Despite the common occurrence and frequent clinical effects of peritumoral cysts in the central nervous system (CNS), the mechanism underlying their development and evolution is not understood. Because they commonly produce peritumoral cysts and because serial magnetic resonance imaging (MRI) is obtained in von Hippel-Lindau disease patients, hemangioblastomas provide an opportunity to examine the pathophysiology of CNS peritumoral cyst formation. Serial MRI was correlated with the clinical findings in 16 von Hippel-Lindau disease patients with 22 CNS hemangioblastomas (11 spinal cord; 11 cerebellar) that were associated with the appearance and evolution of peritumoral cysts. Hemangioblastoma-associated cyst wall histomorphological analysis was performed on postmortem tissues from three von Hippel-Lindau disease patients (not in the clinical series). Comparative proteomic profiling was performed on peritumoral cyst fluid and serum. Vascular endothelial growth factor levels were determined in peritumoral cysts. MRI clearly showed peritumoral edema that developed and slowly and progressively evolved into enlarging hemangioblastoma-associated cysts in all tumors (mean follow-up, 130 +/- 38 months; mean +/- standard deviation). Postcontrast MRI demonstrated convective leakage of gadolinium into cysts. Mean time required for edema to evolve into a cyst was 36 +/- 23 months (range, 8-72 months). Thirteen (59%) hemangioblastoma-cysts became symptomatic (mean time to symptom formation after cyst development, 35 +/- 32 months; range, 3-102 months) and required resection. Protein profiles of cyst fluid and serum were similar. Mean cyst fluid vascular endothelial growth factor concentration was 1.5 ng/ml (range, 0-5.4 ng/ml). Histology of the cyst walls was consistent with reactive gliosis. CNS peritumoral cyst formation is initiated by increased tumor vascular permeability, increased interstitial pressure in the tumor, and plasma extravasation with convective distribution into the surrounding tissue. When the delivery of plasma from the tumor exceeds the capacity of the surrounding tissue to absorb the extravasated fluid, edema (with its associated increased interstitial pressure) and subsequent cyst formation occur.
An experimental in vitro biomechanical study was conducted on human cadaveric spines to evaluate the motion segment (C4-C5) and global subaxial cervical spine motion after placement of a cervical arthroplasty device (Altia TDI TM ,Amedica, Salt Lake City, UT) as compared to both the intact spine and a single-level fusion. Six specimens (C2-C7) were tested in flexion/extension, lateral bending, and axial rotation under a ± 1.5 Nm moment with a 100 N axial follower load. Following the intact spine was tested; the cervical arthroplasty device was implanted at C4-C5 and tested. Then, a fusion using lateral mass fixation and an anterior plate was simulated and tested. Stiffness and range of motion (ROM) data were calculated. The ROM of the C4-C5 motion segment with the arthroplasty device was similar to that of the intact spine in flexion/extension and slightly less in lateral bending and rotation, while the fusion construct allowed significantly less motion in all directions. The fusion construct caused broader effects of increasing motion in the remaining segments of the subaxial cervical spine, whereas the TDI did not alter the adjacent and remote motion segments. The fusion construct was also far stiffer in all motion planes than the intact motion segment and the TDI, while the artificial disc treated level was slightly stiffer than the intact segment. The Altia TDI allows for a magnitude of motion similar to that of the intact spine at the treated and adjacent levels in the in vitro setting.
Human trafficking is recognized as a major public health problem and a tragic transnational crime. Little is known about the health outcomes of victims of human trafficking. This study identifies the relationship of risk factors to physical, sexual, and mental health outcomes in three groups of women (N = 38) exploited for sex in the United States: international trafficking victims, domestic trafficking victims, and nontrafficked sex workers. To date this is the first study to examine the impact of risk factors on health outcomes using a sample of women trafficked for sex in the United States that includes both domestic and international victims. Overall, findings suggest that the experiences in sex work of domestic trafficking victims were dissimilar to those of international trafficking victims. Moreover, domestic trafficking victims displayed poorer health outcomes compared to international trafficking victims. In terms of risk factors, a higher percentage of women involved in street prostitution reported sexual health problems, co-occurring health issues, and addiction. Childhood physical/sexual victimization was related to poor physical health.
Research Summary Differences in outcomes for domestic violence cases were compared across two court jurisdictions, one that employed victim‐centered prosecutorial policies and one that employed evidence‐based prosecutorial policies. Evidence‐based prosecutorial policies argue that the reoccurrence of violence is deterred through the certain, swift, and severe punishment of offenders, whereas victim‐centered prosecutorial policies claim that the reoccurrence of violence declines when victims interact with court officials who provide them with the opportunity to participate actively and provide input into the court's actions. Overall, 170 victims were interviewed at three time points (intake, disposition, and 6 months after disposition) to assess levels of court empowerment, reoccurrence of physical violence and psychological aggression, and perception of safety reported by victims. The results indicate that cases in the evidence‐based policy jurisdiction, compared with the victim‐centered policy jurisdiction, were significantly more likely to report reoccurrence of physical violence and psychological aggression. Victims who experienced physical violence during the 6 months after case disposition perceived themselves as less safe (i.e., they reported that physical violence was more likely to occur in the future). Policy Implications Interest in the positive and negative effects of prosecutorial policies on the lives of domestic violence victims involved in the justice process has been growing. Currently, the dual aims of the justice process are to assure offender accountability and to enhance victim safety, and two distinct policy approaches have emerged (mandatory prosecution and victim‐centered prosecution) to accomplish these aims. The current study examines the influence of each policy on revictimization and perceptions of safety of domestic violence victims rather than official measures of offender recidivism, thus informing policy makers of the broader impact of prosecutorial policies on the lives of victims. The results suggest that victim‐centered polices yield better outcomes for domestic violence victims than evidence‐based policies. This finding has implications for jurisdictions considering whether to adopt evidence‐based policies, and it suggests that careful consideration be given to their implementation if their effect is to regard victims primarily as witnesses to a crime and they do not make efforts to encourage, educate, and support victims throughout the court process. As victim‐centered prosecutorial policies are rooted in the theory of therapeutic jurisprudence, our findings suggest that justice professionals be encouraged to think more broadly about how involvement with the justice process can foster the improved well‐being of victims. Although the current study was conducted in traditional courts, the number of specialty courts that addresses domestic violence is growing nationally, and the findings suggest this is a positive development.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.