bluuebunny/crossref_metadata_2025 huggingface dataset:
Identity work of children with a parent with early-onset dementia in the Netherlands: Giving meaning through narrative construction
Authors: Hoppe Silke
Published: August 2021

Background

In the past years an increasing amount of research has been done on the experiences of adult children of a parent with early-onset dementia. However, little is still known about how the socio-cultural context influences the narratives of these children.

Aim

This study aimed to provide insights into the far-reaching consequences of parental early-onset dementia for adult children in the Netherlands. It illustrates how the experiences of these adult children are shaped by the context they live in.

Method

16 in-depth interviews were conducted with adult children of a parent with early-onset dementia in the Netherlands. The interviews offered the children space to reflect on the impact the illness of their parent had on them and their lives. The data were analysed using thematic analysis.

Findings

This article illustrates that the comparative processes of relating to others' experiences help the children to reflect on the impact that their parent's illness has on their own lives, which in turn aids them in contextualising and making meaning out of their changing lives and relationships. This contextualization and recovery of meaning is shaped by three processes. The first concerns the ways these adult children draw comparisons between their own lives and experiences and those of their peers of the same age group. The second process entails comparative understandings of having a parent with early-onset dementia versus having a parent with late-onset dementia. The third process explores how having a parent with early-onset dementia compares to having a parent with other diseases. The processes of contextualisation which the adult children engage in are shaped by what the children perceive to be normal and thus also by their socio-cultural contexts.

Conclusions

This article reveals how meaning is created in a constant interplay between the primary experiences of having an ill parent and the socio-cultural context in which the experiences take place. It illustrates how this context provides for particular narratives, which in turn shape how the children are able to give meaning to their experiences.
Opportunistic cognitive screening in Sweden: What the tests mean and do for patients and healthcare professionals
Authors: Zeiler Kristin , Karlsson Göran , Gunnarson Martin
Published: August 2021

Since 2017, opportunistic screening for cognitive impairment takes place at the geriatric ward of a local hospital in Sweden. Persons above the age of 65 who are admitted to the ward, who have not been tested for cognitive impairment during the last six months nor have a previously known cognitive impairment, are offered the Mini-Mental State Examination and the Clock-Drawing Test. This article analyses what the opportunistic screening practice means for patients and healthcare professionals. It combines a phenomenologically-oriented focus on subjectivity and sense-making with a focus that is inspired by science and technology studies on what the tests become within the specific context in which they are used, which allows a dual focus on subjectivity and performativity. The article shows how the tests become several different, not infrequently seemingly contradictory, things: an offer, an important tool for knowledge-production, something unproblematic yet also emotionally troubling, something one can fail and an indicator that one belongs to a risk group and needs to be tested. Further, the article shows how the practice is shaped by the sociocultural context. It examines the role of the affective responses to the test for subjectivity – particularly patient subjectivity – and offers a set of recommendations, if this practice were to expand to other hospitals.
Artificial intelligence in psychology: How can we enable psychology students to accept and use artificial intelligence?
Authors: Gado Sabrina , Kempen Regina , Lingelbach Katharina , Bipp Tanja
Published: August 2021

Psychologists with their expertise in statistics and regarding human perception and behavior can contribute valuable insights to the development of innovative and useful artificial intelligence (AI) systems. Therefore, we need to raise attention and curiosity for AI and foster the willingness to engage with it among psychology students. This requires identifying approaches to integrate a general understanding of AI technology into formal psychological training and education. This study investigated to what extent psychology students currently accept and use AI and what affects their perception and usage. Therefore, an AI acceptance model based on established technology acceptance models was developed and tested in a sample of 218 psychology students. An acceptable fit with the data was found for an adapted version. Perceived usefulness and ease of use were most predictive for the students’ attitude towards AI; attitude itself, as well as perceived usefulness, social norm, and perceived knowledge, were predictors for the intention to use AI. In summary, we identified relevant factors for designing AI training approaches in psychology curricula. In this way, possible restraints regarding the use of AI can be reduced and its beneficial opportunities exploited in psychological contexts.
Ultraviolet light exposure degradation effect on the properties of nanocrystalline cellulose-reinforced polyvinyl alcohol composite film
Authors: Sri Aprilia NA , HPS Abdul Khalil , Olaiya NG , Amin Amri , Abdullah CK , Kamarazaman Suraiya , Zuhra Zuhra , Rahmah Khairul , Fitriani Fitriani , Gopakumar Deepu A
Published: August 2021

PVA used in packaging applications has been faced with a UV light degradation challenge, which often reduces its durability while in use. The UV light stability enhancement effect of nanocrystalline cellulose (NCC) reinforcement in PVA was studied. Polyvinyl alcohol composite film was reinforced with NCC from palm oil waste (PVA-NCC film) and exposed to UV light (22 W, SUV-16 254 nm) for different time duration to study the material durability enhancement. The percentage weight loss of the samples was measured to observe the UV light degradation effect. Furthermore, the samples’ structural, morphological, and tensile properties were studied before and after exposure to UV light with FT-IR, scanning electron microscopy (SEM), and tensile test. The results showed physical degradation, morphological and tensile properties enhancement of PVA with NCC’s addition. The addition of NCC to the PVA matrix reduced the degradation rate under UV light significantly. Also, the percentage of weight loss was observed to change with the exposure time to UV light.
The Electoral Crisis of Social Democracy: Postindustrial Dilemmas or Neoliberal Contamination?
Authors: Bandau Frank
Published: August 2021

The crisis of social democracy has been the subject of numerous articles and books from different fields such as party politics, political sociology, and political economy. This article contrasts two competing explanations prevalent in the related literature. According to the postindustrial dilemmas hypothesis, the crisis of social democracy is the inevitable result of the transition from industrial to postindustrial society and the electoral trade-offs social democrats are facing as a consequence. The neoliberal contamination hypothesis instead emphasizes social democracy’s neoliberal turn and the resulting loss of trust in social democracy, especially among working-class voters. It is argued that both hypotheses are not only based on diverging conceptions of partisan politics, pitting Downs against Gramsci, but also on different theories of capitalist development (modernization theory vs Polanyian “double movement”). As a result, each explanation captures important aspects of the current crisis of social democracy but also misses other aspects that are essential to fully understand this phenomenon.
Intimate Partner Violence in the Middle East Region: A Systematic Review and Meta-Analysis
Authors: Moshtagh Mozhgan , Amiri Rana , Sharafi Simin , Arab-Zozani Morteza
Published: August 2021

Background and Objective:

Intimate partner violence (IPV) is a clinical and social problem globally, especially in the Middle East. This study aimed to analyze the prevalence of IPV and its types against women in the Middle East region.

Method:

PubMed, Scopus, and Web of Science were searched in January 2020. From 1995 to 2020, all studies performed in the Middle East, investigating at least one type of abuse against women and written in English, entered the study. All included studies were appraised using Joanna Briggs Institute Checklist, which was adapted for prevalence studies. The random effect model of meta-analysis was performed using the Mantel–Haenszel method by comprehensive meta-analysis software. Each type of abuse as event rate with 95% CI was calculated for each variable. Heterogeneity was investigated using the I 2 statistic test.

Results:

Fifty-five studies encompassing 138,692 participants were included in our meta-analysis. The rate of overall abuse was 26.3 ( n = 55, 95% CI: [15.8, 40.5], p = .002). The highest rate of abuse in the included studies was reported for psychological abuse 48.6% ( n = 46, 95% CI: [39.8, 57.5], p = .758). The rate of abuse for physical, economical, sexual, and injury were 28.4% ( n = 53, 95% CI: [22.1, 35.7], p = .0001), 19% ( n = 10, 95% CI: [9.8, 33.7], p = .0001), 18.5% ( n = 45, 95% CI: [13.6, 24.6], p = .0001), and 18.4% ( n = 5, 95% CI: [7.1, 40.2], p = 0.008), respectively. The overall abuse reported by World Health Organization Multi-Country Domestic Violence (DV)Questionnaire was 25.7% ( n = 17, 95% CI: [18.4, 34.7], p = .0001). This value was 41.8% ( n = 11, 95% CI: [29.7, 55], p = .223) for the Conflict Tactics Scale Questionnaire.

Conclusion:

Although this review highlights the lack of or insufficient IPV data in some contexts and inconsistencies in defining and measuring IPV among studies, the evidence shows that a moderate to high pattern of abuse has been observed in the study population. Due to this region’s unique cultural-religious characteristics, it is urgent to reduce this phenomenon.
Now You See Me, Now You Don’t: Living With Deleuze, Intimating in the Dance of Movements, Moments, and Sensation
Authors: Gale Ken
Published: August 2021

In this article, I argue that writing with intimacy through an animation of Deleuzian thought helps to destabilize the simply human practice of signifying, representing, and locating emotions within a metaphysics of being, which firmly ignores affective relationality and the emergence of posthuman practices of thinking and doing. By positing the practice of intimating, I argue that such an approach will prompt movement away from thinking about what a body is or what it might mean toward moving with and sensing encounters and engagements with what bodies can do. Continuing this line of thinking and writing with Deleuze will involve me in engaging in rupture, of taking a line of flight, of speculating about intimacy, not as a linear, molar attribute of simply human bodies, but rather as a complex, relational multiplicity of molecular lines. In this, I suggest that, in what Manning calls the “politics of touch,” bodies are always in the play of affective relationality, engaging in the dance between affecting and being affected, always sensing and shifting in intensive moments of movement and change. I extend this argument by proposing that intimating, as a practice of doing, involves working, with Deleuze and Guattari, with difference as “involutionary,” as emergent in and creative of fields of play in which “becoming-animal” leads us to new sensings of what bodies can do. In this “becoming-animal,” therefore, I will argue with and from Deleuze that intimating can be conceptualized as a means of “worlding” in which practices of always being on the lookout can be used to animate new creative relational forces in event/ful encounters with spacetime in so(u)rceries of the always not-yet-known.
Rare Case of Pyoderma Gangrenosum in the Setting of PAPA Syndrome in a 12-Year-Old Child
Authors: Alhumam Aminah
Published: August 2021

We report on a 12-year-old boy who presented with an intermittently painful wound present for months without any tendency to heal after a slackline accident two years ago. A biopsy of the ulcer margin revealed epithelial hyperplasia, marked fibrosis, and vascular proliferation without evidence of vasculitis. Pretibial findings on the right side were a 3.8 ×  3.1 cm fibrin-covered, flat ulcer with slight reddening of the surrounding area. Other findings were unremarkable with hypermobility of the wrists and finger joints. Local therapy with a foam dressing, topical steroid in the wound margin, and class II compression stockings showed no effect. The pediatric rheumatologist evaluated the ulcer with a camptodactyly of digit 5, subluxation of the wrists on both sides, and symmetric ulnar deviation. Elevated S100 as an isolated autoimmune phenomenon or concomitant with systemic autoimmune disease or autoinflammation (eg, Pyogenic sterile arthritis, pyoderma gangrenosum, and acne syndrome) was also observed. The therapy with oral steroids, initially 30 mg/day and gradual reduction in the course, only achieved a tissue bridge's formation with the same size extension of the ulcer. Unfortunately, the patient spontaneously developed a second ulcer on the left lateral malleolus, which is why the therapy was changed to dapsone 50 mg/day and tacrolimus in the wound margin after nine weeks. In the absence of success, further treatment with ciclosporin or tumor necrosis factor-alpha antibody therapy is planned in interdisciplinary cooperation.
Validity and Reliability of a Vibration-Based Cell Phone in Detecting Peripheral Neuropathy among Patients with a Risk of Diabetic Foot Ulcer
Authors: Jasmin Muh , Yusuf Saldy , Syahrul Syahrul , Abrar Eva Arna
Published: August 2021

The aim of this study was to determine the validity and reliability of a vibration-based cell phone in detecting peripheral neuropathy among individuals with a risk of diabetic foot ulcer (DFU). The current study consisted of 3 phases: a pilot study, concurrent validity study, and interreliability study. A 128 Hz tuning fork and vibration-based cell phone using the Vibrations-Test app was compared in the primary care setting. The pilot study confirmed that the vibration-based cell phone has an adequate reliability ( r > 0.70, P < .001). The concurrent validity test involved 96 participants (aged 55.78 ± 8.32 years). The Pearson correlation test found the highest correlation in the fifth metatarsal heads ( r = 0.741, right feet; 0.772, left feet; P < .001). In the 4 primary care settings, the interrater reliability between nurses of the vibration-based cell phone were k = 1.000, 1.000, 1.000, and 0.720. The concurrent validity test found moderate to strong correlation results and that the interrater reliability had a strong agreement that was almost perfect. Thus, vibration-based cell phone applications can be used as screening tools for detecting neuropathy among individuals with a risk of DFU.
Wound Healing in the Golden Agers: What We Know and the Possible Way Ahead
Authors: Goswami Aakansha Giri , Basu Somprakas , Shukla Vijay Kumar
Published: August 2021

While “population aging” is an accomplishment that deserves acclamation, it is in itself a tremendous challenge. Age-related skin changes, impaired wound healing, and concurrent comorbidities are the deadly triad that contribute most to the development of nonhealing chronic wounds in the elderly. This imposes enormous medical, social, and financial burden. With the rising trend in the aging population, this problem is likely to exacerbate unless multidisciplinary, rapt wound care strategies are developed. The last decade was dedicated to understand the basic biology underlying the wound healing process but most in vitro and animal model studies translated poorly to human conditions. Forthcoming, the focus is on the development of diagnostic and therapeutic strategies to improve healing in this vulnerable age group. Further, understanding the complex pathobiology of cellular senescence and wound healing process is required to develop focused therapy for these “problem wounds” in the elderly.
Teaching Meaning: A Pedagogical Strategy to Help Ministry Students Understand Meaning Making in Narrative Perspective
Authors: Kelley Melissa M.
Published: August 2021

This article describes a pedagogical classroom exercise that encourages ministry students to understand the jarring experience some people may confront when their life stories are disrupted and their ways of making meaning are challenged. Contemporary work in narrative and meaning making that grounds the exercise is presented. This exercise may be helpful to professionals who teach or mentor ministry students in their care of those enduring loss.
Neurophysiology of Gambling Behavior and Internet Use Vulnerability: A Comparison Between Behavioral and EEG Measures
Authors: Balconi Michela , Angioletti Laura
Published: August 2021

The present research explored electrophysiological activity (EEG) related to problematic internet use (PIU) vulnerability in a nonclinical population. Vulnerability to PIU was assessed through internet addiction test (IAT) in a sample of 23 participants. Moreover, they underwent a behavioral Iowa gambling task (IGT) for testing decision-making functioning and N2 event-related potentials (ERPs) component was monitored during an attentional inhibitory Go/NoGo task performance with addiction-related background pictures (videogames, online gambling, and neutral stimuli). IAT measure positively correlated with both IGT index and N2 variation at the Go/NoGo task. High-IAT young participants showed specific responses to internet addiction-related cues (pictures representing online gambling) in terms of ERPs amplitude of N2pc for Go trials in Pz. Findings suggested an early attentional facilitation effect for specific addiction-related stimuli, online gambling-related stimuli, suggesting a selective attention bias for salient stimuli in this population. While higher levels of IAT do not seem to correspond to a deficit in decision-making abilities, the selective attention mechanisms show to be partially biased in response to the salience of external cues.
Engaging Immigrant and Racialized Communities in Community-Based Participatory Research During the COVID-19 Pandemic: Challenges and Opportunities
Authors: Salma Jordana , Giri Deena
Published: August 2021

Community-based participatory research (CBPR) approaches have been important avenues for addressing community vulnerability during pandemics and times of crises. There has been little guidance, however, on how to approach CBPR within the context of the COVID-19 pandemic where physical distancing and closure of essential community organizations became the norm. This study discusses challenges and possibilities of using CBPR during a pandemic to address the needs of immigrant and racialized older adults in Alberta, Canada. Two case studies of active research projects that aim to engage immigrant and racialized older adults are presented. Three key challenges are identified related to research activities during the pandemic: (a) pivoting as new foci emerge, (b) recognizing inequity in research participation, and (c) reflecting on well-being in the research team. Approaches to addressing these challenges are highlighted with recommendations for future considerations in CBPR research within vulnerable communities.
Experimental investigation on self-loosening of a bolted joint under cyclical temperature changes
Authors: Eraliev Oybek Maripjon Ugli , Zhang Yi-He , Lee Kwang-Hee , Lee Chul-Hee
Published: August 2021

The most commonly used part in engineering fields is threaded fasteners. There are a lot of advantages of fasteners. One of them is that they can be easily disassembled and reused, but a bolted joint can loosen easily when a transversal load is applied. The clamp load of a bolted joint can also loosen slowly when subjected to repeated temperature changes. This paper presents an experimental investigation of the self-loosening of bolted joints under cyclical temperature variation. Experiments are carried out under several cyclical temperature changes with different bolt preloads. Rectangular threaded bolted joints with M12 × 1.75 bolts and nuts are tested in a specially designed testing apparatus. Material of bolt, nut, and plates is a stainless steel. The experimental results show that the high initial bolt preload may prevent the joint from self-loosening and the bolted joint has loosened significantly in the first cycle of temperature changes. From this investigation, the loosening of the bolted joint can be considered as a first stage self-loosening.
Image and report quality in non-obstetric ultrasound examinations undertaken by sonographers: Results of an audit of 3731 cases
Authors: Freeman Simon , Cantin Peter , Gutteridge Catherine , Williams Petra , Hamilton Sarah , Lam QiQi , Dubbins Paul
Published: August 2021

Introduction

This paper reports the results of a rolling audit of sonographer-performed non-obstetric ultrasound examinations undertaken between 2010 and 2020 in a large University Teaching Hospital Ultrasound Department in the United Kingdom. We believe that this represents the largest published audit of sonographer non-obstetric ultrasound examination quality.

Methods

Random samples of sonographer ultrasound examinations were regularly and systematically audited by consultant-level ultrasound practitioners through review of soft copy images and reports. Examination and report quality were assessed against an internal audit standard in 3731 patients over an 11-year period and also against externally set audit standards in 3186 patients over a nine-year period.

Results

Both image and report quality exceeded externally set audit standards in all nine years of audit. In the internal audit, the quality standard just failed to be met for the first five years of audit but was achieved in all the subsequent six years.

Conclusion

This audit provides further information on the quality and safety of sonographer-led ultrasound service delivery within a service that has quality safeguards, readily available support and an active education programme. It is used not only to provide assurance to patients, clinicians, managers and commissioners of this service but also to direct individual professional development and drive an iterative process of quality improvement.
The influence of calculation method and relative strength on the load-velocity relationship in bench press exercise
Authors: Bautista Iker J , Martín-Rivera Fernando , Martínez Isidoro , Haff Gregory G , Maroto-Izquierdo Sergio
Published: August 2021

Purpose

The objective of this study was: (1) to compare the effect of the calculation method using average (Avalue), and best value (Bvalue) of Mean Propulsive Velocity (MPV) on the Load Velocity Profile (LVprofile) during the barbell bench press exercise in elite handball players. In addition, (2) to analyze the relationship between the individual coefficient of variation (CVind) of an incremental load protocol in the bench press exercise with relative strength (Frel) in professional handball players.

Methods

Nineteen elite international handball players (age 18 [±1] y; body mass 93 [±14] kg; height 191 [±6] cm) performed an incremental test during the barbell bench press exercise. General and individual LVprofile, Frel, and CVind were modelled through MPV and two calculation models (Avalue, vs Bvalue).

Results

There were significant differences (p < 0.05) between both conditions (Bvalue vs. Avalue). There was an inverse relationship between the Frel and the CVind (r = −0.66, p < 0.001). When CVind was >10% significant differences were found between the two calculations method (Avalue, vs Bvalue). However, no significant differences were found between Avalue, vs Bvalue when the CVind was <10%.

Conclusions

The calculation method used to assess the barbell bench press LVprofile impacts the nature of the relationship. Regardless CVind values, Avalue is a good choice to determine the LVprofile when the CVind is >10%, if the CVind is <10%, Bvalue will be the better option to determine the LVprofile.
A systematic scoping literature review on the use of child life therapy (CLT) in the perioperative setting
Authors: Brown Sarah , Cordner Phillipa , Weir Kelly A , Machingura Tawanda
Published: August 2021

Background

Children and their caregivers often experience anxiety related to a perioperative admission. A systematic scoping review was conducted to map the evidence for child life therapy, including the professional background of treating clinicians.

Methods

A scoping review was conducted using the Arksey and O’Malley methodology. Six databases: PubMed, CINAHL, PsychINFO, Cochrane Library, EMBASE and Web of Science were searched.

Results

After reviewing 578 titles and abstracts, and 55 full texts, 11 studies were retained. Included studies were randomised controlled trials ( n = 5), retrospective studies ( n = 3), descriptive studies ( n = 1) and clinical studies ( n = 2). Child life therapy was effective for anxiety, anaesthetic induction quality, child cooperation and parental satisfaction. Professions delivering interventions included Child Life Therapists, nurses and a multidisciplinary team.

Conclusion

There is emerging evidence for child life therapy which may be used to guide delivery of paediatric procedural support in perioperative settings. Further studies are needed to inform practice.
Modern cemented Furlong hemiarthroplasty: Are dislocations rates better?
Authors: Menakaya CU , Shah M , Ingoe H , Malhotra R , Mannan A , Boddice T , Allgar V , Gopal S , Mohsen A , Muthukumar N
Published: August 2021

Background

Dislocation following hip hemiarthroplasty is a major complication with increased mortality and morbidity. Data looking at dislocation following contemporary bipolar stems are lacking in literature.

Methods

Retrospective review of our prospective national hip fracture database over a two-year period. Group 1 comprised of consecutive patients receiving bipolar Furlong prosthesis (N222) while Group 2 was made up of a historical cohort (uncemented; N254). Clinical and radiological records were reviewed to determine dislocation rates, causes and associative factors of dislocations. Data were analysed using SPSS.

Results

Following 476 hemiarthroplasties performed during the study period, 12 (2.5%) dislocations were reported (eight in Group 1; four in Group 2). There was no significant difference in dislocation rates (3.6% vs 1.6%) between groups ( p = 0.159). Subgroup analysis of Group 1 demonstrated a significant difference in dislocations with Furlong cemented (6%) as compared with Furlong uncemented (0%) hemiarthroplasties ( p = 0.024). Following dislocation, death rates increased to 8.3% from 1.7% in both groups.

Conclusion

There is a statistically significant increase in dislocation rate following use of cemented Furlong prosthesis when compared to similar uncemented prosthesis at the same treatment period. However, when compared to traditional uncemented prosthesis, there is no difference in dislocation rates.
Reimagining cultural memory of the arctic in the graphic narratives of Oqaluttuaq
Authors: Viljoen Jeanne-Marie , Zolkos Magdalena
Published: August 2021

The Greenlandic oral story-telling tradition, Oqaluttuaq, meaning “history,” “legend,” and “narrative,” is recognized as an important entry point into Arctic collective memory. The graphic artist Nuka K. Godtfredsen and his literary and scientific collaborators have used the term as the title of graphic narratives published from 2009 to 2018, and focused on four moments or ‘snippets’ from Greenland’s history (from the periods of Saqqaq, late Dorset, Norse settlement, and European colonization). Adopting a fragmentary and episodic approach to historical narrativization, the texts frame the modern European presence in Greenland as one of multiple migrations to and settlements in the Artic, rather than its central axis. We argue that, in consequence, the Oqaluttuaq narratives not only “provincialize” the tradition of hyperborean colonial memories, but also provide a postcolonial mnemonic construction of Greenland as a place of multiple histories, plural peoples, and heterogenous temporalities. As such, the books also narrativize loss and disappearance—of people, cultures, and environments—as a distinctive melancholic strand in Greenlandic history. Informed by approaches in the field of cultural memory and in the study memorial objects, Marks’ haptic visuality and Keenan and Weizman’s forensic aesthetics, we analyze the graphic narratives of Oqaluttuaq in regard to their aesthetic dimensions, as well as investigate the role of material objects and artifacts, which work as narrative “props” for multiple stories of encounter and survival in the Arctic.
Cervical and intracranial artery dissections
Authors: Engelter Stefan T. , Lyrer Philippe , Traenka Christopher
Published: August 2021

This review summarizes recent therapeutic advances in cervical (CeAD) and intracranial artery dissection (IAD) research. Despite unproven benefits, but in the absence of any signal of harm, in patients, with acute ischemic stroke attributable to CeAD, intravenous thrombolysis and, in case of large-vessel occlusion, endovascular revascularization should be considered. Future research will clarify which patients benefit most from either treatment modality. For stroke prevention, the recently published randomized controlled TREAT-CAD study showed that, against the initial hypothesis, aspirin was not shown non-inferior to anticoagulation with vitamin K antagonists (VKAs). With the results of two randomized controlled trials (CADISS and TREAT-CAD) available now, the evidence to consider aspirin as the standard therapy of CeAD is weak. Further analyses might clarify whether the assumption supports, in particular, that patients presenting with cerebral ischemia, clinical or subclinical with magnetic resonance imaging surrogates, might benefit most from VKA treatment. In turn, it remains to be shown, whether in CeAD patients presenting with pure local symptoms and without hemodynamic compromise, antiplatelets are sufficient, and whether a dual antiplatelet therapy during the first weeks of treatment is recommendable. The observation that ischemic strokes occurred (or recurred) very early after CeAD diagnosis, consistently across randomized and observational studies, supports the recommendation to start antithrombotic treatment immediately, whatever antithrombotic agent is chosen in each individual case. The lack of a license for the use in CeAD patients and the paucity of data are still arguments against the use of direct oral anticoagulants in CeAD. Nevertheless, due to their beneficial safety and efficacy profile proven in atrial fibrillation, these agents are a worthwhile treatment option to be tested in further CeAD treatment trials. In IAD, the experience with the use of antithrombotic agents is limited. As the risk of suffering intracranial hemorrhage is higher in IAD than in CeAD, the use of antithrombotic therapy in IAD remains controversial.
‘... You feel like the one that got left behind’: a narrative inquiry into the friendships of people who have endured mental health difficulties
Authors: Doran D , Edgley A , Stickley T
Published: August 2021

Aims:

To explore insights between friendship and mental health through a critical narrative inquiry. To conceptualise friendship and inform public health approaches to loneliness and mental health.

Method:

Seventeen interviews were conducted with middle-age people who had experienced mental health difficulties. Stories were subjected to a narrative analysis and interrogated further using critical theory.

Results:

Compassion in friendship reduces alterity and loneliness, and results in mutual discovery of dignity in relation to distress and stage of life. This is not achievable in all friendship.

Conclusion:

The temporary encounter of friendship can provide new bases for authentically relating. Through dignity and authenticity, friendship can contribute to mental health and reduce loneliness. Suggestions are made to inform public health approaches to friendship.
Defining the Efficacy of Omalizumab in Nasal Polyposis: A POLYP 1 and POLYP 2 Subgroup Analysis
Authors: Damask Cecelia , Chen Meng , Holweg Cecile T. J. , Yoo Bongin , Millette Lauren A. , Franzese Christine
Published: August 2021

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease with variable underlying pathophysiologies. Numerous patient factors have been linked to differences in disease severity, control, and response to treatment, including asthma status, aspirin sensitivity, previous sinonasal surgery, and blood eosinophil levels.

Objective

The present study examines the efficacy of the anti-immunoglobulin E therapy, omalizumab, versus placebo in patients with CRSwNP from the replicate POLYP 1 (NCT03280550) and POLYP 2 (NCT03280537) trials, grouped by inherent patient characteristics to determine the response to therapy.

Methods

Patients in prespecified subgroups from POLYP 1 and POLYP 2 (studies pooled for analysis) were examined. Subgroups included blood eosinophil count at baseline (>300 or ≤300 cells/μL), previous sinonasal surgery (yes or no), asthma status (yes or no), and aspirin sensitivity status (yes or no). Subgroups were examined for subgroup-specific adjusted mean difference (95% confidence interval [CI]) (omalizumab–placebo) in change from baseline at week 24 in Nasal Congestion Score (NCS), Nasal Polyp Score (NPS), Sino-Nasal Outcome Test-22 (SNOT-22), Total Nasal Symptom Score (TNSS), and University of Pennsylvania Smell Identification Test (UPSIT).

Results

Adjusted mean difference (95% CI) (omalizumab–placebo) in NCS, NPS, SNOT-22, TNSS, and UPSIT change from baseline at week 24 consistently favored omalizumab treatment over placebo in patients with blood eosinophil count >300 and ≤300 cells/μL, with or without previous sinonasal surgery, asthma, and aspirin sensitivity.

Conclusion

Together, these data suggest broad efficacy of omalizumab across clinical and patient-reported outcomes in patients with CRSwNP, independent of the underlying patient factors examined, including those with high eosinophil levels and those who have undergone previous surgery, which are associated with high recurrence.

Clinical Trial Registration

ClinicalTrials.gov identifiers: POLYP 1: ClinicalTrials.gov identifier NCT03280550 ( https://clinicaltrials.gov/ct2/show/NCT03280550 ); POLYP 2: ClinicalTrials.gov identifier NCT03280537 ( https://clinicaltrials.gov/ct2/show/NCT03280537 ).
Steatosis grading consistency between controlled attenuation parameter and MRI-PDFF in monitoring metabolic associated fatty liver disease
Authors: Shao Cong xiang , Ye Junzhao , Dong Zhi , Li Fuxi , Lin Yansong , Liao Bing , Feng Shiting , Zhong Bihui
Published: August 2021

Background:

The consistency in steatosis grading between magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) and controlled attenuation parameter (CAP) before and after treatment remains unclear. This study aimed to compare the diagnostic accuracy of steatosis grading between MRI-PDFF and CAP using liver biopsy as standard and to evaluate the value of monitoring changes in steatosis grading with CAP during follow-up utilizing MRI-PDFF as a reference.

Methods:

Consecutive patients from a biopsy cohort and a randomized controlled trial were included in this study and classified into 3 groups (the biopsy, orlistat treatment, and routine treatment subgroups). Hepatic steatosis was measured via MRI-PDFF and CAP at baseline and at the 6th month; the accuracy and cutoffs were assessed in the liver biopsy cohort at baseline.

Results:

A total of 209 consecutive patients were enrolled. MRI-PDFF and CAP showed comparable diagnostic accuracy for detecting pathological steatosis [⩾S1, area under the receiver operating characteristic curve (AUC) = 0.984 and 0.972, respectively]; in contrast, CAP presented significantly lower AUCs in grades S2–3 and S3 (0.820 and 0.815, respectively). The CAP values correlated well with the MRI-PDFF values at baseline and at the 6th month ( r = 0.809 and 0.762, respectively, both p < 0.001), whereas a moderate correlation in their changes ( r = 0.612 and 0.524 for moderate-severe and mild steatosis, respectively; both p < 0.001) was observed. The AUC of CAP change was obtained to predict MRI-PDFF changes of ⩾5% and ⩾10% (0.685 and 0.704, p < 0.001 and p = 0.001, respectively). The diagnostic agreement of steatosis grade changes between MRI-PDFF and CAP was weak (κ = 0.181, p = 0.001).

Conclusions:

CAP has decreased value for the initial screening of moderate-severe steatosis and is limited in monitoring changes in steatosis during treatment. The confirmation of steatosis grading with MRI-PDFF remains necessary.
Impact of exclusive e-cigarettes and heated tobacco products use on muco-ciliary clearance
Authors: Polosa R. , Emma R. , Cibella F. , Caruso M. , Conte G. , Benfatto F. , Ferlito S. , Gulino A. , Malerba M. , Caponnetto P.
Published: August 2021

Background:

Tobacco smoking impairs mucociliary clearance (MCC) efficiency as shown by prolonged saccharin test transit time (STTT). Avoiding exposure to tobacco smoke from combustible cigarettes may restore MCC function and former smokers have been shown to exhibit similar STTT as never smokers. The impact on STTT of switching from smoking to combustion-free tobacco products such as e-cigarettes (ECs) and heated tobacco products (HTPs) is not known.

Methods:

We report STTT of exclusive EC and HTP users. Test results were compared with those obtained in current, former, and never smokers.

Results:

STTT were obtained from 39 current, 40 former, 40 never smokers, and from 20 EC and 20 HTP users. Comparison of STTT values showed significant difference among the five study groups ( p < 0.00001) with current smokers having a median [interquartile range (IQR)] STTT of 13.15 min, which was significantly longer compared with that of all other study groups. In particular, compared with former (7.26 min) and never smokers (7.24 min), exclusive EC users and exclusive HTP users had similar STTT at 7.00 and 8.00 min, respectively.

Conclusion:

Former smokers who have switched to exclusive regular use of combustion-free nicotine delivery systems (i.e., ECs and HTPs) exhibit similar saccharin transit time as never and former smokers. This suggests that combustion-free nicotine delivery technologies are unlikely to have detrimental effects on MCC function.
Endoscopic treatment for gastric antral vascular ectasia
Authors: Peng Mengyuan , Guo Xiaozhong , Yi Fangfang , Shao Xiaodong , Wang Le , Wu Yanyan , Wang Chunmei , Zhu Menghua , Bian Ou , Ibrahim Mostafa , Chawla Saurabh , Qi Xingshun
Published: August 2021

Gastric antral vascular ectasia (GAVE) is one of the uncommon causes of upper gastrointestinal bleeding. Major treatment of GAVE includes pharmacotherapy, endoscopy, and surgery. The efficacy and safety of pharmacotherapy have not been sufficiently confirmed; and surgery is just considered when conservative treatment is ineffective. By comparison, endoscopy is a common treatment option for GAVE. This paper reviews the currently used endoscopic approaches for GAVE, mainly including argon plasma coagulation (APC), radiofrequency ablation (RFA), and endoscopic band ligation (EBL). It also summarizes their efficacy and procedure-related adverse events. The endoscopic success rate of APC is 40–100%; however, APC needs several treatment sessions, with a high recurrence rate of 10–78.9%. The endoscopic success rates of RFA and EBL are 90–100% and 77.8–100%, respectively; and their recurrence rates are 21.4–33.3% and 8.3–48.1%, respectively. Hyperplastic gastric polyps and sepsis are major adverse events of APC and RFA; and Mallory–Weiss syndrome is occasionally observed after APC. Adverse events of EBL are rare and mild, such as nausea, vomiting, esophageal or abdominal pain, and hyperplastic polyps. APC is often considered as the first-line choice of endoscopic treatment for GAVE. RFA and EBL have been increasingly used as alternatives in patients with refractory GAVE. A high recurrence of GAVE after endoscopic treatment should be fully recognized and cautiously managed by follow-up endoscopy. In future, a head-to-head comparison of different endoscopic approaches for GAVE is warranted.
Prevalence of Aspergillus fumigatus skin positivity in adults without an apparent/known atopic disease in Uganda
Authors: Kwizera Richard , Bongomin Felix , Olum Ronald , Worodria William , Bwanga Freddie , Meya David B. , Kirenga Bruce J. , Gore Robin , Fowler Stephen J. , Denning David W.
Published: August 2021

Background:

Skin prick testing (SPT) is an important investigation in the evaluation of allergy to fungal pathogens. However, the background sensitivity to fungal allergens among healthy people in Uganda is unknown. Our aim was to assess the background prevalence of Aspergillus fumigatus SPT positivity in apparently healthy adults without known atopic disease in Uganda.

Methods:

For this pilot study, we recruited 50 healthy volunteers using convenience sampling, 56% of whom were health workers. We performed the SPT for A. fumigatus according to manufacturer’s instructions. A wheal diameter of ⩾3 mm was considered positive.

Results:

The prevalence of A. fumigatus skin positivity was 60% (30/50). Participants with a positive A. fumigatus SPT were significantly younger than those with a negative result [median age (years): 28 versus 35; p = 0.005].

Conclusion:

There is a high skin positivity against A. fumigatus among non-atopic healthy Ugandan adults. There is an urgent need to establish a normal wheal cut-off value for this population. SPT alone may be an unreliable test for the diagnosis of A. fumigatus associated allergic syndromes. More studies are needed to define the prevalence of A. fumigatus skin positivity among non-atopic healthy population in Africa.
US–China commercial rivalry, great war and middle powers
Authors: Jeong Bora , Lee Hoon
Published: August 2021

This paper examines whether the recent trade war between the US and China would lead to a great power war. In so doing, we rely on two theoretical frameworks, mercantilism and power transition theory, that are likely to link trade war to a military confrontation. Evidence shows that the trade war per se is not a sufficient condition for an all-out war between the US and China. Unlike mercantilists argue, first, we identify the importance of domestic coalitions before trade war being escalated to a military conflict. Second, we find that trade war as economic statecraft is a viable means to suppress a challenger’s capability, which may stop or delay the power transition process. The findings provide implications for middle power countries where strategic choices are required between the two major powers.
Video Caravan in Engaging Development: Reflexivity, Agency and Bridging Communication
Authors: Mummidi Thanuja
Published: August 2021

The relation between indigenous people and development agencies is much discussed in anthropology ( Bicker et al., 2004 ; Pottier et al., 2003 ; Sillitoe et al., 2002 ). This relation is more often than not, one of conflict. A conflict that builds from distrust by the people on the development agent and disrespect from the latter on the former. The research on which this article is based addresses this conflict by recording the voice of the Konda Reddis, an indigenous group, through video for development communication. The video recorded peoples’ responses periodically to the key question, ‘is life in the hills or in the resettlement colony better, and why?’ Playing back these videos to the different respondents, including officials responsible for the development programme, in between responses was attempted to help them reflect on what they had said earlier in relation to what others had said, allowing room for them to reflect and respond again. The camera and video recording became the medium of real space and time, bringing the Konda Reddis, development agents and the anthropologist in conversation with each other.
Bilateral tubal incarceration into the broad ligaments caused by pelvic endometriosis: A case report
Authors: Massimello Francesca , Giannini Andrea , Tebache Linda , Nisolle Michelle , Simoncini Tommaso
Published: August 2021

Introduction:

Endometriosis is characterised by the presence of functional endometrial tissue outside the uterus. Salpinges are a common location of endometriotic implants. Endometriosis located into the broad ligament is a rare event.

Case description:

A 38-year-old infertile woman presented to our attention with moderate left iliac fossa pain after menses and intermenstrual bleeding. Transvaginal ultrasounds and pelvic magnetic resonance evidenced the presence of bilateral haematosalpinges. At the laparoscopic pelvic exploration, fallopian tubes were absent. Opening and dissecting the apical portion of the broad ligaments, we identified bilateral haematosalpinges incarcerated in the homolateral broad ligaments. We performed bilateral salpingectomy. Histological examination confirmed the presence of endometriosis.

Conclusion:

Care must be taken to the diagnostic assessment, counselling about the surgical programme before the intervention especially in patients during the reproductive period when the possibility of ablative surgery and subsequent need for an assisted reproductive technique exists.
Medial and Lateral Posterior Tibial Slope Are Independent Risk Factors for Noncontact ACL Injury in Both Men and Women
Authors: Hohmann Erik , Tetsworth Kevin , Glatt Vaida , Ngcelwane Mthunzi , Keough Natalie
Published: August 2021

Background:

Higher posterior tibial slope (PTS) is a risk factor for anterior cruciate ligament (ACL) injury in men and women. The individual contribution of the lateral (LPTS) and medial (MPTS) slope has not yet been investigated.

Purpose:

To determine whether either the LPTS or the MPTS is an independent risk factor for ACL injury, and to determine sex-specific differences between patients with ACL-deficient and ACL-intact knees.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We reviewed knee magnetic resonance (MR) images performed on ACL-deficient and ACL-intact knees between January 2018 and June 2020 at a single institution. Inclusion criteria were isolated ACL injury and noncontact mechanism (ACL-deficient group) and nonspecific knee pain and no history of injury (ACL-intact group). Exclusion criteria for both groups were the following: previous knee surgery; meniscal, collateral ligament, posterior cruciate ligament, or multiligamentous injuries; radiological evidence of osteoarthritis; and chondral damage on the tibia. The MR images were used to establish the posterior bony slope at 25%, 50%, and 75% from the medial and/or lateral border of the tibial plateau with respect to the proximal tibial anatomic axis. One-way analysis of variance (ANOVA) was used to determine differences in PTS at the 25%, 50%, and 75% distances for the medial and lateral tibial plateau between the groups and between the sexes.

Results:

Overall, 325 images were included (mean age, 36.1 ± 11.1 years; 142 ACL-deficient images [82 men and 60 women]; 183 ACL-intact images [112 men and 71 women]). MPTS and LPTS were significantly higher at 25%, 50%, and 75% in the ACL-deficient group (range, –2.7° to –5.7°) compared with the ACL-intact group (range, –2.1° to 1.5°; P = .00001). Similarly, MPTS and LPTS were significantly different in men versus women ( P = .00001). ANOVA revealed that there were no significant differences in PTS between men and women for all measures (MPTS, LPTS, ACL-deficient, ACL-intact; P = .68).

Conclusion:

The study results demonstrated that higher MPTS and LPTS is a potential risk factor for ACL injury in both men and women. However, despite being highly statistically significant, the differences between groups and sexes were small and may not be clinically relevant.