bluuebunny/crossref_metadata_2025 huggingface dataset:
Uneasy partnerships: Prisoner re-entry, family problems and state coercion in the era of neoliberalism
Authors: Cheliotis Leonidas K , McKay Tasseli
Published: April 2021

Hundreds of thousands of Americans are released from prison every year. Drawing on interviews conducted in the mid-2010s in the context of the Multi-site Family Study on Parenting, Partnering and Incarceration, this article explores how the strains of prisoner re-entry interact with those of poverty and family life, and how these combined strains condition proactive engagement with the legal system among re-entering individuals and their intimate and co-parenting partners. We focus our analysis on problems, tensions and struggles for control in parenting and partnership, including inter-parental violence, as these often led to calls or actions that clearly allowed for coercive intervention by parole authorities, courts, child support enforcement, or child protective services. We identify the precise circumstances and motives that lay behind such requests or allowances, and explain how these related to the cynical regard in which former prisoners and their partners typically held the coercive apparatus of the state. Through bringing our empirical findings into an interplay with scholarship on the role of punishment in the governance of poverty under neoliberalism, we examine how the strains faced by former prisoners' households and the tactics they used to deal with them pertain to broader politico-economic arrangements.
Mechanical performance of three-dimensional printed sandwich composite with a high-flexible core
Authors: Ahmed Waleed , Ahmed Sidra , Alnajjar Fady , Zaneldin Essam
Published: April 2021

This paper aims to investigate experimentally and using finite element analysis the performance of using three-dimensional printing technology to produce a composite sandwich panel that is made of the high-flexible core as well as with high stiffness upper and lower surfaces made of a glass fiber reinforced composite filament. There are many advantages of using sandwich structures in many applications, especially the aerospace field, where the high stiffness to strength and the lightweight is the most preferred in such applications. The conventional manufacturing methods that are used to produce sandwich panels are limited to particular core geometry, whereas manufacturing a composite core is not possible by these traditional production methods. So by using additive manufacturing technology, it becomes more applicable to design a combination of different geometries and materials to achieve properties that have never been made before, especially combining flexibility and high energy absorption keeping high strength to failure. A central deflection to a length of 0.26 is observed within the elastic zone, a remarkable ratio in beams that reflects the three-dimensional printed sandwich beams’ capability with a highly flexible core to absorb energy that would open doors for many industrial applications that is attributed to the lowest flexural rigidity (167E-3Pa · m4) of the sandwich by using the TriHex infill pattern. In contrast, the Gyroid infill structure could afford the highest central load (0.264 kN). At the peak load applied on the sandwich beam, a maximum error of 5.4% is estimated by finite element analysis lower than the experimental values.
Fabrication defects and limitations of AlSi10Mg lattice structures manufactured by selective laser melting
Authors: Ossola Enrico , Shapiro Andrew A , Pate Andre , Firdosy Samad , Brusa Eugenio , Sesana Raffaella
Published: April 2021

Additive manufacturing has enabled the production of lattice structures with tailored mechanical properties. However, process limitations still exist, affecting the quality of the struts, practically limiting sizes and types of printable unit cells. Typically, long, thin, unsupported horizontal struts exhibit large deviations from ideal geometries, due to high surface roughness and internal porosity. AlSi10Mg specimens were designed and fabricated by laser powder bed fusion to investigate the role of strut orientation, size, and overhang length using different sets of process parameters. Visual inspection, three-dimensional scanning, and metallographic inspection of the cross-sections were performed. A quality control methodology based on dimensional and geometric tolerances has been defined in order to quantitatively characterize the quality of the struts. Optimized process parameters were selected and used to fabricate octet-truss specimens which were then characterized by compression testing.
Splashing in deep waters of theory: A commentary section on Sandberg and Alvesson’s (2020) “Meanings of theory”
Authors: Bajde Domen , Fischer Eileen M. , Cochoy Franck , Brown Stephen
Published: April 2021

This section presents four commentaries to Sandberg and Alvesson’s (2020) “Meanings of theory,” an article that argues common definitions of theory are too restrictive. To contribute toward a more diverse and level playing field, Sandberg and Alvesson propose a typology of five “basic theory types.” The commentaries here consider their arguments in the light of marketing and consumer research.
Normative tensions in filial caring for a mother with dementia: A narrative perspective
Authors: Luichies Ina , Goossensen Anne , van der Meide Hanneke
Published: April 2021

This article aims to gain insight in the normative struggles of adult children caring for their ageing mother living with dementia. Two Dutch autobiographical books written by siblings recording their own caregiving experience were analysed using a narrative design. Children appear to understand their normative concerns through six fields of tension. Our analysis shows that filial caregivers describe two distinct approaches to deal with these normative tensions. One approach aims to preserve the child’s pre-existing personal beliefs and values, but also causes the child to demonstrate rigid and uncompromising behaviour at odds with the needs of their parent. The other approach is more reflective and flexible, prioritizing the needs of the vulnerable person over previously held values, providing an opportunity for better care. We conclude that caregiving children have to find their way between being faithful to their principles and showing moral flexibility.
Evaluating Social Marketing Messages in New Zealand’s Like Minds Campaign and Its Effect on Stigma
Authors: Kemper Joya , Kennedy Ann-Marie
Published: April 2021

Background:

A key objective of government and social marketers is to remove the institutionalized stigma of mental illness, increasing mental health service uptake. While research has evaluated past campaigns based on changes in attitudes and beliefs, very little research has examined the communication messages used in social marketing campaigns.

Focus of the Article:

This impact evaluation research identifies the institutionalized cultural-moral norms incorporated into New Zealand’s Like Minds mental health advertisements and examines how attitudes and beliefs changed over time in response to these norms.

Importance to the Social Marketing Field:

This research offers a new approach to social marketing evaluation and demonstrates the importance of consistent incorporation of cultural-moral institutional norms in social marketing campaigns.

Method:

Using macro-social marketing theory, thematic analysis is used to identify the cultural-moral institutional norms in the Like Minds campaign advertisements over a 10-year period (2002–2012).

Results:

The Like Minds campaign was found to have multiple cultural-moral institutional norms, such as Mental illness as a villain, Personal responsibility, and Inherent human dignity, as well as utilizing two different institutionalization processes of Socialization and Identity Formation. However, these norms were inconsistently and sometimes contradictorily presented and as a result, not all changes in mental health stigma beliefs and attitudes show long term change. Rates for service uptake also had mixed results during the campaign duration, though overall an increase in uptake was found.

Recommendations for Research and Practice:

The research highlights the importance of understanding the underlying institutionalized cultural-moral norms presented in communications and aligning those with the overall objectives of a social marketing campaign.

Limitations:

Like Minds campaign phases 2 to 5 are analyzed, phase 1 was inaccessible for analysis and advertisements after 2012 are not analyzed.
Atypical Pyoderma Gangrenosum in the Setting of Venous and Arterial Insufficiency
Authors: Wong Lulu L. , Borda Luis J. , Liem Timothy , Keller Jesse J. , Ortega-Loayza Alex G. , Jung Enjae
Published: April 2021

Ulcers of mixed etiology are diagnostically elusive and challenging to treat, especially when rare conditions are superimposed. Pyoderma gangrenosum (PG) is an autoinflammatory, ulcerative skin disease that is difficult to diagnose. Diagnostic criteria exist but there are no specific clinical tests to identify it. We discuss a case of PG initially diagnosed as venous ulcer in the setting of peripheral artery disease, complicated by superinfection, refractory to standard wound care, multiple surgical debridements, revascularization, negative pressure therapy, and parenteral antibiotics. Findings differentiating PG from other wound etiologies are explored, with the aim of improving clinical recognition of this condition.
Lung Decortication With Argon Plasma Energy for the Treatment of Chronic Pleural Empyema
Authors: Lampridis Savvas , Mitsos Sofoklis , Lawrence David R. , Panagiotopoulos Nikolaos
Published: April 2021

Lung decortication for the treatment of chronic pleural empyema remains a technically challenging procedure that is associated with bleeding and air leak. The recent advent of pure argon plasma has provided thoracic surgeons with an electrically neutral energy source for dissection and coagulation of pulmonary tissue with minimal depth of necrosis. In this article, we describe the technique of lung decortication with argon plasma energy (PlasmaJet, Plasma Surgical, Roswell, GA, USA) for the treatment of chronic pleural empyema. With appropriate application, the PlasmaJet can facilitate the removal of fibrous cortex with satisfactory hemostasis and aerostasis. Argon plasma energy can potentially be a useful adjunct in lung decortication. Controlled trials are needed to determine its role in the surgical management of advanced pleural empyema.
Mixed Reality Technology as a Delivery Mechanism for Psychological Intervention in Adolescents With Asthma: A Qualitative Protocol
Authors: Sharrad Kelsey , Kopsaftis Zoe , Tai Andrew , Spurrier Nicola , Smith Ross , Esterman Adrian , Gwilt Ian , Stallman Helen , Carson-Chahhoud Kristin
Published: April 2021

Australia has one of the highest asthma prevalence rates in the world, with this chronic and debilitating condition affecting one in nine people. The health and mental wellbeing of young people with asthma are worse than not only their peers without asthma but also worse than that of people with asthma at other ages. Psychological interventions could be beneficial in treating symptoms of elevated psychological distress in patients with asthma. However, evidence suggests that engagement with mental health services is low in this population. Technology-based solutions that engage youth may overcome barriers to service uptake for both mental health and asthma management. To fast-track the successful translation of evidence-based treatment into practice, interactive, mixed-reality technologies such as augmented reality (AR), virtual reality (VR) and holographic technology may provide a novel, low-cost solution, yet to date, methodological rigor in the evaluation of mixed reality for this purpose is lacking. To evaluate the perceived usability and acceptability of these technologies, mixed reality tools will be developed by the author team to deliver a component of a psychological intervention for treatment of elevated psychological distress among young people with asthma. Qualitative research will be conducted through one-on-one interviews with young people with asthma, parents/caregivers of young people with asthma, and with health professionals, during which participants will have time to interact with the resources. Moderator guides will be used to direct interviews, and will be supplemented with a questionnaire, including Likert-type measures of usability and acceptability to facilitate triangulation of data. Understanding and data obtained through this study will be used to develop version 2.0 mixed reality tools, which will be tested for feasibility in a RCT. Improving access to and uptake of evidence-based treatments for elevated psychological distress in young people with asthma may reduce the burden of this highly prevalent disease.
Experimental investigations of the dynamic responses of a multi-link mechanism with revolute clearance joints
Authors: Li Xiaofeng , Zhao Deng , Xie Fuqi , Wu Shijing , Li XiaoYong
Published: April 2021

Joint clearance is unavoidable in the revolute joint of multi-link mechanism. Excessive value of joint clearance generally leads to the noise, vibration, and fatigue failure. In this paper, a multi-link articulated mechanism system with three revolute clearance joints is selected as the study object. At first, its ideal motion equations and dynamic responses without joint clearance are outlined. Then an experimental rig is set up, and the acceleration responses of the mechanism in different scenarios are investigated. Comparative analysis indicates that in the presence of joints clearance, clear periodic transient impacts appear in the acceleration outputs while this mechanism moves to specific positions, and the impacts amplitude increases along with the clearance size and driving speed. Also, certain sequence among three motion states of clearance joint, named free flight, penetration and continuous-contact is observed twice in one circle movement of the mechanism. Besides, the clearance joint at the end of the transmission chain has greater effects on the mechanism system than the other joints. Finally, flexible rubber sleeves are set into the clearance joints, and the obtained experimental results indicate that the undesired transient impact by clearance joints on the mechanical system can be suppressed by flexible sleeves.
Expression of Piezo mRNA is unaffected in a rat model of knee osteoarthritis
Authors: Ikeda Ryo , Arimura Daigo , Saito Mitsuru
Published: April 2021

Osteoarthritis of the knee impairs activities of daily living of those affected. Its irreversible degenerative changes to the knee joint induce functional disturbance and unpleasant arthralgia. The pain has inflammatory components and often is manifested with mechanical allodynia and hyperalgesia. Sustained weight bearing and joint movements increase pain sensitivity in knee osteoarthritis. Understanding the mechanisms underlying the mechanical allodynia and hyperalgesia might provide a therapeutical target for pain relief in patients with such symptoms. Piezo channel is a mechanically activated ion channel that may be involved in mechanical transduction in the articular cartilage. Although it has been shown that inflammation potentiates Piezo channel current induced by mechanical stimulation, whether Piezo expression levels are influenced by knee osteoarthritis has remained unknown. We measured Piezo mRNA in knee joints and dorsal root ganglia after establishing a model of knee osteoarthritis in rats using monosodium iodoacetate and found Piezo mRNA level is not upregulated. This finding raises a question as whether and how Piezo channels may be involved in mechanically induced pain in osteoarthritis.
Design of bio-inspired binocular UAV detection system based on improved STC algorithm of scale transformation and occlusion detection
Authors: Song Huajun , Wu Yanqi , Zhou Guangbing
Published: April 2021

With the rapid development of drones, many problems have arisen, such as invasion of privacy and endangering security. Inspired by biology, in order to achieve effective detection and robust tracking of small targets such as unmanned aerial vehicles, a binocular vision detection system is designed. The system is composed of long focus and wide-angle dual cameras, servo pan tilt, and dual processors for detecting and identifying targets. In view of the shortcomings of spatio-temporal context target tracking algorithm that cannot adapt to scale transformation and easy to track failure in complex scenes, the scale filter and loss criterion are introduced to make an improvement. Qualitative and quantitative experiments show that the designed system can adapt to the scale changes and partial occlusion conditions in the detection, and meets the real-time requirements. The hardware system and algorithm both have reference value for the application of anti-unmanned aerial vehicle systems.
Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty?
Authors: Kooner Sahil , Kubik Jeremy , Mahdavi Saboura , Piroozfar Sophie (Ghashang) , Khong Hoa , Mohan Kanwal , Batuyong Eldridge , Sharma Rajrishi
Published: April 2021

Introduction:

The purpose of this study is to evaluate the role of major psychiatric illness on patient outcomes after total joint arthroplasty.

Methods:

Patients with a diagnosis of a major psychiatric disorder undergoing total joint arthroplasty were retrospectively matched one-to-one with a cohort without such a diagnosis. Major psychiatric disorder in the registry was identified by diagnosis of anxiety, mood, or a psychotic disorder. Primary outcome of interest included perioperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included EuroQol-5D, adverse events, length of stay, 30-day readmission, and discharge destination.

Results:

Total number of patients were 1828. The total hip arthroplasty (37.80 ± 17.91, p = 0.023) and the total knee arthroplasty psychiatric group (43.38 ± 18.41, p = 0.050) had significantly lower pre-operative WOMAC scores. At 3 months, the total hip arthroplasty (76.74 ± 16.94, p = 0.036) and total knee arthroplasty psychiatric group (71.09 ± 18.64, p < 0.01) again had significantly lower 3-month post-operative WOMAC score compared to the control groups. However, outcomes at 1 year were difficult to interpret, as patients with major psychiatric conditions had an extremely high loss to follow-up. Compared to the control groups, the total hip arthroplasty and total knee arthroplasty psychiatric group had an increased length of stay by 1.43 days (p < 0.01) and 0.77 days, respectively (p = 0.05). Similarly, the psychiatric groups were discharged directly home less often (total hip arthroplasty 86.9%, p = 0.024 and total knee arthroplasty 87.6%, p = 0.022) than the control groups.

Conclusion:

Patients with the diagnosis of a major psychiatric illness have an increased length of stay and are more likely to require a rehabilitation facility, compared to the control groups. Arguably, of utmost importance, there is a very high rate of loss to follow-up within the psychiatric groups. As such, we recommend these patients should be treated for their diagnosis prior to total joint arthroplasty. Furthermore, importance of clinical follow-up should be emphasized carefully.
Criminologist or criminal? Liminal spaces as the site for auto/biography
Authors: Ahearne Gemma
Published: April 2021

Feminist epistemologies place value on disrupting dominant ways of knowing. Personal experience and struggle can serve as transformative sites of meaning-making. I have lived experience of sex work and of organised crime. In 2018, I endured two crown court trials, both as the wife of the defendant, and as a victim. This article will interrogate the complexities of occupying such liminal spaces and the role of emotion as a way of knowing.
Multivariate Distribution in the Stock Markets of Brazil, Russia, India, and China
Authors: Mata Leovardo Mata , Núñez Mora José Antonio , Serrano Bautista Ramona
Published: April 2021

The purpose of this article is to analyze the dependence between Brazil, Russia, India, and China (BRIC) stock markets, adjusting the multivariate Normal Inverse Gaussian probability distribution (NIG) in 2010–2019 on data yields. Using the estimated parameters, a robust estimator of the correlation matrix is calculated, and evidence is found of the degree of integration in BRIC financial markets during the period 2000–2019. In addition, it is found that the Value at Risk presents a better performance when using the NIG distribution versus multivariate generalized autoregressive conditional heteroscedastic models.
An Integrated Approach to Pragmatic Competence: Its Framework and Properties
Authors: Mao Tiaoyuan , He Shanhua
Published: April 2021

The exploration of pragmatic competence has been endowed with theoretical and empirical significance for half a century, yet a common framework is still under investigation from different perspectives. First, this article conducts a critical review of the investigation of pragmatic competence in communicative ability theory, the function-discourse model, the componential and meaning-driven model, and the relevance-theoretic model. Based on the merits and demerits of these proposals and their relation with Chomsky’s dichotomy of grammatical and pragmatic competences, an integrated model of pragmatic competence (IMPC) is reformulated for thought and communication, focusing on the interactions among various organism-internal submodules under the current minimalist framework and their interactions with outside sociocultural factors. Finally, a comparison is made between the integrated proposal and the theory and models.
Subliminal Shock Learning: An Inverted Remapping Exercise
Authors: Sudhakaran Sudheer , Anjali A.
Published: April 2021

This study looks at the phenomenon of avoidance as a behaviour and as a strategy applied in an academic context in the case of final year management students sitting for their end-term exam where multiple questions are offered and the students are allowed to choose and attempt answers for selected questions. Why did they not answer it is for teachers to chew the cud. The case looks at how educators need to realign their perspectives and improve subsequent class delivery in terms of realigned content emphasis and pedagogical initiatives after papers have been evaluated and marked. The article suggests that accreditation processes should take note of the impact on overall academic measurement of program performance.

Research question

Research question for which perspectives have been opened up for curated answers are: How to discover topics requiring teachers to introspect and reimagine their classroom delivery and their engagement strategies? The principle of inversion brings into relief these discoveries. Theory: The study draws on psychological and physical sciences wherein multiple theories explain why a particular path has been eschewed. Type of the case: The case study strategy draws on the experiences of both the researchers and the participants and therefore the orientation of this case is primarily heuristic. Purposive data samples were used accessing data in the academic databases related to 198 students for the core compulsory course related to Sales and Distribution Management. Basis of the case: Actual score sheets for all 198 students for their final exam mapped for each question. Therefore, concepts for each question have been assessed. Using the principle of inversion/reversal the complementary gaps have been discovered, quantified, and interpreted. Findings: From the complementary data, it becomes self-explanatory for an educator that the blind spots—gaps in understanding—have been identified for future course corrections in delivery and engagement. Discussions: The avenues to be taken is food for thought for each educator and the audience to be addressed. Meaningful eye-opening gaps have been identified for future courses of action depending on concept to be redelivered. These findings have implications for all accreditation processes.
Effectiveness of Loyalty Programs in Customer Retention: A Multiple Mediation Analysis
Authors: Fook Andy Chin Woon , Dastane Omkar
Published: April 2021

The impact of loyalty programs on customer retention was investigated in this study. Concomitantly, the mediating effects of brand association and customer satisfaction between loyalty programs and customer retention were also tested in three ways, viz., in parallel, distinct, and sequential through a series of structural models. The study focuses on the Malaysian national car sector, and empirical data was collected from 313 Malaysian national cars users through convenience sampling. This explanatory, quantitative research adopts a questionnaire as a survey instrument, and the collected data was first subjected to normality and reliability assessment followed by confirmatory factor analysis, structural equation modeling using IBM SPSS AMOS 24. Multiple mediation analysis was then conducted, and results were confirmed through bootstrapping. Findings show that there is a significant positive impact of loyalty programs on customer retention. The brand association has a full mediation effect between loyalty programs and customer retention when tested in parallel with customer satisfaction; on the contrary, customer satisfaction demonstrated an insignificant mediation effect. On the other hand, when tested distinctly, brand association showed a partial mediating effect while there was no mediation effect of customer satisfaction. Besides, customer satisfaction and brand association demonstrated sequential partial mediation.
Pediatric Anaphylaxis: Etiology and Predictive Factors in an Emergency Setting
Authors: Uppala Rattapon , Phungoen Pariwat , Mairiang Dara , Chaiyarit Jitjira , Techasatian Leelawadee
Published: April 2021

Anaphylaxis is a serious allergic life-threatening condition that needs immediate treatment to prevent unfavorable outcomes. The present study revealed that the prevalence of anaphylaxis in children increased with age and the adolescent group has the most frequent anaphylaxis events. Food-induced anaphylaxis was the most common cause of anaphylaxis in pediatric population. This etiology revealed a significant correlation with a known history of food allergy in the study population, P = .029. Anaphylaxis from insect stings associated with cardiovascular symptoms, P < .001 and inclined to be severe. Univariate analysis showed predicted probability of severe anaphylaxis increased with age with an odds ratio of 1.1. This finding strengthens and supports the view that physicians should be aware of severe anaphylaxis reactions in older age group when there is a documented history of insect sting. The overall pediatric anaphylaxis patients in the study population had favorable outcomes. The authors recommended at least 24 hours hospital observation in order to observe biphasic reaction in pediatric anaphylaxis especially in adolescent age group.
The mask of the red death: Leadership, hubris, and the Covid-19 crisis
Authors: Villanueva Jaume , Sapienza Harry J
Published: April 2021

Throughout history, societies have been beset by disasters that took them by surprise, often with widespread and devastating consequences. When crops, animals, or people began dying with unusual frequency, especially when the causes were not observable, people often failed to respond, responded very slowly, or responded in surprisingly misdirected ways. In this essay, we focus on the role of leadership in addressing or failing to address such crises, paying special attention to the responses to the Covid-19 crisis during 2020. Our central thesis is that leadership hubris was a central (though not the only) culprit in poor responses, and we introduce the problem of inaction as a symptom of hubris. We conclude with some reflections for practitioners and researchers, suggesting a few areas worthy of examination to better understand how societies and business organizations may construct defenses against the dangers of leadership hubris.

JEL CLASSIFICATION M14; L26; D70; N00
Medical Anthropology Courses and Concepts Tested on the MCAT: A Content Analysis of 40 U.S. Course Syllabi
Authors: Stodola Tyler J , Bruna Sean P
Published: April 2021

The Association of American Medical Colleges recommends students seeking to enter medical school complete courses in the social sciences. Despite calls to teach social science—including anthropology—in pre-medical curriculum, little is known about what is taught in undergraduate medical anthropology courses and if concepts taught in those courses addresses topics tested in the MCAT exam. Given the growing number of anthropology students in baccalaureate allied health fields, there is a growing need to examine if anthropological coursework addresses relevant MCAT topics. Using a mixed methods content analysis, this study examined syllabi from forty U.S.-based medical anthropology courses to assess if MCAT concepts are taught in Medical Anthropology courses. Survey data was examined using descriptive statistics; syllabi were analyzed with NVivo using a binary coding scheme and modified grounded theory. Overall, only 8.69% of 155 possible concepts and terms from the Psychological, Social, and Biological Foundations of Behavior section of the MCAT were present in the syllabi. We close with considerations for future course design of medical anthropology courses.
Arterial Spin Labelling Patterns in Acute Large Vessel Occlusion Stroke
Authors: Nedunchelian Meena , Varadharajan Shriram , Keerthy S , Karthikeyan MA , Poyyamozhi Santosh , Mehta Pankaj , Cherian Mathew
Published: April 2021

Background:

Arterial spin labelling (ASL) is a noncontrast, magnetic resonance perfusion technique which can provide information about the parenchymal perfusion status and collaterals in acute stroke. Its role in the setting of large vessel occlusion (LVO) is underutilized due to the limited availability of magnetic resonance imaging (MRI) in the emergency settings. However, it might serve as an useful adjunct to other perfusion modalities in future.

Objective:

To study ASL perfusion patterns in anterior circulation LVO stroke and evaluate the presence of arterial transit artefacts (ATA) as a surrogate marker of collaterals.

Methods:

We performed a retrospective analysis of our mechanical thrombectomy database over the last 2 years for acute stroke cases in which ASL perfusion as part of MRI was performed. ASL perfusion patterns in acute LVO stroke were reviewed, with respect to presence of ATA and diffusion-weighted imaging (DWI)-ASL mismatch. Inter-rater reliability was analyzed between 2 readers of varying experience. Baseline variables were analyzed between those with and without ATA.

Results:

Out of 95 patients, 78 had anterior circulation occlusions, among which 27 had ASL. Type I (with ATAs) was seen in 11 patients and all of these had DWI mismatch. Type II (without ATAs) was seen in 16 patients. Of these, 15 had mismatch with DWI and only 1 had no mismatch. Inter-rater reliability for the detection of ATA on ASL was substantial (Cohen’s k—0.64). No statistical significance was noted between ATA and clinical outcomes.

Conclusion:

ASL patterns vary amongst patients with LVO stroke and can be classified based on the presence of ATA since resulting DWI mismatch actually indicates a pseudo-perfusion deficit.
The impact of previous cesarean section on the outcome of patients with non-adherent placenta previa
Authors: Sindiani Amer , Obeidat Nail , Abu-Azzam Omar , Hijazi Heba
Published: April 2021

Objective

To evaluate the impact of previous lower segment cesarean section on maternal and fetal outcomes of patients with non-adherent placenta previa

Methods

This is a retrospective study of all patients who delivered at a tertiary referral university hospital by lower uterine cesarean section with non-adherent placenta previa, over a 10-year period. Data were obtained through hospital registry and medical records. The differences in demographic, obstetric characteristics, peripartum complications, and fetal outcome between patients with no previous cesarean and those with previous cesarean section were analyzed.

Results

Ninety patients with non-adherent placenta previa were included, 54 patients with no previous cesarean and 36 patients with previous cesarean section. Patients with previous cesarean section were significantly more likely to incur inadvertent organ injury, transfusion of 4 or more units of packed red blood cells, transfusion of fresh frozen plasma, uterine brace compressive sutures, uterine artery ligation, and peripartum hysterectomy.

Conclusion

There is a significant increase in the incidence of inadvertent neighboring viscus injury, transfusion of 4 units or more of packed red blood cells, transfusion of fresh frozen plasma, uterine brace compressive sutures, uterine artery ligation, and peripartum hysterectomy in patients with non-adherent placenta previa and previous cesarean section, compared to those with non-adherent placenta previa and no previous history of cesarean section, with no difference in perinatal outcome.
An age-dependent outcome analysis of microvascular decompression and percutaneous thermocoagulation in trigeminal neuralgia
Authors: Keric Naureen , Kalasauskas Darius , Kreth Sophia L. , Glaser Martin B. , Krenzlin Harald , Kantelhardt Sven R. , Ringel Florian
Published: April 2021

Background

Trigeminal neuralgia (TN) is a severe pain condition and the most common facial neuralgia. While microvascular decompression (MVD) presents an excellent treatment in neurovascular compression cases, percutaneous thermocoagulation (PT) of the ganglion Gasseri is an alternative option. This study aimed to evaluate post-operative complication rate and outcome of both treatment strategies related to the patient’s age.

Methods

The medical records of all patients with the diagnosis of trigeminal neuralgia undergoing an MVD or PT of the ganglion Gasseri (between January 2007 and September 2017) were reviewed to determine the efficacy and the complication rate of both methods in regard to the patient’s age.

Results

Seventy-nine patients underwent MVD surgery and 39 a PT. The mean age of patients in the MVD group was 61 years and 73 years in the PT group. There were 59 (50%) female patients. Nerve-vessel conflict could be identified in 78 (98.7%) MVD and 17 (43.6%) PT patients on preoperative MRI. Charlson comorbidity index was significantly higher in PT group (2.4 (1.8) versus 3.8 (1.8) p < 0.001). The Barrow pain score (BPS) at the last follow-up demonstrated higher scores after PT (p = 0.007). The complication rate was markedly higher in PT group, mostly due to the facial hypesthesia (84.6% versus 27.8%; p < 0.001). Mean symptom-free survival was significantly shorter in the PT group (9 vs. 26 months, p < 0.001). It remained statistically significant when stratified into age groups: (65 years and older: 9 vs. 18 months, p = 0.001).

Duration of symptoms (OR 1.005, 95% CI 1.000–1.010), primary procedure (OR 6.198, 95% CI 2.650–14.496), patient age (OR 1.033, 95% CI 1.002–1.066), and postoperative complication rate (OR 2.777, 95% CI 1.309–5.890) were associated with treatment failure.

Conclusion

In this patient series, the MVD is confirmed to be an excellent treatment option independent of patient’s age. However, while PT is an effective procedure, time to pain recurrence is shorter, and the favorable outcome (BPS 1 and 2) rate is lower compared to MVD. Hence MVD should be the preferred treatment and PT should remain an alternative in very selected cases when latter is not possible but not in the elderly patient per se.
Perinatal outcomes of neonates born from different endometrial preparation protocols after frozen embryo transfer: a retrospective cohort study
Authors: Li Cheng , He Yi-Chen , Xu Jing-Jing , Wang Yu , Liu Han , Duan Chen-Chi , Shi Chao-Yi , Chen Lei , Wang Jie , Sheng Jian-Zhong , Huang He-Feng , Wu Yan-Ting
Published: April 2021

Background

Previous studies have focused on pregnancy outcomes after frozen embryo transfer (FET) performed using different endometrial preparation protocols. Few studies have evaluated the effect of endometrial preparation on pregnancy-related complications. This study was designed to explore the association between different endometrial preparation protocols and adverse obstetric and perinatal complications after FET.

Methods

We retrospectively included all FET cycles (n = 12,950) in our hospital between 2010 and 2017, and categorized them into three groups, natural cycles (NC), hormone replacement therapy (HRT) and ovarian stimulation (OS) protocols. Pregnancy-related complications and subsequent neonatal outcomes were compared among groups.

Results

Among all 12,950 FET cycles, the live birth rate was slightly lower for HRT cycles than for NC (HRT vs. NC: 28.15% vs. 31.16%, p < 0.001). The pregnancy loss rate was significantly higher in OS or HRT cycles than in NC (HRT vs. NC: 17.14% vs. 10.89%, p < 0.001; OS vs. NC: 16.44% vs. 10.89%, p = 0.001). Among 3864 women with live birth, preparing the endometrium using OS or HRT protocols increased the risk of preeclampsia, and intrahepatic cholestasis of pregnancy (ICP) in both singleton and multiple deliveries. Additionally, OS and HRT protocols increased the risk of low birth weight (LBW) and small for gestational age (SGA) in both singletons and multiples after FET.

Conclusion

Compared with HRT or OS protocols, preparing the endometrium with NC was associated with the decreased risk of pregnancy-related complications, as well as the decreased risk of LBW and SGA after FET.
Midwives’ experiences of cultural competency training and providing perinatal care for migrant women a mixed methods study: Operational Refugee and Migrant Maternal Approach (ORAMMA) project
Authors: Fair Frankie , Soltani Hora , Raben Liselotte , van Streun Yvonne , Sioti Eirini , Papadakaki Maria , Burke Catherine , Watson Helen , Jokinen Mervi , Shaw Eleanor , Triantafyllou Elena , van den Muijsenbergh Maria , Vivilaki Victoria
Published: April 2021

Background

The number of international migrants continues to increase worldwide. Depending on their country of origin and migration experience, migrants may be at greater risk of maternal and neonatal morbidity and mortality. Having compassionate and culturally competent healthcare providers is essential to optimise perinatal care. The “Operational Refugee and Migrant Maternal Approach” (ORAMMA) project developed cultural competence training for health professionals to aid with providing perinatal care for migrant women. This presents an evaluation of ORAMMA training and explores midwives’ experiences of the training and providing care within the ORAMMA project.

Methods

Cultural competence was assessed before and after midwives (n = 35) received ORAMMA compassionate and culturally sensitive maternity care training in three different European countries. Semi-structured interviews (n = 12) explored midwives’ experiences of the training and of caring for migrant women within the ORAMMA project.

Results

A significant improvement of the median score pre to post-test was observed for midwives’ knowledge (17 to 20, p < 0.001), skills (5 to 6, p = 0.002) and self-perceived cultural competence (27 to 29, p = 0.010).

Exploration of midwives’ experiences of the training revealed themes of “appropriate and applicable”, “made a difference” and “training gaps” and data from ORAMMA project experiences identified three further themes; “supportive care”, “working alongside peer supporters” and “challenges faced”.

Conclusions

The training improved midwives’ knowledge and self-perceived cultural competence in three European countries with differing contexts and workforce provision. A positive experience of ORAMMA care model was expressed by midwives, however clearer expectations of peer supporters’ roles and more time within appointments to assess the psychosocial needs of migrant women were desired. Future large-scale research is required to assess the long-term impact of the ORAMMA model and training on practice and clinical perinatal outcomes.
Patterns of surveillance for late effects of BCR-ABL tyrosine kinase inhibitors in survivors of pediatric Philadelphia chromosome positive leukemias
Authors: Smith Stephanie M. , Sabnis Himalee S. , Lewis Rebecca Williamson , Effinger Karen E. , Bergsagel John , Patterson Briana , Mertens Ann , Sakamoto Kathleen M. , Schapira Lidia , Castellino Sharon M.
Published: April 2021

Background

Targeted anticancer therapies such as BCR-ABL tyrosine kinase inhibitors (TKIs) have improved outcomes for chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL). However, little is known about long-term risks of TKIs in children. Exposure-based survivorship guidelines do not include TKIs, thus surveillance practices may be variable.

Methods

We retrospectively examined surveillance for cardiac and endocrine late effects in children receiving TKIs for Ph + leukemias, diagnosed at < 21 years between 2000 and 2018. Frequency of echocardiogram (ECHO), electrocardiogram (EKG), thyroid stimulating hormone (TSH), dual-energy x-ray absorptiometry (DXA), and bone age testing were abstracted. Descriptive statistics were stratified by leukemia type.

Results

66 patients (CML n = 44; Ph + ALL n = 22) met inclusion criteria. Among patients with CML, ≥1 evaluation was done: ECHO (50.0%), EKG (48.8%), TSH (43.9%), DXA (2.6%), bone age (7.4%). Among patients with Ph + ALL, ≥1 evaluation was done: ECHO (86.4%), EKG (68.2%), TSH (59.1%), DXA (63.6%), bone age (44.4%). Over a median 6.3 and 5.7 years of observation, respectively, 2% of patients with CML and 57% with Ph + ALL attended a survivorship clinic.

Conclusions

Despite common exposure to TKIs in survivors of Ph + leukemias, patterns of surveillance for late effects differed in CML and Ph + ALL, with the latter receiving more surveillance likely due to concomitant chemotherapy exposures.

Targeted therapies such as TKIs are revolutionizing cancer treatment, but surveillance for late effects and referral to survivorship clinics are variable despite the chronicity of exposure. Evidence based guidelines and longer follow-up are needed.
MACE-Seq-based coding RNA and TrueQuant-based small RNA profile in breast cancer: tumor-suppressive miRNA-1275 identified as a novel marker
Authors: Majed Sevan Omer , Mustafa Suhad Asad
Published: April 2021

Introduction

Disruption of cellular processes in the breast by abnormally expressed miRNA is characterized to develop cancer. We aimed to identify the differential expression of small RNAs (sRNAs) and mRNAs in formalin-fixed paraffin-embedded (FFPE) tissue of the breast cancer (BC) and normal adjacent tissue (NAT). Another aim is to determine the differential expression of miR-1275 as a novel biomarker for BC and also identify its target genes.

Methods

TrueQuant method for analysis of sRNA expression and MACE-sequencing method for analysis of gene expression were used analyzing. The RT-qPCR technique was used to confirm miR-1275 down expression. Target genes of miR-1275 were computationally identified using target prediction sites and also the expression level of them was experimentally determined among the expressed genes.

Results

TrueQuant findings showed that 1400 sRNAs were differentially expressed in the FFPE tissue of two Kurdish cases with BC, as compared to NAT. Among the sRNAs, 29 small RNAs were shown to be significantly downregulated in BC cells. The RT-qPCR results confirmed that miR-1275 was significantly down-expressed in 20 Kurdish cases with BC compared to NAT. However, Overall survival (OS) analysis revealed that the correlation between the expression level of miR-1275 and clinical significance was highly corrected in cases with BC (OS rate: P = 0.0401). The MACE-seq results revealed that 26,843 genes were differentially expressed in the BC tissue compared to NAT, but 7041 genes were displayed in a scatter plot. Furthermore, putative target genes (DVL3, PPP2R2D, THSD4, CREB1, SYT7, and PRKACA) were computationally identified as direct targets of miR-1275 in several target predicted sites. The MACE-seq results revealed that the expression level of these targets was increased in BC tissue compared to NAT. The level of these targets was negatively associated with miR-1275 expression. Finally, the role of down-regulated miR-1275 on its targets in biological mechanisms of BC cells was identified; including cell growth, proliferation, movement, invasion, metastasis, and apoptosis.

Conclusion

Down-expressed miR-1275, a tumor suppressor, is a novel biomarker for early detection of BC. DVL3, PPP2R2D, THSD4, CREB1, SYT7, and PRKACA are newly identified to be targeted by miR-1275.
USH2A gene variants cause Keratoconus and Usher syndrome phenotypes in Pakistani families
Authors: Ahmed Asif Naveed , Tahir Raheel , Khan Niamat , Ahmad Mushtaq , Dawood Muhammad , Basit Abdul , Yasin Muhammad , Nowshid Maha , Marwan Muhammad , Sultan Komal , Saleha Shamim
Published: April 2021

Background

Retinitis pigmentosa (RP) is the most common inherited retinal dystrophy, affecting approximately 1 in 4000 individuals worldwide. The most common form of syndromic RP is Usher syndrome (USH) accounting for approximately 20–30 % of RP cases. Mutations in the USH2A gene cause a significant proportion of recessive non-syndromic RP and USH type II (USH2). This study aimed to determine the causative role of the USH2A gene in autosomal recessive inherited ocular diseases and to establish genotype-phenotype correlation associated with USH2A variants.

Methods

We performed direct Sanger sequencing and co-segregation analysis of the USH2A gene to identify disease causing variants in a non-syndromic RP family, two USH2 families and two Keratoconus (KC) families.

Results

Disease causing variants in the USH2A gene were identified in two families displayed KC and USH2 phenotypes. A novel variant c.4029T > G, p.Asn1343Lys in the USH2A gene was detected in a Pakistani family with KC phenotype. In addition, a missense variant (c.7334 C > T, p. Ser2445Phe) in the USH2A gene was found segregating in another Pakistani family with USH2 phenotype. Homozygosity of identified missense USH2A variants was found associated with autosomal recessive inherited KC and USH2 phenotypes in investigated families. These variants were not detected in ethnically matched healthy controls. Moreover, the USH2A variants were predicted to be deleterious or potentially disease causing by PolyPhen-2, PROVEAN and SIFT.

Conclusions

This study provided first evidence for association of a novel USH2A variant with KC phenotype in a Pakistani family as well as established the phenotype-genotype correlation of a USH2A variant (c.7334 C > T, p. Ser2445Phe) with USH2 phenotype in another Pakistani family. The phenotype-genotype correlations established in present study may improve clinical diagnosis of affected individuals for better management and counseling.