowsiness and left hemiparesis, and computerized tomography demonstrated a large right cerebral hemisphere and left cerebellar region infarction with impending uncal herniation and pseudoaneurysms from the IA and proximal right subclavian artery. After emergency craniectomy to avert herniation, endovascular treatment was performed to facilitate vessel repair due to anatomical difficulty and the patient’s unstable condition. She was discharged home 3 weeks after operation, and 2 months postoperatively, she was neurologically intact with no evidence of endoleakage or pseudoaneurysm.

Conclusion

In such a complex polytrauma case, correct prioritization of interventions is crucial to obtaining the best outcomes, and the Endovascular Resuscitation and Trauma Management protocol can be applied as an alternative treatment protocol with good results.
The time in between a case of ‘wrongful’ and ‘rightful’ conviction in the UK: Miscarriages of justice and the contribution of psychology to reforming the police investigative process
Authors: Poyser Sam , Milne Rebecca
Published: April 2021

Wrongful convictions or miscarriages of justice are experienced by justice systems worldwide. At the centre of each miscarriage lies a complex mix of causes. The contribution of the police investigative process and particularly the interview process, to this mix is, however, significant and enduring. Nevertheless, in the UK important inroads have been made with respect to reform in this regard. This has occurred partly in response to revelations of dreadful miscarriages of justice and the findings of ground-breaking psychological research. This research began in earnest in the 1970s, the decade when Noel Jones, a vulnerable young man falsely confessed to, and was wrongfully convicted of, the killing of schoolgirl Janet Commins. It has continued through to the second decade of the 21st century when following a case review, Stephen Hough was rightfully convicted of the same crime; the justice system acknowledging that the original police investigation was flawed and that Jones was ‘wholly exonerated’ (Evans, 2019). Taking these wrongful and rightful convictions as rough ‘start’ and ‘end’ points in time, this article critically examines the contribution of psychological research to bringing about reform of the investigative process and particularly the interview process, in the UK. In doing so, it argues that miscarriages of this nature are now less likely, but that further psychological research and policing reform are required to continue progress already made.
Assessing the efficacy of investigative interviewing training courses: A systematic review
Authors: Akca Davut , Larivière Cassandre Dion , Eastwood Joseph
Published: April 2021

Substantial resources have been dedicated to designing and implementing training courses that focus on enhancing the interviewing skills of police officers. Laboratory research studies and real-world assessments of the effectiveness of interview training courses, however, have found notably mixed results. In this article, empirical studies ( N = 30) that have assessed the effectiveness of police interview and interrogation training courses were systematically reviewed. We found a wide variation in terms of the type, length, and content of the training courses, the performance criteria used to assess the training effectiveness, and the impact of the training courses on interviewing performance. Overall, the studies found that basic interviewing skills can be developed to a certain level through even short evidence-based training courses. More cognitively demanding skills, such as question selection and meaningful rapport-building, showed less of an improvement post training. The courses that included multiple training sessions showed the most consistent impact on interviewing behavior. This review also indicated a need for more systematic research on training effectiveness with more uniform and longer-term measures of effectiveness. Our findings should help guide future research on this specific topic and inform the training strategies of law enforcement and other investigatory organizations.
Manifold reduction techniques for the comparison of crank angle-resolved particle image velocimetry (PIV) data and Reynolds-averaged Navier-Stokes (RANS) simulations in a spark ignition direct injection (SIDI) engine
Authors: Fang Xiaohang , Shen Li , Willman Christopher , Magnanon Rachel , Virelli Giuseppe , Davy Martin H , Stone Richard
Published: April 2021

In this article, different manifold reduction techniques are implemented for the post-processing of Particle Image Velocimetry (PIV) images from a Spark Ignition Direct Injection (SIDI) engine. The methods are proposed to help make a more objective comparison between Reynolds-averaged Navier-Stokes (RANS) simulations and PIV experiments when Cycle-to-Cycle Variations (CCV) are present in the flow field. The two different methods used here are based on Singular Value Decomposition (SVD) principles where Proper Orthogonal Decomposition (POD) and Kernel Principal Component Analysis (KPCA) are used for representing linear and non-linear manifold reduction techniques. To the authors’ best knowledge, this is the first time a non-linear manifold reduction technique, such as KPCA, has ever been used in the study of in-cylinder flow fields. Both qualitative and quantitative studies are given to show the capability of each method in validating the simulation and incorporating CCV for each engine cycle. Traditional Relevance Index (RI) and two other previously developed novel indexes: the Weighted Relevance Index (WRI) and the Weighted Magnitude Index (WMI), are used for the quantitative study. The results indicate that both POD and KPCA show improvements in capturing the main flow field features compared to ensemble-averaged PIV experimental data and single cycle experimental flow fields while capturing CCV. Both methods present similar quantitative accuracy when using the three indexes. However, challenges were highlighted in the POD method for the selection of the number of POD modes needed for a representative reconstruction. When the flow field region presents a Gaussian distribution, the KPCA method is seen to provide a more objective numerical process as the reconstructed flow field will see convergence with an increasing number of modes due to its usage of Gaussian properties. No additional criterion is needed to determine how to reconstruct the main flow field feature. Using KPCA can, therefore, reduce the amount of analysis needed in the process of extracting the main flow field while incorporating CCV.
Reading texts, reading people: Cognitive literary science and pedagogy
Authors: Tucker Amanda
Published: April 2021

Cognitive literary science has explored the the complex relationship between literary reading and social cognition. However, this insightful work about reading literature is frequently distanced from discussions about teaching literature. This essay discusses the results and ramifications of a pedagogical study conducted in two sections of an introductory literature course that was redesigned around cognitive literary studies. Qualitative and quantitative data is collected and analyzed in order to see if a pedagogy rooted in cognitive literary science affects students’ perspective-taking. The essay also illustrates how such a teaching practice might be incorporated into any undergraduate literature curriculum.
12 Survival-related differentially expressed genes based on the TARGET-osteosarcoma database
Authors: Rothzerg Emel , Xu Jiake , Wood David , Kõks Sulev
Published: April 2021

The Therapeutically Applicable Research to Generate Effective Treatments (TARGET) project aims to determine molecular changes that drive childhood cancers, including osteosarcoma. The main purpose of the program is to use the open-source database to develop novel, effective, and less toxic therapies. We downloaded TARGET-OS RNA-Sequencing data through R studio and merged the mRNA expression of genes with clinical information (vital status, survival time and gender). Further, we analyzed differential gene expressions between dead and alive patients based on TARGET-OS project. By this study, we found 5758 differentially expressed genes between deceased and alive patients with a false discovery rate below 0.05; 4469 genes were upregulated in deceased patients compared to alive, whereas 1289 genes were downregulated. The survival-related genes were obtained using Kaplan–Meier survival analysis and Cox univariate regression (KM < 0.05 and Cox P-value < 0.05). Out of 5758 differentially expressed genes, only 217 have been associated with overall survival. Eight survival-related downregulated genes ( ERCC4, CLUAP1, CTNNBIP1, GCA, RAB40C, SIRPA, USP11, and TCN2) and four survival-related upregulated genes ( MUC1, COL13A1, JAG2 and KAZALD1) were selected for further analysis as potential independent prognostic candidate genes. This study may help to discover novel prognostic markers and potential therapeutic targets for osteosarcoma.
The role of calcium-sensing receptor signaling in regulating transepithelial calcium transport
Authors: Tan Rebecca Siu Ga , Lee Christy Hui Lin , Dimke Henrik , Todd Alexander R
Published: April 2021

The calcium-sensing receptor (CaSR) plays a critical role in sensing extracellular calcium (Ca2+) and signaling to maintain Ca2+homeostasis. In the parathyroid, the CaSR regulates secretion of parathyroid hormone, which functions to increase extracellular Ca2+levels. The CaSR is also located in other organs imperative to Ca2+homeostasis including the kidney and intestine, where it modulates Ca2+reabsorption and absorption, respectively. In this review, we describe CaSR expression and its function in transepithelial Ca2+transport in the kidney and intestine. Activation of the CaSR leads to G protein dependent and independent signaling cascades. The known CaSR signal transduction pathways involved in modulating paracellular and transcellular epithelial Ca2+transport are discussed. Mutations in the CaSR cause a range of diseases that manifest in altered serum Ca2+levels. Gain-of-function mutations in the CaSR result in autosomal dominant hypocalcemia type 1, while loss-of-function mutations cause familial hypocalciuric hypercalcemia. Additionally, the putative serine protease, FAM111A, is discussed as a potential regulator of the CaSR because mutations in FAM111A cause Kenny Caffey syndrome type 2, gracile bone dysplasia, and osteocraniostenosis, diseases that are characterized by hypocalcemia, hypoparathyroidism, and bony abnormalities, i.e. share phenotypic features of autosomal dominant hypocalcemia. Recent work has helped to elucidate the effect of CaSR signaling cascades on downstream proteins involved in Ca2+transport across renal and intestinal epithelia; however, much remains to be discovered.
Medical image security authentication method based on wavelet reconstruction and fractal dimension
Authors: Sun Tiankai , Wang Xingyuan , Lin Da , Bao Rong , Jiang Daihong , Ding Bin , Li Dan
Published: April 2021

In this article, based on wavelet reconstruction and fractal dimension, a medical image authentication method is implemented. According to the local and global methods, the regularity of the mutation structure in the carrier information is analyzed through a measurement defined in the medical image transformation domain. To eliminate the redundancy of the reconstructed data, the fractal dimension is used to reduce the attributes of the reconstructed wavelet coefficients. According to the singularity of the fractal dimension of the block information, the key features are extracted and the fractal feature is constructed as the authentication feature of the images. The experimental results show that the authentication scheme has good robustness against attacks, such as JPEG compression, multiplicative noise, salt and pepper noise, Gaussian noise, image rotation, scaling attack, sharpening, clipping attack, median filtering, contrast enhancement, and brightness enhancement.
Comparative Analysis Between Mesenchymal Stem Cells From Subcutaneous Adipose Tissue and Omentum in Three Types of Patients: Cancer, Morbid Obese and Healthy Control
Authors: Posada-González María , Villagrasa Alejandro , García-Arranz Mariano , Vorwald Peter , Olivera Rocío , Olmedillas-López Susana , Vega-Clemente Luz , Salcedo Gabriel , García-Olmo Damián
Published: April 2021

Objective. The aims of this study are to compare 2 origins of adipose-derived mesenchymal stem cells (MSCs) (omentum and subcutaneous) from 2 pathologies (morbid obesity and cancer) vs healthy donors. Adipose tissue has revealed to be the ideal MSC source. However, in developing adipose-derived stem cells (ASCs) for clinical use, it is important to consider the effects of different fat depots and also the effect of donor variability. Methods. We isolated and characterized the membrane markers and differentiation capacities of ASCs obtained from patients with these diseases and different origin. During the culture period, we further analysed the cells’ proliferation capacity in an in vitro assay as well as their secretome. Results. Adipose-derived stem cells isolated from obese and cancer patients have mesenchymal phenotype and similar cell proliferation as ASCs derived from healthy donors, some higher in cells derived from subcutaneous fat. However, cells from these 2 types of patients do not have the same differentiation potential, especially in cancer patients from omentum, and exhibit distinct secretion of both pro-inflammatory and regulatory cytokines, which could explain the differences in use due to origin as well as pathology associated with the donor. Conclusion. Subcutaneous and omentum ASCs are slightly different; omentum generates fewer cells but with greater anti-inflammatory capacity. Adipose-derived stem cells from patients with either obesity or cancer are slightly altered, which limits their therapeutic properties.
Can We Innovatively Modify the Surgical Helmets to Protect Against the Droplets and Aerosols of COVID-19?
Authors: Sahu Dipit , Bagaria Vaibhav , Rathod Vaibhavi
Published: April 2021

We tested the filtration efficiency of Stryker T5 surgical helmets with and without the addition of a filter medium. Two particle counters were used to count the particles of sizes .5 μm, 1 μm, and 5 μm, both inside and outside the Stryker T5 helmet, concurrently. The total inward leakage (TIL) for the helmet with and without the filter was zero for 5 μm particles at all time points. The TIL (3.4) for the .5 μm particles decreased significantly after application of the filter (1.7; P = .007). We recommend that an N95 should be used inside the helmet system.
Salidroside Protects Against Influenza A Virus-Induced Acute Lung Injury in Mice
Authors: Lu Rufeng , Wu Yueguo , Guo Honggang , Zhang Zhuoyi , He Yuzhou
Published: April 2021

Influenza A virus infections can cause acute lung injury (ALI) in humans; thus, the identification of potent antiviral agents is urgently required. Herein, the effects of salidroside on influenza A virus-induced ALI were investigated in a murine model. BALB/c mice were intranasally inoculated with H1N1 virus and treated with salidroside. The results of this study show that salidroside treatment (30 and 60 mg/kg) significantly attenuated the H1N1 virus-induced histological alterations in the lung and inhibited inflammatory cytokine production. Salidroside also decreased the wet/dry ratio, viral titers, and Toll-like receptor 4 expression in the lungs. Therefore, salidroside may represent a potential therapeutic reagent for the treatment of influenza A virus-induced ALI.
An Insight Into Intestinal Microbiota of Spontaneously Hypertensive Rats After Valsartan Administration
Authors: Qi Ying-Zi , Jiang Yue-Hua , Jiang Ling-Yu , Shao Lin-Lin , Yang Xue-Song , Yang Chuan-Hua
Published: April 2021

It has been proven a close relationship between intestinal microbiota and hypertension. Valsartan is a widely used ARB antihypertensive drug; so far, the effect of valsartan on intestinal microbiota remains largely unexplored. Herein, we evaluated the composition, structure and metabolites of intestinal microbiota of spontaneously hypertensive rats (SHRs) after valsartan administration. In the present study, valsartan administration decreased intestinal microbiota diversity, altered gut microbiota composition, leading to 192 unique OTUs deficiency ( vs WKY rats) and 10 unique OTUs deficiency ( vs SHRs) and did not prove impaired intestinal mucosal barriers. Valsartan decreased the production of isobutyric acid and isovaleric acid in SCFAs. Our findings revealed valsartan administration induced far-reaching and robust changes to the intestinal microbiota of SHRs and provided a better understanding of the relationship between efficacy of valsartan and gastrointestinal tract reaction.
Fitness Policies Within the Fire Service: A Pilot Investigation of Exercise Adherence on Fitness Outcomes Among Rural Firefighters
Authors: Melton Bridget F. , Ryan Greg , Snarr Ronald L. , Weeks Macy , Langford Emily , Villafuerte Marissa
Published: April 2021

The purpose of this study was to investigate the adherence to departmental fitness policies and to evaluate the impact of on-duty firefighters’ adherence to fitness outcomes. This cross-sectional designed study utilized a convenience sample of 40 career firefighters from one department in rural southeast Georgia. Onsite gym attendance logs were recorded during a 10-month period. Firefighters were classified as lowest (0-16 sessions), low (17-30 sessions), moderate (31-44 sessions), or high (45+ sessions) adherence for analyses based on gym attendance. The fitness outcomes were retrieved from required annual fitness testing, including measurements of muscular strength (1RMest leg press and 1RMest bench press), muscular endurance (pushup), muscle power (vertical jump), cardiovascular fitness (submaximal treadmill), mobility (functional movement screen), and flexibility (shoulder elevation). Only 12.5% (n = 5) of firefighters complied with the department’s fitness policy of a minimum 75% adherence rate. Furthermore, there were significant differences (P ≤ .05) between various muscular strength, endurance, and flexibility between adherence rates. This study indicated that firefighters that complied more with the fitness policies were more physically fit than those that did not. Considerations should be made to promote and enforce departmental fitness policies to ensure that firefighters can physically perform their responsibilities.
Engaging the Senses in Qualitative Research via Multimodal Coding: Triangulating Transcript, Audio, and Video Data in a Study With Sexual and Gender Minority Youth
Authors: Craig Shelley L. , McInroy Lauren B. , Goulden Ami , Eaton Andrew D.
Published: April 2021

The variety of formats in which qualitative data may be collected have been explored within the methodological literature. Yet, the multiple options for coding these data formats have not been comprehensively detailed. While transcript analysis is widely used across disciplines, it may have limitations—particularly for research involving marginalized populations. This paper presents a multimodal coding approach as a methodological innovation for triangulating three data formats (transcript, audio, and video), detailed through the application of this analytic approach during a qualitative study exploring media engagement with sexual and gender minority youth (SGMY). Nineteen semi-structured interviews with SGMY were filmed and transcribed. Nine independent coders then utilized the innovative multimodal approach to code the three data formats using a constructivist grounded theory framework. Some codes were similar across modalities, such as those related to safety issues and finding identity and community through media. Others differed between modalities, such as those related to participant affect, perceived contradictions, discrepancies between verbal statements and body language, level of comfort and engagement, and distress when discussing traumatic experiences. Video coding captured the broadest range of emotions and experiences from marginalized youth, while transcripts provided the most straightforward form of data for coding. Multimodal coding may be applicable across qualitative approaches to enrich analyses and account for potential biases, thereby enhancing analytical lenses in qualitative inquiry. Methodological strategies for coding and integrating data types are discussed.
Key Stakeholders’ Experiences and Perceptions of Virtual Reality for Older Adults Living With Dementia: A Qualitative Evidence Synthesis Protocol
Authors: Flynn Aisling , Healy David , Houghton Catherine , Casey Dympna
Published: April 2021

Background:

Technology is increasingly being used in dementia care as a means of non-pharmacological intervention. One such technology, Virtual Reality (VR) has shown to be a promising vehicle to deliver interventions for people living with dementia. The views of people living with dementia and key stakeholders must be considered to inform future research. There is a lack consensus regarding VR design considerations for this population which makes it difficult for researchers and practitioners to develop meaningful VR spaces.

Methods:

This qualitative evidence synthesis (QES) protocol aims to explore key stakeholders’ experiences and perceptions of VR for older adults living with dementia. A systematic search will be conducted across six electronic databases. Forward and backward citation searching, and hand searching will identify additional articles. Two authors will independently complete title and abstract, and full text screening. Quality appraisal will be conducted using the CASP qualitative checklist. Included studies will be analyzed using a thematic synthesis approach. The GRADE-CERQual will assess the researcher’s confidence in the findings.

Discussion:

This QES will constitute part of a larger project which aims to develop a VR social connecting space for older adults living with dementia. The findings will also add to the existing body of literature exploring VR in dementia care contexts. It is anticipated that this review will add to the momentum toward holistic design practices, resulting in usable and acceptable VR spaces for older adults living with dementia.
A novel elimination method of preloading force on the unconfined compression tests of soft tissue
Authors: Yang Jing , Hu Ming , Han Zejie , Zhao Deming , Qin Tao
Published: April 2021

Accurate description of the mechanical properties for soft tissues can help surgeon predict the state during surgery. In unconfined compression tests (UCT) of soft tissue, a tiny force is typically applied to determine the starting position of compression. The preloading force will cause the obtained material parameters to deviate from the real parameters. In this paper, a novel elimination method was proposed to eliminate the effect of the preloading force. The effects of preloading force on mechanical response were analyzed by performing unconfined compression numerical tests. Different preloading force were applied in the simulation. The parameters obtained by traditional optimization method were defined as preloading material parameters. In the proposed method, an estimation model between the preloading material parameters and the preloading force was established to estimate real parameters. The proposed elimination method was verified by three sample diameters and material parameters. The results show that the material parameters obtained by proposed method are closer to the real parameters (estimated accuracy exceeds 97%). The proposed method can obtain more accurate constitutive model parameters, and eliminate the effect of preloading force.
Optimizing mother–baby wellness during the 2019 coronavirus disease pandemic: A case for telemedicine
Authors: Markwei Metabel , Goje Oluwatosin
Published: April 2021

Background:

The 2019 coronavirus disease pandemic poses unique challenges to healthcare delivery. To limit the exposure of providers and patients to severe acute respiratory syndrome coronavirus 2, the Centers for Disease Control and Prevention encourages providers to use telehealth platforms whenever possible. Given the maternal mortality crisis in the United States and the compounding 2019 coronavirus disease public health emergency, continued access to quality preconception, prenatal, intrapartum, and postpartum care are essential to the health and well-being of mother and baby.

Objective:

This commentary explores unique opportunities to optimize virtual obstetric care for low-risk and high-risk mothers at each stage of pregnancy.

Methods:

In this review paper, we present evidence-based literature and tools from first-hand experience implementing telemedicine in obstetric care clinics during the pandemic.

Results:

Using the best evidence-based practices with telemedicine, health care providers can deliver care in the safest, most respectful, and appropriate way possible while providing the critical support necessary in pregnancy. In reviewing the literature, several studies endorse the implementation of specific tools outlined in this article, to facilitate the implementation of telemedicine. From a quality improvement standpoint, evidence-based telemedicine provides a solution for overburdened healthcare systems, greater confidentiality for obstetric services, and a personalized avenue for health care providers to meet maternal health needs in the pandemic.

Conclusion:

During the COVID-19 pandemic, continued access to quality prenatal, intrapartum, and postpartum care are essential to the health and well-being of mother and baby.
Understanding the document bias in face matching
Authors: Feng Xinran , Burton A. Mike
Published: April 2021

Matching unfamiliar faces is a well-studied task, apparently capturing important everyday decisions such as ID checks. In typical laboratory studies, participants make same/different judgements to pairs of faces, presented in isolation and without context. However, it has recently become clear that matching faces embedded in documents (e.g., passports and driving licences) induces a bias, resulting in elevated levels of “same person” responses. While practically important, it remains unclear whether this bias arises due to expectations induced by the ID cards or interference between textual information and faces. Here, we observe the same bias when faces are embedded in blank (i.e., non-authoritative) cards carrying basic personal information, but not when the same information is presented alongside a face without the card (Experiments 1 and 2). Cards bearing unreadable text (blurred or in an unfamiliar alphabet) do not induce the bias, but those bearing arbitrary (non-biographical) words do (Experiments 3 and 4). The results suggest a complex basis for the effect, relying on multiple factors which happen to converge in photo-ID.
Reducing the residual error of multibeam sounding data through empirical mode decomposition based on cubic Bessel interpolation
Authors: Sun Jialong , Zhang Zhengyang , Zhang Chi , Liu Jinlei , Zhang Peng
Published: April 2021

The systematic residual errors present in multibeam echo-sounding data cause the areas of overlap between adjacent swaths to become distorted. A method is proposed in this paper to reduce the residual error of multibeam sounding data through empirical mode decomposition (EMD) based on cubic Bessel interpolation. Numerical experiments confirm that the discrepancy in the overlap between two swaths is significantly reduced after applying EMD improved by cubic Bessel interpolation compared with both the original water depth data and with data processed using conventional EMD based on cubic spline interpolation. The mean square error of the improved method is decreased by 67% and 29% compared with that of the original and conventional EMD cases, respectively. Therefore, EMD with cubic Bessel interpolation can efficiently reduce the residual error of multibeam echo-sounding data.
Suspicious oral lesions
Authors: Collins Timothy
Published: April 2021

Oral lesions typically present as swellings/lumps or mucosal lesions. Mucosal lesions can be red, white, red-and-white or pigmented. Lesions are typically incidental findings in routine dental examinations of asymptomatic patients. Symptoms (typically soreness) prompt patients to seek advice from GPs as well as dentists. Oral ulceration is a common reason for presentation and may indicate a suspicion of underlying pathology. It is common for mucosal lesions to warrant referral, but it is useful to identify benign pathology to inform the urgency of referral. The study of suspicious oral pathology, in addition to benign pathology mimicking suspicious aetiology, forms a significant component of the dental undergraduate curriculum. This is a large topic and full familiarity will require reading beyond the scope of this article.
Ginsenoside Rg3 Attenuates Early Hepatic Injury via Inhibiting PPARγ- and Ang II-Related Inflammation and Fibrosis in Type II Diabetic Mice
Authors: Jiang Yichuan , Sui Dayun , Yu Xiaofeng , Wang Yaozhen , Xu Huali , Fu Li
Published: April 2021

Ginsenoside Rg3 (Rg3), a natural product abundantly present in Korean Red Ginseng, is widely known for its anti-tumor activity. In our previous studies, we had further demonstrated that Rg3 has protective effects on the hearts, kidneys, and aortas of animals with hypertension or hypercholesterolemia, and its main mechanisms include down-regulation of angiotensin II (Ang II) levels and activation of peroxisome proliferator-activated receptor gamma (PPARγ) pathway in those tissues. In this study, the protective effects of Rg3 on liver were determined in db/db mice, a most recognized type II diabetes (T2DM) animal model with nonalcoholic fatty liver disease (NAFLD). The results showed that Rg3 did not have obvious effects to the body weight, blood glucose, and lipids of db/db mice. According to the results of histology examination, Rg3 could not improve steatosis in the hepatic tissue, too. But Rg3 did attenuate alanine aminotransferase (ALT)/aspartate aminotransferase (AST) elevation in serum and collagen deposition in hepatic tissue. Immunohistochemistry (IHC) and enzyme-linked immunosorbent assay (ELISA) showed that Rg3 upregulated PPARγ and downregulated Ang II in hepatic tissue in db/db mice, which resulted in reducing activities of transforming growth factor β (TGF-β)/connective tissue growth factor (CTGF) pathway, downregulating the levels of inflammatory cytokines and attenuating collagen accumulation. In conclusion, although it has no obvious effect on steatosis in the hepatic tissue, Rg3 indeed attenuates early hepatic injury from NAFLD via inhibiting PPARγ- and Ang II-related inflammation and fibrosis in T2DM db/db mice. These effects are independent of reducing blood glucose and lipids, and the mechanisms are similar to the protective effects of Rg3 in hypertension and hypercholesterolemia animals in our previous studies.
Do gliosarcomas have distinct imaging features on routine MRI?
Authors: Maurer Christoph J , Mader Irina , Joachimski Felix , Staszewski Ori , Märkl Bruno , Urbach Horst , Roelz Roland
Published: April 2021

Purpose

The aim of this study was the development and external validation of a logistic regression model to differentiate gliosarcoma (GSC) and glioblastoma multiforme (GBM) on standard MR imaging.

Methods

A univariate and multivariate analysis was carried out of a logistic regression model to discriminate patients histologically diagnosed with primary GSC and an age and sex-matched group of patients with primary GBM on presurgical MRI with external validation.

Results

In total, 56 patients with GSC and 56 patients with GBM were included. Evidence of haemorrhage suggested the diagnosis of GSC, whereas cystic components and pial as well as ependymal invasion were more commonly observed in GBM patients. The logistic regression model yielded a mean area under the curve (AUC) of 0.919 on the training dataset and of 0.746 on the validation dataset. The accuracy in the validation dataset was 0.67 with a sensitivity of 0.85 and a specificity of 0.5.

Conclusions

Although some imaging criteria suggest the diagnosis of GSC or GBM, differentiation between these two tumour entities on standard MRI alone is not feasible.
Prosecution ex officio or following a complaint by the victim? An analysis on offences related to violence against women and sexual offences
Authors: Nakane Tomohiro
Published: April 2021

In recent years, there has been a tendency in cases of violence against women and sexual offences to prosecute them, regardless of whether the victim files their complaint. This article investigates the recent changes in European criminal law in this respect. The results indicate a variety of approaches under European Union (EU) law, Council of Europe (CoE) law and domestic approaches. Furthermore, existing EU and CoE law has not suggested an ‘in-between’ approach, which exists in some national legal systems such as that of Germany. On that basis, this article suggests a number of amendments to current EU and CoE law.
A novel treatment regimen of granulocyte colony-stimulating factor combined with ultra-low-dose decitabine and low-dose cytarabine in older patients with acute myeloid leukemia and myelodysplastic syndromes
Authors: Zhu Huan , Yang Bin , Liu Jia , Wang Biao , Wu Yicun , Zheng Zhuojun , Ling Yun
Published: April 2021

Background:

Older patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) unfit for intensive chemotherapy are emergent for suitable treatment strategies. Hypomethylating agents and low-dose cytarabine have generated relevant benefits in the hematological malignancies over recent decades. We evaluated the efficacy and safety of the novel treatment regimen consisting of ultra-low-dose decitabine and low-dose cytarabine, with granulocyte colony-stimulating factor (G-CSF) in this population of patients.

Methods and materials:

Patients aged more than 60 years with newly diagnosed AML/MDS were enrolled to receive therapy combined of 300 µg subcutaneously per day for priming, decitabine 5.15–7.62 mg/m2/d intravenously and cytarabine 15 mg/m2/d twice a day subcutaneously and G-CSF for consecutive 10 days every 28 days. The study enrolled 28 patients unfit for standard intensive chemotherapy. The median age of patients was 68 years (range 60–83 years) and 20 (71.4%) patients harbored AML. The primary outcome was to evaluate overall response rate.

Results:

Overall, this novel ultra-low-dose treatment regimen was well tolerated, with 0% of both 4- and 8-week mortality occurrence. Objective response rate (CR + CRi + PR in AML and CR + mCR + PR in MDS) was 57.1% after the first treatment course. Responses of hematologic improvement (HI) aspect were achieved in 18 of 28 (64.3%) patients, 11 (39.3%), 12 (42.9%), and eight patients (28.6%) achieved HI-E, HI-P, HI-N, respectively.

Conclusions:

Untreated elderly with AML/MDS were well tolerated and benefited from this novel ultra-low-dose treatment regimen.
Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: risks, benefits, and current guidelines for use
Authors: Prabakaran Sindhu , Schwartz Arielle , Lundberg Gina
Published: April 2021

Women are at increased risk for cardiovascular disease (CVD) compared with men. While traditional risk factors for CVD seem to disproportionately affect women and contribute to this disparity, increased prevalence of CVD at midlife calls into question the contribution of menopause. Given the potential role that declining hormone levels play in this transition, menopause hormone therapies (MHT) have been proposed as a strategy for risk factor reduction. Unfortunately, trials have not consistently shown cardiovascular benefit with use, and several describe significant risks. Notably, the timing of hormone administration seems to play a role in its relative risks and benefits. At present, MHT is not recommended for primary or secondary prevention of CVD. For women who may benefit from the associated vasomotor, genitourinary, and/or bone health properties of MHT, CVD risks should be taken into account prior to administration. Further research is needed to assess routes, dosing, and formulations of MHT in order to elucidate appropriate timing for administration. Here, we aim to review both traditional and sex-specific risk factors contributing to increased CVD risk in women with a focus on menopause, understand cardiovascular effects of MHT through a review of several landmark clinical trials, summarize guidelines for appropriate MHT use, and discuss a comprehensive strategy for reducing CV risk in women.
Anticoagulation treatment and prophylactic edoxaban for cerebral sinus venous thrombosis in an adolescent with acute lymphoblastic leukemia
Authors: Koganesawa Masaya , Matsuno Ryosuke , Sugishita Yumiko , Kaneko Ryota , Kawabata Naoko , Fujita Sachio , Akiyama Kosuke , Toyama Daisuke , Yamamoto Shohei
Published: April 2021

Pediatric acute lymphoblastic leukemia regimens include large L-asparaginase dosages and steroids, which are associated with an increased risk of venous thromboemboli in adolescents and young adults. Herein, we report the case of an 18-year-old male with acute lymphoblastic leukemia, who was treated with the pediatric regimen, in which edoxaban was employed as a prophylaxis against cerebral sinus venous thrombosis. The event happened on day 20 of induction therapy, when brain magnetic resonance imaging demonstrated a cerebral sinus venous thrombosis in the superior sagittal sinus. Anticoagulation therapy was initiated, and the patient’s symptoms disappeared 3 days later. The induction therapy was restarted after an interruption of 16 days, and the consolidation therapies, which included L-asparaginase and steroids, were completed. Edoxaban was administered as a prophylaxis during the consolidation therapy. There were no further adverse events. Edoxaban could be an effective prophylaxis for coagulation complications in adolescents and young adults with acute lymphoblastic leukemia.
Deciding how to decide on public goods provision: The role of instrumental versus intrinsic motives
Authors: Harms Philipp , Landwehr Claudia , Lutz Maximilian , Tepe Markus
Published: April 2021

What determines citizens’ preferences over alternative decision-making procedures – the personal gain associated with a procedure, or the intrinsic value assigned to it? To answer this question, we present results of a laboratory experiment in which participants select a procedure to decide on the provision of a public good. In the first stage, they choose between majority voting and delegation to a welfare-maximizing algorithm. In the second stage, subjects either vote on the public good provision, or the decision is taken by the algorithm. We define three experimental conditions in which participants receive information about whether a majority in the group faces a positive or negative pay-off from the public good provision, about whether there is a positive group benefit from its provision, or neither kind of information. Findings confirm the importance of instrumental motives in procedural choices. At the same time, however, a significant share of participants chose a procedure that does not maximize their individual benefit. While majority voting seems to be preferred for intrinsic values of fairness and equality, support for delegation to the welfare-maximizing algorithm increases if the group benefit from a public good is known – even in participants who are net payers for its provision.
Maternal mental health and child well-being in Nigeria: A systematic review
Authors: Jidong Dung Ezekiel , Husain Nusrat , Ike Tarela J , Murshed Maisha , Pwajok Juliet Y , Roche Ayesha , Karick Haruna , Dagona Zubairu K , Karuri Gloria S , Francis Christopher , Mwankon Shadrack B , Nyam Pam P
Published: April 2021

Maternal mental health distress has a disease burden of severe adverse effects for both mother and child. This review identified maternal mental health concerns, their impact on child growth and the current practice of maternal healthcare for both mothers and their children in Nigeria. The Population, phenomenon of Interest and Context (PICo) model was adopted to formulate the review strategy, and five databases were searched for published articles between 1999 and 2019. Databases include Scopus, PubMed, ProQuest, Applied Social Science Index and Abstracts and Web of Science. Boolean operators (AND/OR/NOT) helped to ensure rigorous use of search terms which include ‘maternal’, ‘pre/peri/postnatal’, ‘mental health’, ‘mental illness’, ‘disorders’, ‘intervention,’ ‘Nigeria’, ‘child’, ‘infant growth’, and ‘wellbeing’. Thirty-four studies met the inclusion criteria, and extracted data were qualitatively synthesised and analysed thematically. Five themes emerged. These include (i) marital difficulties, (ii) relationship status of the mother, (iii) child’s gender, (iv) mode of child delivery and (v) child growth and development. The review showed a significant paucity of literature on the impact of specific maternal mental health problems on child physical growth and cognitive development. We concluded that culturally appropriate and evidence-based psychological interventions for maternal mental health problems would benefit Nigerian indigenous mothers. Therefore, the study recommends randomised controlled trials that are culturally appropriate and cost-effective for distressed mothers with children.
Technology clinical trials: Turning innovation into patient benefit
Authors: Royle Jennifer K , Hughes Andrew , Stephenson Laura , Landers Dónal
Published: April 2021

Health care needs to continuously evolve and innovate to maintain the health of populations. Technology has the potential to enable better patient engagement and ownership, as well as optimise therapeutic interventions and data-science approaches to facilitate improved health care decisions. Yet, to date, technological innovation has not resulted in the rate of change that could have been predicted from other sectors. This article discusses multiple reasons for this and proposes a newly tested and deployed solution: the technology clinical trial. The technology clinical trial methodology has been developed through working directly with patients, clinical and medical devicetrial experts. This approach enables researchers to use the complex environment of health care as an opportunity to transform the pace of innovation and create new care pathways. Instead of testing a single innovation, researchers can ‘step back’ and systematically review all areas of the patient's journey for potential optimization. Then integrate novel data science, technological advances, process updates, behavioural science, and patient engagement to co-create a streamlined multidisciplinary solution. As a result, this research has the potential for larger advances due to the emergent benefits that can arise when the individual elements work together as a whole. These potential benefits are then robustly tested, characterised and measured in the trial environment to ensure that future application of the innovative pathway is supported by the robust empirical data health care requires.
Effectiveness and safety of dimethyl fumarate in progressive multiple sclerosis
Authors: Moreira Ferreira Vanessa F , Liu Yanqing , Healy Brian C , Stankiewicz James M
Published: April 2021

Background

There is limited data analyzing the safety and effectiveness of dimethyl fumarate (DMF) in the progressive multiple sclerosis (PMS) population.

Objective

To analyze the safety and effectiveness of DMF in patients with PMS.

Methods

We used Cox proportional hazards models to compare the time to confirmed worsening and improvement on the Expanded Disability Status Scale (EDSS) and timed 25-foot walk (T25FW) between patients treated with DMF and glatiramer acetate (GA) for at least one year.

Results

We included 46 patients treated with DMF and 42 patients treated with GA. The safety and tolerability of GA and DMF were consistent with established profiles. There was no difference in confirmed EDSS progression. A trend towards reduced T25FW was seen in the DMF compared to GA after adjustment (HR = 0.86; 95% CI:0.37, 1.98; p = 0.72 and HR = 0.60; 95% CI:0.27, 1.34; p = 0.21, respectively).

Conclusion

Dimethyl fumarate showed a trend towards reduction in T25FW but no evidence of clinically significant impact on EDSS. The small sample precluded definitive determination.
Low-grade adenosquamous carcinoma of the breast: a review with focus on imaging and management
Authors: Romanucci Giovanna , Mercogliano Sara , Carucci Elisabetta , Lunardi Maria , Caneva Andrea , Benassuti Chiara , Quaglia Andrea , Fornasa Francesca
Published: April 2021

Low-grade adenosquamous carcinoma is a less frequent variant of metaplastic breast carcinoma, incidentally detected during screening and has an age distribution similar to other breast carcinomas. It shares characteristics with both benign and malignant carcinomas: its mammographic and sonographic features are therefore nonspecific. Breast conserving surgery with adjuvant radiation therapy is currently the preferred therapeutic approach. The aim of this review is to describe the imaging and clinical features of low-grade adenosquamous carcinoma for appropriate identification and diagnosis. The associated pitfalls, histopathologic and epidemiologic factors, natural course, and management of low-grade adenosquamous carcinoma are also discussed.