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The number of studies on the marketing–finance interface has escalated in response to increased interest in the value of marketing investments, such as sports sponsorship. This study integrates current research findings and establishes empirical generalizations on how sports sponsorship announcements impact firm value. The empirical literature finds contradicting results on the value shareholders place on these marketing investments. This paper addresses this issue by undertaking a meta-analysis on stock reactions to sport sponsorship announcements, using 3192 of these announcements taken from 36 studies (41 samples). On aggregate, these announcements drew the attention of shareholders since there was a positive and significant cumulative abnormal return (CAR). However, this positive effect was mostly observed in the 1990s and became negative in the 2000s. Overall, shareholders viewed sports sponsorship investments favorably when there was a functional and geographical congruence between sponsors and sponsees. This paper also shows that the differences in the CAR can be explained by controlling for confounding events and host country. The paper concludes by providing potential avenues for further research in sports sponsorship, using the event study method.

Sports sponsorships are almost a $20 billion business in North America alone. Yet, despite the significant academic and corporate interest in such high financial stakes, the literature is equivocal on several key aspects. While some papers report that sports sponsorships enhance shareholder value, others dispute this. Furthermore, the marketing determinants of this value are unclear, particularly the role of firms’ marketing capabilities. To address these, the authors first created a database of sports sponsorship announcements over 19 years by Canadian and U.S. firms, complementing it with the stock market and firm-level financial and marketing data. The authors then conducted an event study and found that investor response to sports sponsorship announcements is, on average, positive. The authors found that investors not only credit firms with higher marketing capabilities, amplifying their positive reaction, but that they also seem to use firms’ marketing capabilities to offset the potential barriers to the value generated from these announcements. Specifically, for investors, the firms’ marketing capabilities can compensate for the dampening effect of financial risk. Our results are robust to considerations of sample selection bias, endogeneity, and outliers.

Objectives The world is fighting with a COVID-19 pandemic, some of the uncertainties have been revealed. To figure out an estimation of asymptomatic patients and seropositive SARS-COV-2 blood donors in Iran, a national survey was conducted to find the prevalence of asymptomatic blood donors with positive SARS-COV-2 IgM/IgG test results at the end of May 2020. Material and methods From all 31 provinces, 1339 blood donors were included. At first, data was collected with an interview containing demographic data, risk factors and possible signs and symptoms held for each donor by a trained medical expert. Then, SARS-COV-2 serologic rapid tests were conducted. Subsequently, the test results were observed and recorded; all of their photos were checked by one single expert. We corrected the prevalence rates for sensitivity and weighted them by the last year rate of blood donation of each province. Results The corrected prevalence rates of positive serological test results for sensitivity in provinces were between zero and 38.24%. The national prevalence was calculated 14.45% after weighting. Out of 161 positive donors, only 43 cases reported related signs or symptoms during the defined period of time, while 118 (73.29%) seropositive cases had not reported any related signs or symptoms. Some signs or symptoms were reported more frequent in the SARS-COV-2 serologic rapid test positives. The highest OR (10.19) was linked to ageusia. Conclusions This study has shown the prevalence of seropositive results to be around 14% in target population in which around ¾ had not reported any signs or symptoms.

Supplemental Digital Content is available in the text., Background and Purpose: Blinded outcome assessment in trials with prospective randomized open blinded end point design is challenging. Unblinding can result in misclassified outcomes and biased treatment effect estimates. An outcome adjudication committee assures blinded outcome assessment, but the added value for trials with prospective randomized open blinded end point design and subjective outcomes is unknown. We aimed to assess the degree of misclassification of modified Rankin Scale (mRS) scores by a central assessor and its impact on treatment effect estimates in a stroke trial with prospective randomized open blinded end point design. Methods: We used data from the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands). The primary outcome was the mRS at 90 days. Standardized, algorithm-based telephone interviews to assess the mRS were conducted from a central location by an experienced research nurse, unaware but not formally blinded to treatment allocation (central assessor). Masked reports of these interviews were adjudicated by a blinded outcome committee. Misclassification was defined as an incorrect classification of the mRS by the central assessor. The effect of endovascular treatment on the mRS was assessed with multivariable ordinal logistic regression. Results: In MR CLEAN, 53/500 (10.6%) of the mRS scores were misclassified. The degree and direction of misclassification did not differ between treatment arms (P=0.59). Benefit of endovascular treatment was shown on the mRS when scored by the central assessor (adjusted common odds ratio, 1.60 [95% CI, 1.16–2.21]) and the outcome adjudication committee (adjusted common odds ratio, 1.67 [95% CI, 1.21–2.20]). Conclusions: Misclassification by the central assessor was small, randomly distributed over treatment arms, and did not affect treatment effect estimates. This study suggests that the added value of a blinded outcome adjudication committee is limited in a stroke trial with prospective randomized open blinded end point design applying standardized, algorithm-based outcome assessment by a central assessor, who is unaware but not formally blinded to treatment allocation. Registration: URL: https://www.isrctn.com; Unique identifier: ISRCTN10888758.

This article presents a new self-powered wireless failure detection method that uses different signal transmission rates from piezoelectric energy harvesters. Reliable signal transmission from a wireless sensor network has been challenging due to the power supply issue, often covered by batteries that need regular replacement. Piezoelectric energy harvesting is an excellent option to power the sensors in a vibrational environment, but the power level is limited by input vibrational energy. In this article, we introduce a new failure detection strategy that uses multifunctional piezoelectric material for vibration sensing and energy harvesting. That is, when the vibration is stronger and the material strain is higher, piezoelectric material produces higher voltage, and power. Different power level from multiple piezoelectric sensors is used for sensing structural failure. We design a simple power management circuit that saves power proportional to the piezoelectric voltage so that the piezoelectric patch with higher strain can transmit more frequent wireless signals (higher transmission rate). To store the piezoelectric power, the circuit is composed of a full-bridge rectifier, a single pole double throw switch, a comparator with hysteresis, and a wireless transmitter (Zigbee). The failure detection performance is investigated in a case study that monitors screw joint failure in a vibrating plate. Reliability-based design optimization is conducted to determine the piezoelectric sensor network in terms of the number and sizes of multiple piezoelectric (PZT) patches. The test results show that the proposed system successfully powers the wireless transmitter using the ultra-low scale of power from the PZT sensors (microwatt) and detect the different combination of screw joint failure in the vibrating plate.

Background The “FIFA 11 + Shoulder” programme has been reported to reduce the incidence of upper extremity injuries among soccer goalkeepers. It has also been recommended for overhead sports. The purpose of this study was therefore to investigate the effect of an 8-week “FIFA 11 + shoulder” (11 + S) programme on shoulder joint position sense (JPS), threshold to detect passive motion (TTDPM) and upper quarter Y Balance Test in young male volleyball players. Methods Thirty-two healthy young elite male volleyball players (17.49 ± 1.47 years) participated in this quasi-experimental study. Participants, recruited from two clubs participating in Iranian premier league, were randomly assigned into two groups; (1) the intervention group who performed the “FIFA 11 + shoulder” programme as their warm up protocol, three times per week, and (2) the control group who kept their routine warm up protocol meanwhile. Proprioception tests including JPS and TTDPM of internal and external rotator muscles of the dominant shoulder were recorded via the isokinetic system pro 4. The upper quarter Y Balance Test determined the shoulder dynamic stability. Results No statistically significant differences were observed for JPS and TTDPM of shoulder internal and external rotator muscles; shoulder stability however significantly increased only in the intervention group (p = 0.03, ηp2=0.02). Conclusion Upper quarter dynamic stability improvement due to the 11+S programme leads to volleyball players’ performance and may therefore contribute to a reduction in risk of sustaining injury if applied long-term. Trial registration The trial was retrospectively registered atIranian Registry of Clinical Trials with the number of IRCT20201030049193N1 at 04/12/2020.

Evaluating the effect of convalescent plasma (CP) on some cytokine storm indices in severe COVID-19 patients. Totally, 62 patients were randomly assigned into two groups for this clinical trial. Patients in the intervention group received one unit (500 mL) plasma on the admission day plus standard drugs while the controls merely received standard treatments. Eventually, primary and secondary outcomes were evaluated. In the CP group, compared with controls, the mean levels of lymphocytes and IL-10 significantly increased while the levels of IL-6, TNF-α, and IFN-γ decreased (p 0.05) while WHO severity scores remarkably improved (p = 0.01), despite the higher frequency of underlying diseases among the CP group (66.7%) vs. controls (33.3%). Although CP has a remarkable immunomodulatory and antiviral potential to improve the cytokine storm and disease severity in COVID-19 patients, it did not considerably affect the mortality rate. Supplementary Information The online version contains supplementary material available at 10.1007/s11739-021-02734-8.

Introduction To evaluate the efficacy of empagliflozin compared to pioglitazone in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2DM). Methods In this prospective randomized, double-blind, placebo-controlled trial, we assigned 106 patients with NAFLD and T2DM to receive empagliflozin 10 mg (n = 35), pioglitazone 30 mg (n = 34), or placebo (n = 37) for 24 weeks. Liver fat content and liver stiffness were measured using fibroscans. Body composition assessment was performed by dual-energy x-ray absorptiometry (DEXA) scans. The primary end point was change from baseline in liver steatosis, using the controlled attenuation parameter (CAP) score. Results A borderline significant decrease in CAP score was observed with empagliflozin compared to placebo, mean difference: − 29.6 dB/m (− 39.5 to − 19.6) versus − 16.4 dB/m (− 25.0 to − 7.8), respectively; p = 0.05. Using multivariate analysis, we observed a significant reduction in the placebo-corrected change in liver stiffness measurement (LSM) with empagliflozin compared to pioglitazone: − 0.77 kPa (− 1.45, − 0.09), p = 0.02, versus 0.01 kPa (95% CI − 0.70, 0.71, p = 0.98), p for comparison = 0.03. Changes in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT), fasting insulin, homeostatic model assessment for insulin resistance (HOMA-IR), HOMA2-IR, fibrosis-4 index (FIB4 index), NAFLD fibrosis score, aspartate aminotransferase to platelet ratio index (APRI), android/gynecoid ratio (A/G ratio), and skeletal muscle index (SMI) were comparable between the two treatment groups, while significant reductions of the body weight and visceral fat area were observed only in the empagliflozin group (p

Accessing the veins for blood delivery, sampling or nutrition is a critical factor in the process of care and management of pediatric patients. In this regard, the peripherally inserted central catheter (PICC) is one of the main alternatives which could be applied effectively as traditional central venous devices in neonates and adults. Due to their essential role in providing safe central venous entry, PICCs could be applied extensively in patients who are critically ill. The main aims of the present study are to review approximately all relevant publications concerning PICC procedures, any possible complications, and the most appropriate decision for preventing these complications due to their high mortality rate. We carried out a comprehensive search on PubMed, HubMed, EMBASE, MEDLINE, Science Direct, Scopus, MEDLINE, and EMBASE databases for identifying the most relevant publications related to potential complications following the application and insertion of PICCs in hospitalized children and infants. Through appropriate care of catheters, the rate of possible infectious, mechanical and thrombotic complications would decrease considerably compared to those patients who received traditional central venous catheters. However, the process of vascular access in neonatal and children is very challenging. Any delay or denying treatment due to the lack of vascular access is intolerable. In this regard, anesthesiologists must achieve extra knowledge of various vascular devices.

The purpose of this study was to examine the effects of an eight-week 11 + S programme on isokinetic shoulder strength in young male volleyball players. Twenty-eight top-level young male volleyball players were recruited for this study. The players were randomly assigned into intervention (14 players) and control (14 players) groups. The intervention group performed the 11 + S as a warm-up before training at least three times a week for eight weeks. Dominant shoulder strength was measured using an isokinetic dynamometer at 60°/s and 180°/s. The functional deceleration ratio (FDR) was calculated as a functional strength profile. 20% FDR improvement after eight weeks of 11 + S at 180°/s (

This study aims to examine the relationship between the level of hope in mothers who have a child with cancer and its related factors in Iran. A cross-sectional and descriptive correlational design was used in this study. A demographic questionnaire and the Herth Hope Index (HHI) were administered to a sample of 240 mothers who have a child with cancer to assess level of hope. Mothers were also asked to indicate their highest priority hopes such as view of their supportive resources including financial support, psychosocial support, religiosity and spirituality. Data was analysed using descriptive statistics, Spearman’s rho, independent sample t test and one-way ANOVA. The mean HHI score was 35.44 (n = 237). There was a positive correlation between HHI total score and spirituality (r = 0.267, P < 0.001), and psychosocial support (r = 0.281, P < 0.001). No significant differences were found between HHI total score and respondents who saw themselves as a religious person and the family financial support. There was a significant difference in HHI total scores for a mother who has a disabled child (M = 32.92, SD = 2.75; t (235) = 2.00, P = 0.046) and mothers of a child who do not have any disability besides their cancer (M = 35.59, SD = 4.91). No significant differences were found in the HHI total score and different group of the child’s diagnoses and the mother’s age or/and child’s age. Mothers who have a child with cancer with better psychosocial and spiritual support showed a higher level of hope. A thorough knowledge of factors associated with hope in mothers caring for children suffering from cancer could provide a means to further advance the support delivered and the available resources given to the parents, especially the mothers.

Background and Aim: Diabetes is a metabolic disorder in the body. Sclerorhachis leptoclada belongs to the chicory family, is used to treat aids and cancer due to the antioxidant compounds in the root. Therefore, in this study, the effect of hydroalcoholic extract of Sclerorhachis leptoclada on glucose and cholesterol, triglyceride, high density lipoprotein (HDL) and low density lipoprotein (LDL) levels in diabetic rats was investigated. Materials and Methods: In this experimental study, 60 male Wistar rats were randomly divided into 10 groups of 6: Control group, treatment groups 1, 2, and 3 (healthy, treated with 150 mg/kg and 300 and 600 extracts), Diabetic control group, experimental groups 1, 2 and 3 (diabetic, treated with doses of 150 mg/kg and 300 and 600 extracts), Positive control group (diabetic+glibenclamide), The healthy group (healthy+glibenclamide) was divided. After one month of gavage, blood samples were taken from the rats, and glucose, urea, creatinine, and albumin levels were measured. A comparison was made between the effect of hydroalcoholic extract of Sclerorhachis leptoclada and the common drug glibenclamide and the results of the groups were compared by using t-test and ANOVA. Results: The results showed that the administration of hydroalcoholic extract of Sclerorhachis leptoclada can significantly reduce glucose levels in experimental groups (diabetic+extract at doses of 150, 300, 600) compared with the diabetic group (p

An ever-increasing volume of contextual data appearing on various types of media overwhelms users sharing information, as well as bringing up storage concerns. Automatic text summarization mitigate...

Prophylactic cranial irradiation (PCI) is used to decrease the probability of developing brain metastases in patients with small cell lung cancer and has been linked to deleterious cognitive effects. Although no well-established imaging markers for these effects exist, previous studies have shown that structural and metabolic changes in the brain can be detected with MRI and PET. This study used an image processing technique called texture analysis to explore whether global changes in brain glucose metabolism could be characterized in PET images. Methods:18F-FDG PET images of the brain from patients with small cell lung cancer, obtained before and after the administration of PCI, were processed using texture analysis. Texture features were compared between the pre- and post-PCI images. Results: Multiple texture features demonstrated statistically significant differences before and after PCI when texture analysis was applied to the brain parenchyma as a whole. Regional differences were also seen but were not statistically significant. Conclusion: Global changes in brain glucose metabolism occur after PCI and are detectable using advanced image processing techniques. These changes may reflect radiation-induced damage and thus may provide a novel method for studying radiation-induced cognitive impairment.

Background COVID-19 first appeared in Iran on 19 February 2020, and then spread rapidly over the country. In this article, we review the action plan of the Iranian Blood Transfusion Organization with respect to this disease. Method and materials We collected data on blood donations and RBC inventory for the first 8 weeks of the outbreak. We also evaluated the trend of blood donations and RBC inventory and compared them with the data of the past year. We include a summary of actions taken by the National Committee on Management of COVID-19 outbreak. Results Blood donations decreased from 33 275 to 23 465 units during the first 2 weeks of the outbreak with a corresponding decrease in the RBC inventory. But after that, donations gradually increased from 23 465 to 29 665 units. RBC inventory levels improved at the same time. Then, the Iranian New Year's holiday resulted in another downward trend. After the holiday, blood donations revived, along with the RBC inventory. Discussion Although it appears that this virus cannot be transmitted through transfusion, changes in lifestyle had a significant impact on reducing blood supply. Following implemented measures, we saw an upward trend in blood donations and an adequate supply of RBC units in blood centres, helped by a reduction in demand by hospitals. Blood centres need to be more prepared to manage future viral disasters, especially in case of transfusion-transmissible infections.

Sparse coding allows the representation of complex data as a linear combination of basis sparse vectors (alternatively called atoms or codewords), a collection of which constitutes a dictionary. Dictionary learning is a learning process aimed at finding a small number of optimal basis vectors for a more accurate representation of the original data. The existing dictionary learning methods do not address the inherent uncertainty of the input data in their learning processes. To compensate for the uncertainty, and to obtain a flexible and effective learning system, we introduce a new adaptive fuzzy dictionary learning (AFDL) method for image classification purposes. The new method iteratively alternates between sparse coding based on a given dictionary and an adaptive fuzzy dictionary learning approach to learn (improve) dictionary atoms. The adjustability of the dictionary and coefficients vectors, in this method, provide us a more accurate and straight representation of input data. AFDL was applied on magnetic resonance images from the cancer image archive datasets, for medical image classification of cancer tumors. Finally, the overall experimental results clearly show that our approach outperforms its rival techniques in terms of accuracy, sensitivity, and specificity. Convergence speed in the experimental results shows that AFDL can achieve its acceptable precision in a reasonable time.

Trade of pre-owned context-dependent-pricey mechanical equipment involves lots of uncertainty, due to the complexity of the condition checking procedure of this category of equipment. We put forward the idea of continuous operation monitoring and simple reporting to make this trade experience as efficient and peaceful as possible. To validate the practicality of the idea, we choose pre-owned passenger vehicles as the target use-case. In the last several years, the market for secondhand car sales has grown a lot, due to its affordability and rising new car prices, thus, giving it a larger share of the overall car market’s value. The used car trade is usually a time-consuming, stressful, and fraud-prone process. In this paper, we propose a system, which is a novel concept rather than technology, to represent the treatment history of a car simply with two scores, denoting the mechanical and the body treatments, using the electronic control unit and other add-on sensors’ information. These scores are cyclically and wirelessly transmitted to and recorded in a data center to be fetched at a later time. The two treatment scores alongside the production year, the mileage, the vehicle history reports, and online marketplace valuations provide buyers with comfort and peace of mind in choosing a used car.

In this research, the radiation protection features of bismuth boro-tellurite doped with NdCl3 glass system in the form of 65B2O3–12.5Bi2O3–12.5TeO2–(10 − y)Na2O–yNdCl3 with $$0\leq y\leq10$$ $${\text{mol}}\%$$ have been investigated by using Phy-X/PSD, XMuDat and XCOM programs. The photon radiation shielding parameters of suggested glasses were calculated in the photon energy range of 0.015–15 MeV. The results showed that the addition of NdCl3 in the present glass system improves the shielding performance of the glasses system. The obtained results have been plotted and discussed in terms of photon energy. Also, the obtained results were compared together.

Summary Aims Muscle atrophy is one of the complications of people with diabetes. Exercise have reversing effect of muscle atrophy in various conditions, hence the aim of the study was to evaluate The effect of five weeks of high intensity interval training (HIIT) on the expression of Atrogin-1, miR-23a, miR-206 and myostatin in gastrocnemius muscles of diabetic rats. Methods For this purpose, diabetes was induced in 14 Wistar male rats with an average weight of 260 ± 10 g by injection of streptozotocin (50 mg/kg). They were randomly divided into two groups, controls (n = 7) and HIIT (n = 7). HIIT protocol included implementing four sets (3-minutes) at intensity of 85–90% VO2max and one minute recovery between each set with intensity of 30 to 35% VO2max. Twenty-four hours after the last training session, animals were anesthetized, gastrocnemius muscles were removed and Atrogin-1, miR-23a, miR-206 and myostatin genes expression was evaluated by quantitative REAL time PCR. Data were analyzed by Kolmogorov–Smirnov test and t-test (P Results In addition, the expression of myostatin and Atrogin-1 genes in the HIIT group was significantly lower than the control group (P ≤ 0.05). Conclusion It indicates that HIIT due to hyperglycemic healing can alter the expression of atrogin-1, miR-23a, miR-206 and myostatin genes, as an effective factors in reducing the complications of diabetes, including muscle atrophy.

Significance Genome-wide association studies have identified genetic variation at the ARMS2/HTRA1 locus as a risk factor for the development and progression of age-related macular degeneration (AMD). We have developed a potent anti-HtrA1 Fab inhibitor of HtrA1 proteolytic activity in the retina as a potential therapeutic for treating AMD. A set of proteomic analytical tools was established to characterize HtrA1 activity and discover in vivo HtrA1 substrates. These efforts led to the identification of an eye-specific and clinically applicable pharmacodynamic biomarker of anti-HtrA1 Fab activity. Analysis of HtrA1-mediated cleavage of Dickkopf-related protein 3 in the aqueous humor of patients with geographic atrophy provided evidence of anti-HtrA1 Fab activity and information on duration of activity in a phase 1 study., Genetic polymorphisms in the region of the trimeric serine hydrolase high-temperature requirement 1 (HTRA1) are associated with increased risk of age-related macular degeneration (AMD) and disease progression, but the precise biological function of HtrA1 in the eye and its contribution to disease etiologies remain undefined. In this study, we have developed an HtrA1-blocking Fab fragment to test the therapeutic hypothesis that HtrA1 protease activity is involved in the progression of AMD. Next, we generated an activity-based small-molecule probe (ABP) to track target engagement in vivo. In addition, we used N-terminomic proteomic profiling in preclinical models to elucidate the in vivo repertoire of HtrA1-specific substrates, and identified substrates that can serve as robust pharmacodynamic biomarkers of HtrA1 activity. One of these HtrA1 substrates, Dickkopf-related protein 3 (DKK3), was successfully used as a biomarker to demonstrate the inhibition of HtrA1 activity in patients with AMD who were treated with the HtrA1-blocking Fab fragment. This pharmacodynamic biomarker provides important information on HtrA1 activity and pharmacological inhibition within the ocular compartment.

Collapse is the most critical performance level of seismic assessment of concrete buildings. Most of the conventional collapse assessment methods employ incremental dynamic analysis (IDA) for an equivalent single degree of freedom system. Meanwhile, the ambiguity about the stories, where the maximum engineering demands (such as drifts) occur, has raised grave doubts about the efficiency of the IDA for the conventional collapse assessment approach. This study proposes a new method to overcome this shortcoming by improving the existing IDA-based technique. For this purpose, a matrix is made up of drifts resulted from a pushover analysis of a multi-degree of freedom frame. This matrix of critical drifts is employed in the interpretation of the IDA results. Therefore, those stories, that experience partial collapse, are identified. To illustrate how the proposed methodology is implemented, two sets of 7- and 10-story typical building frames are modeled. It is assumed that they would fail in the flexural mode, and also the premature failure of the joints would never occur under seismic excitations. This new methodology results in a more conservative assessment of the collapse capacity in comparison with the IDA-based conventional method. Therefore, the proposed method is reliable enough to predict the building collapse possibility. In this method, the uncertainty associated with the estimated collapse limit state is lower than the conventional approach evaluation.

The accuracy and performance of deep neural network models become important issues as the applications of deep learning increase. For example, the navigation system of autonomous self-driving vehicles requires very accurate deep learning models. If a self-driving car fails to detect a pedestrian in bad weather, the result can be devastating. If we can increase the model accuracy by increasing the training data, the probability of avoiding such scenarios increases significantly. However, the problem of privacy for consumers and lack of enthusiasm for sharing their personal data, e.g., the recordings of their self-driving car, is an obstacle for using this valuable data. In Blockchain technology, many entities which cannot trust each other in normal conditions can join together to achieve a mutual goal. In this paper, a secure decentralized peer-to-peer framework for training the deep neural network models based on the distributed ledger technology in Blockchain ecosystem is proposed. The proposed framework anonymizes the identity of data providers and therefore can be used as an incentive for consumers to share their private data for training deep learning models. The proposed framework uses the Stellar Blockchain infrastructure for secure decentralized training of the deep models. A deep learning coin is proposed for Blockchain compensation.

Aim: This study aimed to perform an economic evaluation of Hemophilia ambulatory service delivery model (HASDM) comparing to the traditional home-episodic treatment model. Study Design: Tehran university of medical science, department pharmacoeconomics and pharmaceutical administration, between Jun 2016 and September 2018. Methods: A cost-minimization analysis (CMA) was conducted for evaluating potential savings of HASDM in comparison to the traditional home-episodic treatment model. The main cost of regular episodic service delivery, basic arm, consists of the cost of recombinant factor VIII (FVIII). In the comparator arm, HASDM, the costs of HASDM for 1660 hemophilia A patients (HAPs) in Tehran were calculated. One-way sensitivity analysis was done to investigate the robustness of the results and to investigate the impact of uncertainty in the percentage of mistakes in bleeding sensation. Results: There were 1660 patients with severe Hemophilia A (PWSHA) in Tehran in 2018. The mean utilization of annual per patient FVIII was 44814 international units (IUs) in Iran. The total annual cost of FVIII concentrate for 1660 hemophilic patients in Tehran was estimated at $ 11,001,816. The cost of running HASDM, personal, and equipment is equal to $ 580,956. The cost of FVIII in HASDM would be $ 4,004,661. Therefore, the total cost of HASDM is estimated at $ 4,585,617. The amount of savings was $ 6,416,199. Sensitivity analysis indicated the robustness of the results up to 94.64% of the variation in the model parameters. Conclusions: HASDM, compared to episodic model, can save 58.32% of the funding for controlling bleeding in HAPs annually. This can save more than 38 times of HAPs annual cost over their lifetime.

Background and Purpose: Endovascular treatment for acute ischemic stroke has been proven clinically effective, but evidence of the cost-effectiveness based on real-world data is scarce. The aim of this study was to assess whether endovascular therapy plus usual care is cost-effective in comparison to usual care alone in acute ischemic stroke patients. Methods: An economic evaluation was performed from a societal perspective with a 2-year time horizon. Empirical data on health outcomes and the use of resources following endovascular treatment were gathered parallel to the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) and its 2-year follow-up study. Incremental cost-effectiveness ratios were calculated as the extra costs per additional patient with functional independence (modified Rankin Scale score 0–2) and the extra cost per quality-adjusted life year gained. Results: The mean costs per patient in the intervention group were $126 494 versus $143 331 in the control group (mean difference, −$16 839 [95% CI, −$38 113 to $5456]). Compared with patients in the control group, more patients in the intervention group achieved functional independence, 37.2% versus 23.9% (absolute difference, 13.3% [95% CI, 4.0%–22.0%]) and they generated more quality-adjusted life years, 0.99 versus 0.83 (mean difference of 0.16 [95% CI, 0.04–0.29]). Endovascular treatment dominated standard treatment with $18 233 saved per extra patient with a good outcome and $105 869 saved per additional quality-adjusted life year. Conclusions: Endovascular treatment added to usual care is clinically effective, and cost saving in comparison to usual care alone in patients with acute ischemic stroke. Registration: URL: https://www.trialregister.nl/trial/695 ; Unique identifier: NL695. URL: https://www.isrctn.com ; Unique identifier: ISRCTN10888758.

Purpose Mid-rise steel moment-resisting frames (MRFs) with intermediate ductility are a major part of conventional residential buildings in Iran. According to Iranian seismic design codes, in this resisting system, considering the strong-column/weak-beam (SCWB) criterion is not mandatory. Where a metal deck ceiling system is used, the composite action of a concrete slab and steel beams could change the collapse mechanism of the structure, especially in the MRFs with intermediate ductility. The purpose of this paper is to investigate the influence of the composite action in the seismic collapse risk of this type of structures. Seismic collapse risk assessment can be carried out by using simplified pushover-based methods. In these methods, the cyclic deterioration of an equivalent single degree of freedom (ESDoF) system must be considered when the modified Ibarra–Medina–Krawinkler is used for nonlinear modeling of MRFs. Accordingly, a modified method is developed to use in simplified collapse risk assessment process. For these purposes, two mid-rise MRFs with intermediate ductility located in Tehran have been selected as case studies. The results confirm that the composite action is very effective in collapse risk value in the steel MRFs in which their SCWB ratio is less than 1. Moreover, the proposed approach of considering the cyclic deterioration of ESDoF systems increases the accuracy of the simplified collapse assessment approaches. Design/methodology/approach Identifying seismically vulnerable buildings to collapse requires using robust methods. These methods can be simplified based on pushover analysis methods. An attempt was made to apply one of these approaches for steel MRFs with intermediate ductility. In these frames, the composite action of a concrete slab and steel beams could change the collapse mechanism. Here, two MRFs were investigated in order to assess this effect on collapse risk value. This process was done by modifying the SPO2IDA method as a simplified collapse capacity evaluation approach by developing a relationship to consider the cyclic deterioration effects for the ESDoF systems. Findings The results showed that it is necessary to consider the slab effects in the analytical model in the collapse assessment process of MRFs with intermediate ductility, especially in the condition in which the SCWB ratios of the frame are less than 1. Furthermore, by utilizing the proposed method of considering the ESDoF cyclic deterioration, the error values of the SPO2IDA program were reduced significantly. Moreover, estimating the collapse risk parameters shows that the utilized simplified method presents suitable accuracy and could be an acceptable approach to collapse risk assessment of mid-rise steel MRFs. Originality/value The influence of the composite action in seismic collapse risk of MRFs with intermediate ductility is investigated. Also, a modified relationship is developed to consider the deterioration effects on the ESDoF parameters used in simplified collapse risk assessment process. Also, a framework is presented for utilized methodology.

Hospital resources, especially critical care beds and ventilators, have been strained by additional demand throughout the COVID-19 pandemic. Rationing of scarce critical care resources may occur when available resource limits are exceeded. However, the dynamic nature of the COVID-19 pandemic and variability in projections of the future burden of COVID-19 infection pose challenges for optimizing resource allocation to critical care units in hospitals. Connecticut experienced a spike in the number of COVID-19 cases between March and June 2020. Uncertainty about future incidence made it difficult to predict the magnitude and duration of the increased COVID-19 burden on the healthcare system. In this paper, we describe a model of COVID-19 hospital capacity and occupancy that generates estimates of the resources necessary to accommodate COVID-19 patients under infection scenarios of varying severity. We present the model structure and dynamics, procedure for parameter estimation, and publicly available web application where we implemented the tool. We then describe calibration using data from over 3,000 COVID-19 patients seen at the Yale-New Haven Health System between March and July 2020. We conclude with recommendations for modeling tools to inform decision-making using incomplete information during future crises.

Purpose:Hypernasality and atypical voice characteristics are common features of dysarthric speech due to amyotrophic lateral sclerosis (ALS). Existing acoustic measures have been developed to primarily target either hypernasality or voice impairment, and the effects of co-occurring hypernasality-voice problems on these measures are unknown. This report explores (a) the extent to which acoustic measures are affected by concurrent perceptually identified hypernasality and voice impairment due to ALS and (b) candidate acoustic measures of early indicators of hypernasality and voice impairment in the presence of multisystem involvement in individuals with ALS.Method:Two expert listeners rated severity of hypernasality and voice impairment in sentences produced by individuals with ALS (n= 27). The samples were stratified based on perceptual ratings: voice/hypernasality asymptomatic, predominantly hypernasal, predominantly voice impairment, and mixed (co-occurring hypernasality and voice impairment). Groups were compared using established acoustic measures of hypernasality (one-third octave analysis) and voice (cepstral/spectral analysis) impairment.Results:The one-third octave analysis differentiated all groups; the cepstral peak prominence differentiated all groups except asymptomatic versus mixed, whereas the low-to-high spectral ratio did not differ among groups. Additionally, one-third octave analyses demonstrated promising speech diagnostic potential.Conclusions:The results highlight the need to consider the validity of measures in the context of multisubsystem involvement. Our preliminary findings further suggest that the one-third octave analysis may be an optimal approach to quantify hypernasality and voice abnormalities in the presence of multisystem speech impairment. Future evaluation of the diagnostic accuracy of the one-third octave analysis is warranted.

Integration of 2D structures into other low-dimensional materials results in the development of distinct van der Waals heterostructures (vdWHSs) with enhanced properties. However, obtaining 2D-1D-0D vdWHSs of technologically useful next generation materials, transition-metal carbide MXene and monoelemental Xene nanosheets in a single superlattice heterostructure is still challenging. Here, the fabrication of a new multidimensional superlattice heterostructure "GerMXene" from exfoliated M

Background and purpose: Delayed cerebral ischaemia (DCI) is a severe complication of aneurysmal subarachnoid hemorrhage that can significantly impact clinical outcome. Cerebral vasospasm is part of the pathophysiology of DCI and therefore a computed tomography angiography (CTA) Vasospasm Score was developed and an exploration was carried out of whether this score predicts DCI and subsequent poor outcome after aneurysmal subarachnoid hemorrhage. Methods: The CTA Vasospasm Score sums the degree of angiographic cerebral vasospasm of 17 intradural arterial segments. The score ranges from 0 to 34 with a higher score reflecting more severe vasospasm. Outcome measures were cerebral infarction due to DCI (CI-DCI), radiological and clinical DCI, and unfavorable functional outcome defined as a modified Rankin Scale >2 at 6 months. Receiver operating characteristic analyses were used to assess predictive value and to determine optimal cut-off scores. Inter-rater reliability was evaluated by Cohen's kappa coefficient. Results: This study included 59 patients. CI-DCI occurred in eight patients (14%), DCI in 14 patients (24%) and unfavorable outcome in 12 patients (20%). Median CTA Vasospasm Scores were higher in patients with (CI-)DCI and poor outcome. Receiver operating characteristic analysis revealed the highest area under the curve on day 5: CI-DCI 0.89 (95% confidence interval [CI] 0.79–0.99), DCI 0.68 (95% CI 0.50–0.87) and functional outcome 0.74 (95% CI 0.57–0.91). Cohen's kappa between the two raters was moderate to substantial (0.57–0.63). Conclusions: This study demonstrates that the CTA Vasospasm Score on day 5 can reliably identify patients with a high risk of developing (CI-)DCI and unfavorable outcome.

INTRODUCTION AND OBJECTIVE:Patients with ureteral tumors managed endoscopically often benefit from adjuvant immuno-chemotherapy and require interval upper tract surveillance with ureteroscopy. Howe...

Chemotherapy followed by prophylactic cranial irradiation (PCI) is associated with increased survival in patients with small cell lung cancer but is associated with fatigue and cognitive impairment. This retrospective study evaluated regional differences in 18F-FDG uptake by the brain before and after PCI. The null hypothesis was that direct toxic effects on the brain from PCI and chemotherapy are symmetric; thus, asymmetric deviations may reflect functional changes due to therapy. Methods: Electronic medical records from 2013 to 2016 were reviewed for patients with small cell lung cancer, MRI of brain negative for metastasis, and 18F-FDG PET/CT scans before and after PCI. As the standard of care, patients received first-line chemotherapy or chemoradiation to the thorax followed by PCI. The 18F-FDG PET/CT scans nearest the PCI were selected. Sixteen patients met these initial criteria. Commercially available PET software was used to register and subtract the PET scans before and after PCI to obtain difference maps. Occipital and cerebellar regions were excluded from the final statistical analysis given the known high variability and misregistration. The χ2 test was used to analyze the data. Results: Two patients had 18F-FDG uptake differences only in the occipital and cerebellar regions. The software registration failed on 1 patient's scans. Therefore, 13 patients were included in the final analysis. Nine of 13 patients demonstrated significant unilateral changes in only 1 region of the brain, and 3 of 13 showed significant changes unilaterally in 2 regions. The χ2 test revealed a significant unilateral regional difference on a patient level (χ2 = 6.24, P = 0.025). The most commonly affected brain region was the frontal lobe. Conclusion: Significantly more patients had unilateral than bilateral regional differences (both increases and decreases) in 18F-FDG uptake in the brain before and after PCI. This finding suggests that differences in unilateral distribution are related to functional changes, since direct toxicity alone from PCI and chemotherapy would be symmetric. The frontal region was the most commonly affected, suggesting a potential contributing etiology for cognitive impairment and decreased executive function after therapy.

Background and objectives The use of COVID-19 convalescent plasma (CCP) has been approved by the FDA. We assessed the outcome of patients with moderate and severe COVID-19 following convalescent plasma therapy and the association with variables such as antibody titer in CCP units and transfusion time. Materials and methods In this prospective cohort study, 3097 patients with moderate and severe COVID-19 (according to WHO Progression Scale) had heterogeneous demographic and clinical characteristics received plasma with an unknown titer at the transfusion time. Firstly, information about age, sex, blood group, the time interval from hospitalization to CCP transfusion, underlying disease, and antibody titer with the outcome were investigated. Then, multivariate logistic regression and area under the curve (AUC) were performed for the association between disease severity and intubation variables with transfusion time and outcome. Results Patients with younger age receiving CCP in the first five days of hospitalization had lower mortality (P < 0.0001). Moreover, patients without the underlying disease had lower mortality (P < 0.001). The mortality rate also decreased in severe patients who were intubated receiving CCP for less than five days (P < 0.001). In patients with moderate severity (score less than 5) who received IgG antibody levels above 1:320 in less than five days had lower mortality (P < 0.0001). Conclusion Our findings suggested that COVID-19 patients with the moderate type of disease receiving CCP units with high antibody titers in the early stages of the disease experienced greater effectiveness of CCP therapy.

Type 3 von Willebrand disease (VWD3) is a rare and severe bleeding disorder characterized by often undetectable von Willebrand factor (VWF) plasma levels, a recessive inheritance pattern, and heterogeneous genotype. The objective of this study was to identify the VWF defects in 265 European and Iranian patients with VWD3 enrolled in 3WINTERS-IPS (Type 3 Von Willebrand International Registries Inhibitor Prospective Study). All analyses were performed in centralized laboratories. The VWF genotype was studied in 231 patients with available DNA (121 [115 families] from Europe [EU], and 110 [91 families] from Iran [IR]). Among 206 unrelated patients, 134 were homozygous (EU/IR = 57/77) and 50 were compound heterozygous (EU/IR = 43/7) for VWF variants. In 22 patients, no or only one variant was found. A total of 154 different VWF variants (EU/IR = 101/58 [5 shared]) were identified among the 379 affected alleles (EU/IR = 210/169), of which 48 (EU/IR = 18/30) were novel. The variants p.Arg1659*, p.Arg1853*, p.Arg2535*, p.Cys275Ser, and delEx1_Ex5 were found in both European and Iranian VWD3 patients. Sixty variants were identified only in a single allele (EU/IR = 50/10), whereas 18 were recurrent (≥3 patients) within 144 affected alleles. Nine large deletions and one large insertion were found. Although most variants predicted null alleles, 21% of patients carried at least 1 missense variant. VWD3 genotype was more heterogeneous in the European population than in the Iranian population, with nearly twice as many different variants. A higher number of novel variants were found in the Iranian VWD3 patients.

Background Treponema pallidum ssp. pallidum (Tp), the causative agent of syphilis, is a highly invasive pathogen that moves throughout the body via the bloodstream and invades organs and tissues to cause the serious sequelae associated with sexually transmitted and congenitally acquired syphilis infections. The endothelium represents a crucial barrier for Tp dissemination, and we hypothesized that Tp alters endothelial structure and signalling. In this study, we apply an integrative omics approach to characterize transcriptomic, proteomic, and immune secretomic responses of endothelial cells to Tp. Methods Endothelial cells were grown in vitro and exposed to viable Tp or a background control lacking the pathogen. For transcriptomic analysis, RNA was harvested from the endothelial cells and sequenced via RNAseq. For proteomic analysis, experimental and control samples grown using stable isotope labeling by amino acids in cell culture (SILAC), total protein was harvested and analyzed via orbitrap fusion tandem mass-spectrometry (LC-MS/MS). For immune secretomic analysis, supernatant from endothelial cells co-incubated with Tp was harvested and analyzed for cytokine content via cytometric bead arrays (CBA) using flow-cytometry. Results RNAseq studies identified genes within immune signalling pathways that are differentially regulated in response to Tp. Proteomic analysis identified several pathways involved in cellular structure and modulation, interleukin signalling, and intracellular signalling. Data from CBA experiments further indicate the ability of Tp to alter endothelial cytokine production and secretion. These data give a novel multi-faceted look into the role and response of the endothelium during Tp infection. Conclusion These studies represent a novel systems-level approach to understanding the molecular mechanisms behind the establishment and persistence of Tp infection. Further, they provide insight into how Tp may induce host cellular changes to enable barrier traversal and immune cell recruitment, and in this way provide information that is relevant to syphilis vaccine design.

Background There is a need to identify patients with haemophilia who have a very low or high risk of developing inhibitors. These patients could be candidates for personalized treatment strategies. Aims The aim of this study was to externally validate a previously published prediction model for inhibitor development and to develop a new prediction model that incorporates novel predictors. Methods The population consisted of 251 previously untreated or minimally treated patients with severe haemophilia A enrolled in the SIPPET study. The outcome was inhibitor formation. Model discrimination was measured using the C-statistic, and model calibration was assessed with a calibration plot. The new model was internally validated using bootstrap resampling. Results Firstly, the previously published prediction model was validated. It consisted of three variables: family history of inhibitor development, F8 gene mutation and intensity of first treatment with factor VIII (FVIII). The C-statistic was 0.53 (95% CI: 0.46-0.60), and calibration was limited. Furthermore, a new prediction model was developed that consisted of four predictors: F8 gene mutation, intensity of first treatment with FVIII, the presence of factor VIII non-neutralizing antibodies before treatment initiation and lastly FVIII product type (recombinant vs. plasma-derived). The C-statistic was 0.66 (95 CI: 0.57-0.75), and calibration was moderate. Using a model cut-off point of 10%, positive- and negative predictive values were 0.22 and 0.95, respectively. Conclusion Performance of all prediction models was limited. However, the new model with all predictors may be useful for identifying a small number of patients with a low risk of inhibitor formation.

Introduction: Bilious vomiting is highly suggestive of an acute and emergent condition among neonates. The aim of this study was to investigate the non-surgical causes of bilious vomiting in neonates admitted to a tertiary center and to compare them with the surgical causes. Methods: This cross-sectional study was performed on 80 infants with bilious vomiting who were admitted at the neonatal intensive care unit of a pediatric tertiary center over 2 years. The demographic characteristics, clinical symptoms and signs, diagnostic assessments and therapeutic approaches were recorded. Results: The mean age of neonates was 9.07 ± 8.84 days and 55% of them were males. The most common final diagnosis was: Necrotizing Enterocolitis (NEC), duodenal atresia, Hirschsprung’s disease, gastroesophageal reflux disease (GERD), volvulus, sepsis, meconium plug, isolated mal-rotation, metabolic abnormalities, imperforate anus, and Ladd’s bands, respectively. Abnormal findings in ultrasound and X-rays were detected in 35% and 46.3%, respectively. About half of the affected neonates were treated non-surgically. Overall, 17.5% of the patients died. Most deaths were seen in infants with NEC. Using multivariable logistic regression analysis, the presence of NEC as an underlying etiology was the only predictor of neonatal death in neonates with bilious vomiting (OR = 12.455, 95%CI: 1.365 – 113.618, P = 0.025). Conclusion: The most common cause of bilious vomiting was NEC followed by duodenal atresia. Half of the neonates with bilious vomiting were treated medically without operation

Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients. Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 patients. Methods: This study was performed on 50 consecutive COVID-19 patients with severe/critically ill disease. Severe disease was defined as having at least one of the following symptoms: shortness of breath, respiratory frequency ≥ 20/min, blood oxygen saturation ≤ 93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio 50% within the last 24-48 h. Critically ill disease was identified by intensive care unit admission, respiratory failure, septic shock, or multiple organ dysfunction or failure. Primary outcomes included the safety of CP transfusion, 14-day and 30-day survival rate, and change in lung computed tomography (CT) scan score. Several other clinical and laboratory features were evaluated as the secondary outcomes. Results: Based on the results, 21 out of 50 consecutive patients were on mechanical ventilation at the time of CP transfusion. In total, 32 patients (64%) survived 30 days after CP transfusion. The survival rates were 74% and 44% in patients who received CP < 7 and ≥ 7 days after admission, respectively. While 92% of patients without mechanical ventilation survived, the survival rate of patients on mechanical ventilation was 29%. Moreover, the CT scan score and some other clinical features were improved in the group that received CP transfusion, and no adverse effects were observed. Conclusion: The CP transfusion is a safe and effective treatment in severe/critically ill COVID-19 patients. The best outcome can be achieved in patients who are not on mechanical ventilation, especially early in the disease course.

Background and Objectives Convalescent plasma has attracted significant attention as a therapeutic option against infectious agents for more than a century. In March 2020, the use of Convalescent COVID-19 plasma (CCP) as a new research drug for COVID-19 treatment was approved by the FDA. The development of SARS-CoV-2 IgG antibodies following infection or vaccination is likely to be essential to provide adequate immunity for the population to halt the COVID19 pandemic. This study aimed to identify the criteria that would be used to determine the most appropriate CCP donors with the highest effective antiviral antibody titers. Materials and Methods In this prospective cohort, univariate analyses and multivariate regression analyses were performed to evaluate the relationship between characteristics of 11949 CCP donors and COVID-19 disease severity prior to donation with antibody titers estimated using ELISA technique and rapid tests. Results The antibody titer was measured among 8206 (68.7 %) donors. Elderly male and nulliparous female CCP donors who resided in the areas with high load of virus had positive ELISA and rapid test results as well as high levels of SARS-CoV-2 IgG antibodies titer. Moreover, the long hospital stay and elderly donors were the variables associated with high levels of SARS-CoV-2 IgG antibodies. Conclusion This study suggests that nulliparous female and male donors with positive rapid tests who resided in areas with a higher prevalence of SARS-CoV-2, with more than 40 years of age and long hospitalization time can be the preferred donors for CCP donation.

Background: Prefabricated band and loops require only one appointment, are quickly placed in a session, and do not require laboratory work; thus, they need less time and cost. The aim of this study was to evaluate the survival rate of prefabricated band and loops in space maintenance of primary teeth and compare them with conventional band and loops. Materials and Methods: In this prospective clinical trial study 4–9‑year‑old patients, who met the requirements of the present study, were divided into two groups. The first group conventional band and loops and the second group prefabricated band and loops were placed. The patients were evaluated for cement dissolving. Failure of soldering (SF), breakdown, and deformation of each component of the band and loops, survival rate, and gingival health at the 1st, 3rd, 6th, and 9th‑month Wilcoxon test, Fisher’s exact test, Mann–Whitney test, Friedman test, and Kaplan–Meier test. Was used The level of statistical significance was set at P ≤ 0.05. Results: The two groups were not significantly different at the 1st, 3rd, 6th, and 9th‑month recalls in cement solution, SF, breakdown, and deformation of each component of the band and loops. The survival rate of the conventional and prefabricated band and loops was 92% in the 9 months, and no significant difference was witnessed in survival rates between the two groups. The prevalence of gingivitis in prefabricated band and loops and conventional band and loops in the 9th month was statistically insignificant (P = 0.03). Conclusion: There is a similar success rate for the conventional and prefabricated band and loops. Key Words: Child, primary teeth, space maintenance

An inseparable part of project management is the existence of uncertainty. There are various methodologies and tools to handle the impact of uncertainty on project performance.Todenote the uncertainty

Introduction: The widespread use of diagnostic and therapeutic ionizing radiation raises concerns regarding excessive occupational and patient exposure. In this study, we test a novel fluo...

Background and Purpose— Hemorrhagic transformation (HT) after acute ischemic stroke may cause severe neurological deterioration and affects functional outcome. Identifying patients most likely to suffer from this complication could potentially be used for future treatment selection. Reperfusion after endovascular therapy could be associated with different risk factors for HT than intravenous thrombolytics as these treatments largely differ. In this study, we aimed to identify clinical and imaging markers that are associated with HT subtypes in the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) population. Methods— In this post hoc analysis, all patients with follow-up imaging were included. HT was classified according to ECASS II (European Cooperative Acute Stroke Study). Variables with an association of P Results— Of the 478 out of 500 included patients in this subanalysis, 46% had HT (n=222). Of these, 66% had hemorrhagic infarction (n=147) and 34% PH (n=75). Symptomatic intracranial hemorrhage was observed in 7.3% (n=35) of all patients. Baseline National Institutes of Health Stroke Scale (odds ratio [OR], 1.05,95% CI, 1.01–1.09 per point) and absent/poor collaterals (OR, 1.90; 95% CI, 1.05–3.42) were significantly associated with hemorrhagic infarction. Increased systolic blood pressure (OR, 1.17; 95% CI, 1.05–1.31 per 10 mm Hg) and atrial fibrillation (OR, 1.94; 95% CI, 1.08–3.48) were associated with PH. Increased systolic blood pressure (OR, 1.28; 95% CI, 1.12–1.48) and antiplatelet use (OR, 2.6; 95% CI, 1.08–6.3) were associated with symptomatic intracranial hemorrhage. Conclusions— Clinical and imaging stroke severity parameters were associated with HT, both in hemorrhagic infarction and PH, whereas baseline patients characteristics like systolic blood pressure, atrial fibrillation, and antiplatelet use were only associated with PH or symptomatic intracranial hemorrhage. Clinical Trial Registration— URL: http://www.controlled-trials.com . Unique identifier: ISRCTN10888758.

Background and Objective: Complex regional pain syndrome (CRPS) is a chronic condition characterized by severe regional pain, allodynia, hyperalgesia, and functional impairment. The aim of this systematic review is to investigate whether a familial subtype of CRPS (fCRPS) exists and to determine whether people with fCRPS have specific characteristics. Methods: Databases CINAHL, Medline, PsycINFO, and PubMed were searched with no date limitation. Quality of reporting was assessed using the Scottish Intercollegiate Guidelines Network scale and the Joanna Briggs Institute’s checklists. Results: Eight studies were included. Family relationships were defined as any immediate (i.e., parents or siblings) or blood relatives. A combination of participants with known or unknown causes for CRPS was recruited. The studies in this review support the potential for the existence of fCRPS, although this included less than 25% of those affected. People with potential fCRPS showed more severe symptoms, more sites involved, a higher percentage of spontaneous onset, and earlier age at onset. An elevated sibling recurrence risk ratio of 5.6 (95% confidence interval [CI], 3.0 to 9.8) was reported for people under 50. None of the studies established a pattern of heritability. Therefore, the most likely explanation for heritability would be a multifactorial model in which cumulative and interactive Gene × Environment effects may be involved. Conclusions: This systematic review supports the potential for the existence of fCRPS; however, all identified studies used uncontrolled case reports, case series, and case–control designs that cannot provide evidence of causation. Further studies are required to reveal the heritability and genetic structure of fCRPS.