bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally invasive (mini-thoracotomy) versus median sternotomy in redo mitral valve surgery: A meta-analysis of observational studies
Authors: Hussain Azhar , Chacko Jacob , Uzzaman Mohsin , Hamid Osama , Butt Salman , Zakai Saad Badar , Khan Habib
Published: February 2021

Objective

Redo mitral valve surgery has traditionally been performed via a median sternotomy. It is often challenging and is associated with increased perioperative mortality. Advances in cardiac surgical techniques over the last two decades have led to an increase in the use of a minimally invasive approach via a right anterolateral mini-thoracotomy as opposed to a repeat median sternotomy. However, despite these advances, there is no general consensus on the best form of entry, and as of yet, there are no randomized controlled trials. We performed a meta-analysis of observational studies to aid in determining the best approach for redo mitral valve surgery.

Method

The MEDLINE and EMBASE databases were conducted up until 1 June 2020. Data regarding mortality, stroke, reoperation for bleeding and length of hospital stay, wound infection and cardiopulmonary bypass time were extracted and submitted to a meta-analysis using random effects modelling and the I2-test for heterogeneity. Seven retrospective observational studies were included, enrolling a total of 1070 patients.

Results

There were a total of 1070 patients. Of these 364 had non-sternotomy approach compared with 707 patients who had median sternotomy. Further subgroup analysis revealed that 327 of the 364 patients had a mini-thoracotomy approach while the remaining 37 patients had a full thoracotomy approach. In-hospital mortality and length of stay were less in non-sternotomy group compared to median sternotomy group. There were no differences in stroke, CPB time and wound infections between the two groups.

Conclusion

Redo mitral valve surgery can be performed safely with satisfactory outcomes via a mini-thoracotomy approach. This meta-analysis shows comparable results with reduced in-hospital mortality and hospital length of stay with a mini-thoracotomy approach.
Predictors of Positive Psychological Capital: An Attempt Among the Teacher Communities in Rural Jharkhand, India
Authors: Clarence Mukti , Viju P. D.  , Jena Lalatendu Kesari , George Tony Sam
Published: February 2021

In the recent times, researchers have shown an increased interest in positive psychological capital (PsyCap). However, it is acknowledged that due to the limited number of studies conducted on the antecedents of psychological capital, there is a lack of sufficient data for conclusively proving the antecedents of PsyCap. Consequently, this article aims to explore the potential antecedents of PsyCap as a reliable source of data in the context of rural school teachers. The focus is to investigate both the individual differences and the contextual factors as desirable variables that constitute PsyCap among the school teachers of rural Jharkhand, India. Samples of 1,120 respondents from different rural schools were collected and analysed with Structural Equation Modeling (AMOS 20.0). The findings of the study explained that both the individual differences ( proactive personality and emotional intelligence) and the contextual factors ( perceived organizational support, servant leadership and meaningful work) have a positive relationship with PsyCap. The impact of PsyCap on teacher performance can form the basis for further research on the subject.

JEL Codes: M12, M53
The impact of monocular and binocular visual impairment on the quality of life of Brazilian children
Authors: Venâncio Tais Siqueira , de Araújo Bruna Michele Freire , Negrão João Vitor Ramos de Toledo , Andrade Freire Lívia de , Kasahara Niro
Published: February 2021

The purpose of this case–control study was to assess the quality of life (QoL) in children with visual impairment from an urban area in Brazil. Participants included children with binocular and monocular visual impairment and normal controls aged between 4 and 15 years. All subjects underwent a basic ophthalmic exam and answered the Pediatric Quality of Life Inventory™ (PedsQL). The score results were compared among the groups with analysis of variance (ANOVA). The sample included 45 children with visual disability (24 binocular and 21 monocular) and 30 age-matched controls. The groups did not differ in age and gender distribution. The child self-report score for the binocular visual impairment group was lower when compared to controls in all four core scales; as compared to monocular children, the binocular group scored lower in physical health and social functioning. The total score of binocular children (67.9 ± 25.2) was lower than that for monocular children (83.0 ± 13.3, p = .01) and controls (84.2 ± 13.6, p < .001). Children with monocular visual disability presented very similar scores to controls in both self-reported and parent proxy inventory (81.6 ± 15.2, p = .97 and 81.9 ± 15.3, p = .99, respectively). These data should help governments develop public health interventions and rehabilitation strategies for visually disabled children.
Better relationships shut the wandering eye: Sociosexual orientation mediates the association between relationship quality and infidelity intentions
Authors: Urganci Betul , Sevi Barış , Sakman Ezgi
Published: February 2021

People who lack quality relationships are more likely to engage in infidelity but how relationship quality is associated with infidelity is less clear. One psychological mechanism that might help to explain these associations is sociosexuality. Here, we tested two models in which we assessed whether overall sociosexuality and sociosexuality subscales (i.e., attitude, behavior, desire) explain how relationship quality is related to infidelity intentions by sampling individuals in exclusive relationships ( N = 219). We found that individuals with lower relationship quality had more unrestricted sexual orientation, which in turn predicted a greater intention toward infidelity. In addition, lower quality relationships were associated with greater intentions toward infidelity through behavior and desire, but not attitude dimensions of sociosexuality.
The computation and suspension of presuppositions by L1-Mandarin Chinese L2-English speakers
Authors: Feng Shuo
Published: February 2021

The Interface Hypothesis proposes that second language (L2) learners, even at highly proficient levels, often fail to integrate information at the external interfaces where grammar interacts with other cognitive systems. While much early L2 work has focused on the syntax–discourse interface or scalar implicatures at the semantics–pragmatics interface, the present article adds to this line of research by exploring another understudied phenomenon at the semantics–pragmatics interface, namely, presuppositions. Furthermore, this study explores both inference computation and suspension via a covered-box picture-selection task. Specifically, this study investigates the interpretation of the presupposition trigger stop and stop under negation. The results from 38 native English speakers and 41 first language (L1) Mandarin Chinese learners of English indicated similar response patterns between native and L2 groups in computing presuppositions but not in suspending presuppositions. That is, L2 learners were less likely to suspend presuppositions than native speakers. This study contributes to a more precise understanding of L2 acquisition at the external interface level, as well as computation and suspension of pragmatic inferences.
The main trunk of RCA may be the best choice of sequential vein graft distal end-to-side anastomosis
Authors: Li Bo , Li Haiming , Wang Liangshan , Liu Changcheng , Dai Longsheng , Li Qin , Gu Chengxiong
Published: February 2021

Objective:

The purpose of this study was to investigate the effect of different anastomotic positions on the early patency of the distal end-to-side anastomosis of sequential saphenous vein grafts (SVG) in off-pump coronary artery bypass grafting (OPCAB).

Methods:

A total of 259 patients who underwent OPCAB between August 2014 and August 2019 and presented for coronary computed tomography angiography (CCTA) to evaluate graft patency at 1 year post-OPCAB were analyzed. There are two kinds of distal end-to-side anastomosis of SVG, to posterior descending artery (PDA) and main trunk of right coronary artery (RCA). In all, 1044 distal coronary anastomoses on 518 grafts which included 180 left internal mammary artery (LIMA) grafts, individual 79 SVG and 259 sequential SVG were assessed using CCTA. The blood flow (BF), pulsatility index (PI), and patency of every anastomosis were recorded. Besides, comprehensive data of SV-PDA and SV-RCA patients was also compared.

Results:

The mean BF of SV-RCA was significantly higher than that of SV-PDA (31.71 ± 18.60 vs 22.62 ± 14.48, p = 0.001), and the PI value of SV-RCA was significantly lower than that of SV-PDA (2.57 ± 1.17 vs 3.50 ± 1.69, p = 0.001). The patency of RCA system was significantly lower than that of the LAD and the left circumflex system (79.25% vs 90.13%, 90.23% respectively, p = 0.001). In sequential SVG, the patency of SV-PDA was significantly lower than that of SV-RCA (74.01% vs 86.59%, p = 0.001). Although, there was no significant difference in left ventricular ejective fraction, the left ventricular end-diastolic diameter (LVDd) in SV-PDA group was significantly larger than that in SV-RCA (52.67 ± 8.72 mm vs 47.34 ± 7.55, p = 0.001). In addition, the target vessel diameter in SV-PDA group was smaller than that in SV-RCA group (1.52 ± 0.41 mm vs 3.17 ± 0.88 mm, p = 0.001).

Conclusion:

The early patency of sequential SVG end to RCA after OPCAB is generally superior to that of to PDA, especially for patients with large LVDd.
Interaction of storage medium and silver diamine fluoride on demineralized dentin
Authors: Peng Jing-Yuan , Botelho Michael George , Matinlinna Jukka Pekka , Pan Hao-Bo , Kukk Edwin , Low Kam-Jung
Published: February 2021

Objective

The effects of saliva on demineralized dentin and silver diamine fluoride (SDF) were investigated in vitro.

Methods

Dentin samples stored in deionized water (DIW), buffer solution (BS), basal medium mucin (BMM), and unstimulated whole saliva (UWS) were demineralized for 3 days and immersed in the same storage media. SDF as a 38 mass% solution was applied to the dentin samples for 3 minutes after they had been replaced in their respective medium. Surfaces were analyzed by scanning electron microscopy, energy-dispersive X-ray analysis (EDX), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD).

Results

Scanning electron microscopy showed various surface deposits and coatings, including occlusion of dentinal tubules. DIW resulted in the thinnest coating, whereas BMM resulted in the thickest. EDX and XPS showed the formation of metallic silver and silver compounds in all four media, with the greatest formation in BS. XRD indicated that the main product was silver chloride except in DIW. Sulphur was found in BMM and UWS. EDX and XPS detected fluoride and XRD detected calcium fluoride and fluorohydroxyapatite in BS, BMM, and UWS.

Conclusion

The interaction between SDF and demineralized dentin was dependent upon the storage medium. BMM provided an outcome most similar to human saliva.
Chemical meningitis after cervical transforaminal epidural steroid injection: a case report
Authors: Lee Min Young , Chang Min Cheol
Published: February 2021

We herein report a case of chemical meningitis that developed after cervical transforaminal steroid injection. A 49-year-old man presented with symptoms of meningitis (severe headache and neck stiffness) after cervical transforaminal steroid injection at the right C5–6 level. The injection solution was a mixture of lidocaine (0.3 mL), hyaluronidase (1 mL), placenta hydrolysate (2 mL), and normal saline (1 mL). The patient developed symptoms of meningitis 2.5 hours after the cervical epidural injection. Cerebrospinal fluid (CSF) analysis was performed 1 day after the injection, and the results showed an elevated white blood cell count at 7106 cells/µL. The patient’s CSF analysis findings and symptoms did not differ from those of bacterial meningitis. However, considering that his symptoms developed 2.5 hours after the epidural injection, we believe that the patient developed chemical meningitis; therefore, he was symptomatically treated with an analgesic. Three days after the cervical transforaminal epidural injection, the patient experienced complete relief from the headache and neck stiffness. A Gram stain of the CSF revealed no organisms. Hence, the diagnosis of chemical meningitis was confirmed. Clinicians should be knowledgeable about the risk of this complication.
Expression of aquaporins 3 in low grade risk of recurrence primary bladder cancer
Authors: Ticonosco Marco , Assumma Simone , Iseppi Andrea , Benedetti Mattia , Sarchi Luca , Ferrari Riccardo , Calcagnile Tommaso , Rocco Bernardo , Sighinolfi Maria Chiara , Alriyalat Sulieman , Reggiani Bonetti Luca , Migaldi Mario , Micali Salvatore
Published: February 2021

Introduction:

Bladder cancer (BC) is one of the most frequent malignancy of the urinary tract. Recent studies demonstrated the role of aquaporins urothelial tumor cells (AQPs) as potential prognostic factor for tumor progression and invasion. In this study we investigated the AQP3 expression levels inside primary superficial (pTa) low grade bladder cancer, correlating with pathological parameters and clinical outcomes.

Materials and methods:

We retrospectively analyzed tumor samples of 66 patients with diagnosis of superficial urothelial (pTa) bladder cancer between 1997 and 2007. All patients underwent transurethral bladder resection (TURB ) and immediate single instillation of mitomycin C. All tumors samples were blindly reviewed by two expert anatomopathologists and only pTa low grade urothelial bladder cancer were included. Cancer recurrence was defined as the detection of bladder lesions during follow-up cystoscopy. AQP3-immunoreactive areas detected at immunohistochemical analysis were classified as AQP3 positive.

Results:

Of these 60.6% of patients was detected as negative for AQP3 expression. Forty-two patients develop cancer recurrence during follow-up with a mean progression free survival of 16.44 months. The absence of reaction for AQP3 was observed 56% (9/16) tumor grading G1 and 62% (31/50) tumor grading G2. No correlation was observed with sexual gender, grading of tumor differentiation, and recurrence of cancer disease. Kaplan-Meier curves of disease-free survival (DFS) showed a significant separation ( p = 0.028) between patients AQP3-positive and AQP3-negative. It was observed a mean DFS of 23.83 and 14.43 months respectively in absence and presence of AQP3 expression.

Conclusion:

AQP3 expression is related to disease-free interval (DFI) and the absence of AQP3 expression correlates with a late relapse. The expression of AQP3 does not provide a reproducible quantitative aspect. AQP3 are not suitable to forecast tumor cell behavior but they perform a role as regulator for tumor cell homeostasis and for additional therapeutic developments.
Economic Policy Uncertainty and Entrepreneurship: A Bad for a Good?
Authors: Nguyen Bach , Schinckus Christophe , Canh Nguyen Phuc , Thanh Su Dinh
Published: February 2021

The study examines the influences of the global/domestic economic policy uncertainty (EPU) on entrepreneurship in a sample of 23 economies over the period 2006–2016. Employing the two-step system General Method of Moment estimation for unbalanced panel data, our study provides surprising evidence, indicating that EPU may not always be harmful to entrepreneurship. Precisely, in contrast with existing literature emphasising the negative impact of the uncertainty on entrepreneurship, our article suggests that EPU seems to boost pro-entrepreneurial social and cultural norms (i.e., encouraging actions for creation of new businesses). As such, we suggest that uncertainty may serve as an exogenous shock, filtering ‘good’ business ventures from ‘not-so-good’ ones.
Materiality and Discursivity of Cyber Violence Against Women in India
Authors: Sarkar Sahana , Rajan Benson
Published: February 2021

With the advent of the digital age and online networks, a new facet of human experience materialised called the cyberspace. In other words, it is an addition to an individual’s intrapsychic world. Millions of people are using the Internet as a day-to-day activity to enhance their lives while at the same time there are people who are using it for anti-social purposes such as stalking, harassing, bullying and so on. This, with the advent of the Internet, has become a new weapon of abuse.

This research intends to bring the two realms of virtual and physical, which are considered as binaries into a productive dialogue on violence against women. In doing so, it takes forward the narratives of cyber violence survivors into rethinking the construction of disembodied and embodied violence. I pursue this aim by exploring how women survivors of India conceptualise and respond to cyber violence. This is a qualitative exploratory study located within the theoretical framework of feminist standpoint theory in order to engage each survivor’s story from their individual standpoint. An in-depth interview was conducted for 30 women survivors in India. This study will help to critically understand cyber violence as an embodied experience.
Nonlinear dynamic analysis of anisotropic fiber-reinforced dielectric elastomers: A mathematical approach
Authors: Allahyari Ehsan , Asgari Masoud
Published: February 2021

In this paper, the primary purpose is to have a complete understanding of the importance of fibers in dielectric elastomers due to the influence of fiber orientation in decreasing the applied voltage to simulate the structure and improving mechanical performance. Fibers will also reduce the chance of failure like Wrinkling instabilities and increase the response rate under electric displacement. Implementing the dielectric elastomers with anisotropic structure, despite their great potential, has not adequately analyzed in previous researches. Therefore, based on nonlinear continuum mechanics and large inelastic deformations, the constitutive relationships and equations governing the behavior of viscoelastic dielectric elastomers under harmonic electrical loading are extracted and analyzed in different states. The numerical results, such as phase and frequency-amplitude diagrams and the oscillation, illustrate the dynamic behavior of an anisotropic dielectric elastomer with different fiber orientations. To describe the viscoelasticity behavior of the material, hyperelastic models and the rheological model, are used in conjunction with electrical coupling. Using the theory of anisotropic dielectric elastomers, a geometrically nonlinear formulation under finite deformations is developed by the Euler-Lagrange equations and solved mathematically.
Tier 2 Behavior Interventions: By the Student, for the Student
Authors: Mallory Patrick J. , Hampshire Patricia K. , Carter Deborah R.
Published: February 2021

Research suggests that students are more invested in behavior interventions when they are involved in the development process. Tier 2 behavior interventions in a positive behavior interventions and supports (PBIS) framework can be tailored to embed student involvement and meet individual student needs. The purpose of this article is threefold. First, it explores the importance of student involvement throughout the development and implementation of behavior interventions. Second, a case is made for embedding student involvement at the Tier 2 level of support. Finally, suggestions and examples are provided to aid educators and practitioners with improving student involvement in implementing several common Tier 2 interventions. Using this model can empower students to take charge of their own interventions, resulting in more meaningful learning experiences.
Surgical Approach to Hemipalatal Discrepancy in Tessier 7 Reconstruction: Review of Literature and Case Series
Authors: Kanth Aditi M. , Krevalin Max , Adetayo Oluwaseun A.
Published: February 2021

Objective:

The authors present findings and techniques to address hemipalatal discrepancy in patients with Tessier 7 cleft and associated cleft palate during cleft palatoplasty.

Design:

The authors report 2 cases of pediatric patients with Tessier 7 facial clefts and associated cleft palate. One patient presents on the broader oculo-auriculo-vertebral spectrum and the other is has isolated Tessier cleft 7. Additionally, a PubMed search was performed using the MeSH terms “tessier 7,” “cleft palate”, “macrostomia,” “tessier 7 AND cleft palate,” “macrostomia AND cleft palate,” AND “hemipalatal discrepancy.” All relevant literature was identified and underwent full review for qualitative analysis.

Results:

Two patients met criteria for inclusion in this article. The surgical techniques utilized to mitigate the hemipalatal length discrepancy are detailed, and intraoperative photographs are provided. The results of the literature review are also presented. Tessier 7 craniofacial cleft and palatal clefts, when occurring in combination, is noted to result in discrepant hemipalatal length with short maxillary palate length on the affected side as well hypoplasia of the associated speech musculature. The postoperative palatal length after palatoplasty in both patients was longer than the preoperative hypoplastic palatal length.

Conclusions:

When occurring in combination, Tessier 7 craniofacial cleft and concomitant palatal cleft results in discrepant hemipalatal length, and deficiency of the bony maxillary palatal shelves, and associated speech musculature and soft tissues. The techniques described in this article may assist in maximizing postoperative palatal length.
Real-world treatment patterns in relapsed/refractory multiple myeloma: Clinical and economic outcomes in patients treated with pomalidomide or daratumumab
Authors: Richter Joshua , Anupindi Vamshi Ruthwik , Yeaw Jason , Kudaravalli Suneel , Zavisic Stojan , Shah Drishti
Published: February 2021

Introduction

Real-world evidence on later line treatment of relapsed/refractory multiple myeloma (RRMM) is sparse. We evaluated clinical outcomes among RRMM patients in the 1-year following treatment with pomalidomide or daratumumab and compared economic outcomes between RRMM patients and non-MM patients.

Patient and Methods

Adult patients with ≥1 claim of pomalidomide or daratumumab were identified between January 2012 and February 2018 using IQVIA PharMetrics® Plus US claims database. Patients were required to have a diagnosis or treatment for MM and a claim of any immunomodulatory drugs and proteasome inhibitors before the index date. Mean time to new therapy, overall survival (OS) using Kaplan-Meier curve and adverse events (AEs) were reported over the 1-year post-index period. RRMM patients were also matched to a non-MM comparator cohort and economic outcomes were compared between the two cohorts.

Results

289 RRMM patients were matched to 1,445 patients without MM. Most prevalent hematological AE was anemia (72.0%) and non-hematological AE was infections (75.4%). Mean (SD) time to a new treatment was 4.7 (5.3) months and median OS was 14.6 months. RRMM patients had significantly higher hospitalizations and physician office visits (Both P < .0001) compared to non-MM patients. Adjusting for baseline characteristics, patients with RRMM had 4.9 times (95% CI 3.8-6.4, P < .0001) the total healthcare costs compared with patients without MM. The major driver of total costs among RRMM patients was pharmacy costs (67.3%).

Conclusion

RRMM patients showed a high frequency of AEs, low OS, and a substantial economic burden suggesting need for effective treatment options.
Acute Villitis and Intravascular Microorganisms in Fetal Vessels: A Case Report and Literature Review of an Unusual Histopathological Finding
Authors: Narice Brenda F , Trzeszcz Martyna , Cohen Marta , Anumba Dilly O
Published: February 2021

Optimal management of intrauterine infection to avoid serious adverse perinatal outcomes entails prompt administration of antibiotics and consideration of early delivery of the fetus to remove the focus of infection. We report an unusual case of preterm chorioamnionitis which did not improve with sensitive antibiotics, or delivery of the fetus, and ultimately required an emergency hysterectomy to save the mother’s life. Interestingly, subsequent histopathological analysis of the post-hysterectomy specimen did not reveal myometrial necrosis or infectious microorganisms. The placental pathological examination, on the other hand, showed evidence of necrotising chorioamnionitis accompanied by a rarely reported lesion: acute villitis with abundant intravascular Escherichia coli, a finding which is strongly associated with fetal demise and adverse maternal outcomes.
Connections Between Culinary Tourism Experiences and Memory
Authors: Stone Matthew J. , Migacz Steven , Sthapit Erose
Published: February 2021

Tourism researchers have identified many factors leading to memorable food tourism (culinary tourism) experiences. This research proposes reasons why food experiences while traveling are especially memorable and proposes avenues for future research on food and memory. The act of travel in addition to the act of eating/drinking and individual attitudes and emotions likely work together to create memories. Travelers agreed with many reasons why food travel experiences are connected with memory. These include sensory connections, emotional connections, social and interpersonal connections, novelty and experimental connections, focus and attention, and reflective connections. These connections may also relate to pretrip expectations. Travelers who identified themselves as motivated to travel for food and drink felt more strongly than other travelers about the reasons that food and drink travel experiences were connected with memory. Suggestions are included for researchers to advance understanding of memorable food tourism experiences.
The Burden of Preventable Adverse Drug Events on Hospital Stay and Healthcare Costs in Japanese Pediatric Inpatients: The JADE Study
Authors: Iwasaki Hitoshi , Sakuma Mio , Ida Hiroyuki , Morimoto Takeshi
Published: February 2021

Background:

Adverse drug events (ADEs) are a burden to the healthcare system. Preventable ADEs, which was ADEs due to medication errors, could be reduced if medication errors can be prevent or ameliorate.

Objective:

We investigated the burden of preventable ADEs on the length of hospital stay (LOS) and costs, and estimated the national burden of preventable ADEs in pediatric inpatients in Japan.

Methods:

We analyzed data from the Japan Adverse Drug Events (JADE) study on pediatric patients and estimated the incidence of preventable ADEs and associated extended LOS. Costs attributable to extended LOS by preventable ADEs were calculated using a national statistics database and we calculated the effect of preventable ADEs on national cost excess.

Results:

We included 907 patients with 7377 patient-days. Among them, 31 patients (3.4%) experienced preventable ADEs during hospitalization. Preventable ADEs significantly increased the LOS by 14.1 days, adjusting for gender, age, ward, resident physician, surgery during hospitalization, cancer, and severe malformation at birth. The individual cost due to the extended LOS of 14.1 days was estimated as USD 8258. We calculated the annual extra expense for preventable ADEs in Japan as USD 329 676 760. Sensitivity analyses, considering the incidence of preventable ADEs and the length of hospital stay, showed that the expected range of annual extra expense for preventable ADEs in Japan is between USD 141 468 968 and 588 450 708.

Conclusion:

Preventable ADEs caused longer hospitalization and considerable extra healthcare costs in pediatric inpatients. Our results would encourage further efforts to prevent and ameliorate preventable ADEs.
Improving lives not just saying no to substances: Evaluating outcomes for a young people’s substance use team trained in the AMBIT approach
Authors: Fuggle Peter , Talbot Laura , Wheeler James , Rees Jessica , Ventre Emily , Beehan Verity , Hare Suzanne , Bevington Dickon , Cracknell Liz
Published: February 2021

Adaptive Mentalization Based Integrative Therapy (AMBIT) is a systemic, mentalization based intervention designed for young people with multiple problems including mental health problems. The purpose of this paper is to examine the impact of this approach both on clinical and functional outcomes for young people seen by a specialist young people’s substance use service between 2015 and 2018. About 499 cases were seen by the service during this period. Substance use outcomes were obtained for 383 cases using the Treatment Outcome Profile (TOP). Cannabis and alcohol use were the key substance use problems for 81% and 63% respectively. Functional outcomes using the AMBIT Integrative Measure (AIM) were obtained for 100 cases covering domains of daily living, socio-economic context, peer relationships and mental health. At treatment end, cannabis use reduced significantly ( t = 10.78; df = 311; p = .00; Cohen’s d ES.61 as did alcohol use ( t = 6.938; df = 242; p = .000; ES 0.44). Functional improvements were shown in five out of seven domains with highly significant total functional improvements on key problems selected by the client ( t = 14.01; df = 99; p = .000; ES1.34). Measuring functional as well as clinical outcomes appears to reflect more accurately the overall benefit of the service to clients.
The messy work of decolonial praxis: insights from a creative collaboration among queer African youth
Authors: Meer Talia , Müller Alex
Published: February 2021

On the African continent, coloniality/modernity and the (un)freedom of queer peoples intersect in particular historically embedded and newly oppressive ways, making queerness a significant area for transformative struggles. This article draws from the learnings of a collaborative project, called the Qintu Collab, wherein queer African youth created an anthology of graphic stories and a set of podcasts based on their life experiences. The project aimed to link academic scholarship with art and activism through a specifically queer feminist perspective in an effort towards decolonising methodology; and to explore queer collaboration as an antidote to the coloniality of power of dominant western perspectives on queerness and the marginalisation of queer Africans, particularly in countries where same-sex sexuality is criminalised. Taking a feminist queer perspective, we explore the potential of participatory creative research as decolonial practice, to reveal the complex messy work of working together. Specifically, we address the question of when collaborations begin and how methodological decision-making takes place; assumptions about shared ideology and how ideological differences, in our case around notions of queer politics and personhood, are addressed within collaborative settings, as well as how the imagined audience shapes collaborative processes. Our learnings are pertinent for anyone undertaking participatory research collaboration as a transformative endeavour. We want to trouble the idea that participatory collaboration and creative methods are sufficient as decolonial practice. We found that early shared decision-making, (queer) insider research and creative methods were significant for raising and holding contestation and ideological difference, as well as enabling critical thinking and conscientisation. However, maintaining an open, collaborative process conducive to decolonial thinking and doing was hard, ongoing and imperfect work, as we constantly negotiated personal and structural conditions of coloniality.
Retrotopian feminism: the feminist 1970s, the literary utopia and Sarah Hall’s The Carhullan Army
Authors: Davidson Joe P. L.
Published: February 2021

In recent years, there has been increasing discontent with feminism’s understanding of its own history and, more specifically, the place of the feminist 1970s. Feminist scholars – most prominently, Elizabeth Freeman, Victoria Hesford, Kate Eichhorn and Kathi Weeks – have sought to move beyond the feelings of progress and nostalgia that the feminist 1970s often inspires. There is a need to mediate between the urge to leave the past behind and the desire to return to it, with feminists adopting positions that ricochet between progress and nostalgia. In this article, I argue that the feminist literary utopia offers a particularly productive means by which to represent this ambivalent, paradoxical temporal understanding. The classic feminist utopias of the 1970s have become the object of critical contention in more recent speculative texts, which destabilise both progress and nostalgia in their evocation of second-wave separatism. To elaborate this claim, I turn to Sarah Hall’s The Carhullan Army, which critically assesses the feminist 1970s via an account of a separatist feminist enclave in a near-future Britain. The community of women is a homage to the feminist 1970s, displaying both the potentialities of the movements of this time as well as their sometimes violent limitations. The dreams of the 1970s emerge in the text as an unsettling presence in the world, a force that can neither be left behind nor fully embraced.
Countering terrorism or criminalizing curiosity? The troubled history of UK responses to right-wing and other extremism
Authors: Zedner Lucia
Published: February 2021

The growth of right-wing extremism, especially where it segues into hate crime and terrorism, poses new challenges for governments, not least because its perpetrators are typically lone actors, often radicalized online. The United Kingdom has struggled to define, tackle or legitimate against extremism, though it already has an extensive array of terrorism-related offences that target expression, encouragement, publication and possession of terrorist material. In 2019, the United Kingdom went further to make viewing terrorist-related material online on a single occasion a crime carrying a 15-year maximum sentence. This article considers whether UK responses to extremism, particularly those that target non-violent extremism, are necessary, proportionate, effective and compliant with fundamental rights. It explores whether criminalizing the curiosity of those who explore radical political ideas constitutes legitimate criminalization or overextends state power and risks chilling effects on freedom of speech, association, academic freedom, journalistic enquiry and informed public debate—all of which are the lifeblood of a liberal democracy.
Lecture capture, social topology, and the spatial and temporal arrangements of UK universities
Authors: Lamb James , Ross Jen
Published: February 2021

This article considers how technologies actively shape the topologies of UK higher education. Using the example of lecture capture systems, we examine the relationship between learning technologies and formations of space and time. Combining theories of sociomateriality and social topology, and concepts of assemblage and relationality, we expose the entanglement of interests that influence university spaces and times. Across 3 months coinciding with the onset of COVID-19 we collected over 500 tweets that discussed lecture capture within UK higher education, leading towards 2 central arguments. First, the topology of the lecture is fluid, and, even while being radically technologised, re-spatialised and disrupted, it persists as a lecture and a central pedagogical feature of university life. Second, lecture capture is a rich site of ‘issuefication’, and viewing learning technologies as dynamic issues enables a better understanding of how their meaning, function and influence are contingent on shifting and relational assemblages of human and non-human interests. Lecture capture can be pedagogical, commercial and political, thereby resisting deterministic framings of the relationship between technologies and the temporal and spatial arrangements of higher education.
The vocational route to higher education in Finland: Students’ backgrounds, choices and study experiences
Authors: Haltia Nina , Isopahkala-Bouret Ulpukka , Jauhiainen Annukka
Published: February 2021

Division between academic and vocational education is a predominant feature of both upper secondary and higher education in Finland as well as in many other country contexts. This article focuses on a minority of higher education students, those who have not proceeded to higher education through the traditional academic track but have enrolled through the vocational route. We deploy the concept of institutional habitus and utilize Eurostudent VI survey data ( N=7318) to analyse the backgrounds and study experiences of higher education students with different kinds of educational backgrounds. Our findings indicate that those enrolling through the vocational route are more often mature students from lower parental educational backgrounds. They have often completed a longer study path and began to see themselves as future higher education students later in their life course. There are also differences in how students with diverse educational backgrounds experience their sense of belonging to the higher education community. This paper focuses on Finland but has relevance for other European countries as the institutional structures and practices discussed in this paper are evident internationally.
Are Continued Efforts to Reduce Radiation Exposures from X-Rays Warranted?
Authors: Oakley Paul A. , Harrison Deed E.
Published: February 2021

There are pressures to avoid use of radiological imaging throughout all healthcare due to the notion that all radiation is carcinogenic. This perception stems from the long-standing use of the linear no-threshold (LNT) assumption of risk associated with radiation exposures. This societal perception has led to relentless efforts to avoid and reduce radiation exposures to patients at great costs. Many radiation reduction campaigns have been launched to dissuade doctors from using radiation imaging. Lower-dose imaging techniques and practices are being advocated. Alternate imaging procedures are encouraged. Are these efforts warranted? Based on recent evidence, LNT ideology is shown to be defunct for risk assessment at low-dose exposure ranges which includes X-rays and CT scans. In fact, the best evidence that was once used to support LNT ideology, including the Life Span Study data, now indicates thresholds for cancer induction are high; therefore, low-dose X-rays cannot cause harm. Current practices are safe as exposures currently encountered are orders of magnitude below threshold levels shown to be harmful. As long as imaging is medically warranted, it is shown that efforts to reduce exposures that are within background radiation levels and that are also shown to enhance health by upregulating natural adaptive protection systems are definitively wasted resources.
Comparisons Inform Me Who I Am: A General Comparative-Processing Model of Self-Perception
Authors: Morina Nexhmedin
Published: February 2021

People’s self-concept contributes to their sense of identity over time. Yet self-perception is motivated and serves survival and thus does not reflect stable inner states or accurate biographical accounts. Research indicates that different types of comparison standards act as reference frames in evaluating attributes that constitute the self. However, the role of comparisons in self-perception has been underestimated, arguably because of lack of a guiding framework that takes into account relevant aspects of comparison processes and their interdependence. I propose a general comparative model of self-perception that consists of a basic comparison process involving the individual’s prior mental representation of the target dimension, the construal of the comparison standard, and the comparison outcome representing the posterior representation of the target dimension. The generated dimensional construal is then appraised with respect to one’s motives and controllability and goes on to shape emotional, cognitive, and behavioral responses. Contextual and personal factors influence the comparison process. This model may be informative in better understanding comparison processes in people’s everyday lives and their role in shaping self-perception and in designing interventions to assist people overcome undesirable consequences of comparative behavior.
BRAF, MEK and EGFR inhibition as treatment strategies in BRAF V600E metastatic colorectal cancer
Authors: Ros Javier , Baraibar Iosune , Sardo Emilia , Mulet Nuria , Salvà Francesc , Argilés Guillem , Martini Giulia , Ciardiello Davide , Cuadra José Luis , Tabernero Josep , Élez Elena
Published: February 2021

Introduction:

BRAF driver mutations are found in up to 15% of patients with colorectal cancer (CRC) and lead to constitutive activation of BRAF kinase and sustained RAS/RAF/MEK/ERK pathway signaling. BRAF mutations define a sub-population characterized by a poor prognosis and dismal median survival. Following successful outcomes with BRAF inhibition in BRAF mutant metastatic melanoma, this approach was evaluated in metastatic colorectal cancer (mCRC). The development and combination of targeted therapies against multiple signaling pathways has proved particularly successful, with improved survival and response rates.

Areas covered:

This review addresses the development of therapeutic strategies with inhibitors targeting MAPK/ERK and EGFR signaling in BRAF V600E mutated mCRC, focusing on encorafenib, binimetinib and cetuximab. A pharmacological and clinical review of these drugs and the therapeutic approaches behind their optimization are presented.

Expert opinion:

Exploiting knowledge of the mechanisms of resistance to BRAF inhibitors has been crucial to developing effective therapeutic strategies in BRAF-V600E mutant mCRC. The BEACON trial is a successful example of this approach, using encorafenib and cetuximab with or without binimetinib in patients with previously treated BRAF V600E mutant mCRC, showing an impressive improvement in clinical outcomes and tolerable toxicity compared with chemotherapy, establishing a new standard of care in this setting.
Contact and the 2020 Pandemic: A Poetic Autoethnography
Authors: Pelias Ronald J.
Published: February 2021

This poetic autoethnography explores aspects of human contact and communication during the COVID-19 pandemic of 2020. Through a series of poems, the inquiry focuses upon the desire for ordinary interactions and the fear of contamination. The piece stands as a lament, not only for those who have died and have become ill from the virus, but also for the loss of human connection as people practice in varying degrees social distancing.
The Effects of Smartphone Spectatorship on Attention, Arousal, Engagement, and Comprehension
Authors: Szita Kata , Rooney Brendan
Published: February 2021

The popularity of watching movies and videos on handheld devices is rising, yet little attention has been paid to its impact on viewer behaviour. Smartphone spectatorship is characterized by the small handheld screen as well as the viewing environment where various unrelated stimuli can occur, providing possible distractions from viewing. Previous research suggests that screen size, handheld control, and external stimuli can affect viewing experience; however, no prior studies have combined these factors or applied them for the specific case of smartphones. In the present study, we compared smartphone and large-screen viewing of feature films in the presence and absence of external distractors. Using a combination of eye tracking, electrodermal activity measures, self-reports, and recollection accuracy tests, we measured smartphone-accustomed viewers’ attention, arousal, engagement, and comprehension. The results revealed the impact of viewing conditions on eye movements, gaze dispersion, electrodermal activity, self-reports of engagement, as well as comprehension. These findings show that smartphone viewing is more effective when there are no distractions, and smartphone viewers are more likely to be affected by external stimuli. In addition, watching large stationary screens in designated viewing environments increases engagement with a movie.
“Access to technology is the major challenge”: Teacher perspectives on barriers to DGBL in K-12 classrooms
Authors: Hébert Cristyne , Jenson Jennifer , Terzopoulos Tatyana
Published: February 2021

In this article, we report on a study of 32 teachers and their implementation of a digital game designed to support the human and physical geography curriculum in grades 7 and 8 in the province of Ontario, Canada. The purpose of the paper is to analyze and robustly represent the experiences of teachers who participated in the study, most of whom had never before constructed an integrated learning experience utilizing a digital game with one of their classes. By centering teacher voices, which often do not appear in research on digital game-based learning (DGBL), we hope to provide insight into some of the real challenges of incorporating digital games into classrooms.
Comparison of the effectiveness of celiac versus common hepatic artery injection for the detection of hepatocellular carcinoma and of the feeding artery on cone-beam computed tomographs obtained during hepatic angiography
Authors: Hotta Akihiro , Ishikawa Masaki , Tachikake Toshihiro , Matsuura Noriaki , Toyota Naoyuki , Awai Kazuo
Published: February 2021

Background

Cone-beam computed tomography (CBCT) has been widely used during transcatheter arterial chemoembolization for hepatocellular carcinoma.

Purpose

To evaluate the sensitivity of CBCT for the detection of hepatocellular carcinomas and the tumor feeders by comparing celiac artery (CA) and common hepatic artery (CHA) injection.

Material and methods

We retrospectively enrolled 30 patients (52 hepatocellular carcinoma lesions) who had undergone CBCT-assisted transcatheter arterial chemoembolization. In 17 procedures (28 hepatocellular carcinomas) we acquired CBCT scans using CA injections (CBCT-CA) and in 18 (24 hepatocellular carcinomas) we used CHA injections (CBCT-CHA). Of the 30 patients, 5 underwent CBCT-CA and CBCT-CHA at different transcatheter arterial chemoembolization procedures. We performed inter-group comparisons of the detectability of hepatocellular carcinoma, the feeding artery, the intrahepatic artery branch order, and the tumor-to-liver contrast.

Results

CBCT-CA detected all 28 hepatocellular carcinomas and 27 of their feeders (96.4%); CBCT-CHA identified 22 of 24 hepatocellular carcinomas (91.7%) and 21 of their feeders (95.5%). There was no significant inter-group difference in the detectability of hepatocellular carcinoma lesions (p = 0.21) or feeding arteries (p = 0.69). CBCT-CHA was superior for the assessment of the tumor-to-liver contrast and the intrahepatic artery branch order (both: p < 0.01).

Conclusion

CBCT-CA and CBCT-CHA were equally useful for the detection of hepatocellular carcinoma and of the feeding artery, although CBCT-CHA yields better visualization of hepatocellular carcinoma and the hepatic artery. Thus CA injection seems sufficient for lesion and vessel detection when the insertion of an angiographic catheter into the CHA is difficult.