Percutaneous Sclerotherapy of Large Venous Malformations Using Consecutive Polidocanol and Bleomycin Foam: MR Imaging Volumetric and Quality-of-Life Assessment.

PURPOSE: To retrospectively evaluate sclerotherapy using consecutive polidocanol and bleomycin foam (CPBF) for large untreated venous malformations (VMs) and/or those resistant to prior treatment. MATERIALS AND METHODS: This retrospective study included all patients treated with CPBF for untreated VMs larger than 10 mL and/or refractory to treatment between May 2016 and October 2019. Baseline and follow-up VM volumes were measured on fat-suppressed T2-weighted magnetic resonance (MR) imaging. Outcome was evaluated on postprocedural MR imaging volumetry and by a retrospective survey assessing clinical response and adverse events. Imaging response was considered good for volume reduction from 50% to 70% and excellent for volume reduction ≥70%. Symptoms and quality-of-life (QoL) scores were compared before and after CPBF sclerotherapy. RESULTS: Forty-five patients (mean age, 16 years; range, 1-63 years; 25 males) with 57 VMs were analyzed and treated by 80 sclerotherapy. Sixty percent (27 of 45) of patients had undergone prior treatment for VM. Median VM volume was 36.7 mL (interquartile range, 84 mL) on pretherapy MR imaging. Good and excellent results after the last sclerotherapy were achieved in 36% (16 of 45) and 29% (13 of 45) of patients, respectively, corresponding to a decrease of >50% in 60% (34 of 57) of VMs. QoL score increased by at least 3 points, regardless of initial symptoms. Most patients did not desire additional sclerotherapy owing to near complete symptomatic relief, even for patients who did not achieve a good response. Swelling, pain, and motor impairment scores significantly improved after CPBF. Adverse events included fever (44%, 15 of 34) and nausea/vomiting (29%, 10 of 34). CONCLUSIONS: CPBF sclerotherapy represents an effective therapy for large and/or refractory VMs with minimal adverse events.

Violent Partners or a Specific Class of Offenders? A Criminal Career Approach to Understanding Men Involved in Intimate Partner Sexual Violence.

The current study investigates the criminal career of individuals involved in intimate partner sexual violence (IPSV). Specifically, the goal is to determine whether men who engage in IPSV can be distinguished from those who engage in intimate partner non sexual violence (IPNSV) only and whether criminal trajectories in the resulting subgroup are heterogeneous. The sample comes from a Canadian database including a total of 12,458 individuals involved in IPSV and 32,474 individuals involved in IPNSV). Bivariate and multivariate analyses are performed to examine the differences in the two groups while latent profile analysis allows examining the heterogeneity of characteristics of men who engaged in IPSV. Findings indicate that the criminal career of men who engage in IPSV follows a pattern that is clearly distinct from that of men who engage in IPNSV only and is more specialized in terms of sexual offenses. Results also show that the criminal trajectories followed by the men who engage in IPSV are heterogeneous. Four profiles of different trajectories were identified. Both theoretical and practical implications are discussed.

A Peek into Their Mind? An Exploration of Links Between Offense-Supportive Statements and Behaviors among Men Who Sexually Exploit Children and Adolescents Online.

While forensic psychologists have some access to their patients' thoughts when deciding on a diagnosis or appraising risk, others, such as police investigators, must rely on physical evidence and behavioral markers to make sense of a crime. Studies showing that offense-supportive cognitions constitute a risk factor for sexual offending, including offenses that take place on the internet, highlight the need for some access to offenders' thoughts. This exploratory study examines the associations between offense-supportive statements about the sexual exploitation of children and adolescents and proxy behaviors. As part of PRESEL, a collaborative research project between Québec provincial police and academic researchers, the case files of 137 men convicted of using child sexual exploitation material or committing child-luring offenses were analyzed. Results showed that many meaningful risk factors and sexual offending behavioral markers were associated with the cognitive themes Sexualization of children, Child as partner, Dangerous world, Entitlement, and Uncontrollability. The use of encryption was negatively associated with the cognition Virtual is not real while Internet is uncontrollable was associated with fewer contacts with minors over the internet. Findings are useful for understanding the psychological needs that should be targeted in treatment, as well as helping prioritize police workloads.

Sexual homicide and the forensic process: The decision-making process of collecting and analyzing traces and its implication for crime solving.

The focus of the current study is to examine the collection and analysis of traces that are related to crime scene behaviors in sexual homicide cases as well as the factors influencing the solving of these crimes. Using 230 sexual homicide cases from the SHielD database, we computed two neural network models based on the multi-layer perceptron algorithm. First, we determined whether certain crime scene characteristics predicted the collection and analysis of traces (dependent variable for Model 1). Not surprisingly, the results indicate that trace collection and analysis were more likely to occur in sexual homicide cases with crime scene behaviors exhibiting the highest risk for trace transfer (e.g. close interactions with the victim) as well as the best conditions for trace persistence (e.g. body is found indoors). Situational and physical aspects of the crime scene are thus taken into account when deciding on the collection and analysis of traces. Second, we examined the situations in which the collection and analysis of traces contributes to crime solving (dependent variable for Model 2). The results suggest that the collection and analysis of traces does not necessarily predict the resolution of the case. Specifically, the analyses show that the collection and analysis of traces is useful for crime solving when: (1) the offenders' behaviors increase the opportunities for leaving traces at the crime scene, and (2) when the environmental and temporal aspects are favorable to the collection of traces. The impact of trace collection and analysis on case resolution is thus depending on the context of the case. Furthermore, the subsequent steps, such as the result of the trace analysis, the introduction into a database, the obtention of a result from this comparison, etc. might also affect case resolution, and thus interfere in the link between trace collection and analysis and case resolution.

Childhood victimization and poly-victimization of online sexual offenders: A developmental psychopathology perspective.

BACKGROUND: Research on childhood victimization of individuals involved in online sexual offending during adulthood is scarce. Studies focusing on adverse childhood of individuals involved in offline child abuse suggested that childhood trauma was associated with an increased probability of sexual offending during adulthood. OBJECTIVE: The purpose of this study is to explore the role that childhood victimization may have in the development of risk factors that increase the likelihood of being involved in online sexual offending. PARTICIPANTS: This comparative study analyzed the characteristics of 127 individuals involved in online sexual offending who did not experience childhood victimization and 77 individuals involved in online sexual offending who experienced childhood victimization. METHODS: Bivariate and regression analyses were conducted to identify variables associated with the presence of victimization and polyvictimization during childhood. Next, structural equation modeling analysis was used to identify the direct and indirect relationships between childhood (poly)victimization and the development of risk factors. RESULTS: Results showed that individuals who experienced childhood victimization presented different risk factors and cognitions compared to those who did not. Depending on the type of victimization experienced, criminogenic cognitions, antisocial behaviors, and sexual interests for children were more likely to be developed. CONCLUSIONS: For individuals involved in online sexual offending during adulthood, childhood abuse is directly associated with the development of offense-supportive cognitions, substance abuse, and youth engagement in sexual offending, while sexual interests for children and sense of loneliness are indirect consequences of childhood trauma.

Child sexual exploitation material offenders, one-size-fits-all for? Exploring tailored clinical dimensions based on cognitive and behavioural criminogenic factors.

BACKGROUND: Interventions for individuals involved in sexual offending behaviours are likely to be more effective if adapted to focus on their specific characteristics, suggesting that men who engage in sexual offences against children over the Internet should be treated differently from those who have actual physical contact against children. AIMS: The goal of this study is to explore possible associations between the criminogenic cognitions and behaviours of men using online child sexual exploitation material (CSEM) and variables relevant to intervention. We hypothesised that antisocial tendencies, sexual, emotional and relational problems and self-regulation problems, as well as cognitive distortions would be associated with CSEM use. METHOD: Ninety-eight men who had been convicted of at least one online CSEM-related offence, but no child contact sexual offences, at any time between 2001 and 2020 were recruited in the province of Quebec (Canada). Cases were reviewed to identify cognitive and behavioural criminogenic factors according to a coding sheet developed after reference to prior literature. Variables were extracted from official criminal records, sexological and psychological reports, as well as investigative and forensic reports and interviews. Exploratory factor analysis was carried out to identify potentially relevant dimensions. RESULTS: Analysis confirmed five distinct factors which, together, accounted for 60% of the variance: dissocial traits, dysfunctional intimacy, passive alienation (internalised sense of alienation), normless alienation (social norms experienced as alien) and coping with threat. CONCLUSION: Because online CSEM-related offenders present heterogeneous risks and needs, a 'one-size-fits-all' intervention is unlikely to be optimal for most of them. Our findings suggest a way of classifying risks and needs to facilitate more focused interventions. Future research should evaluate the relative effectiveness of general interventions compared to those tailored towards the dimensions of risks and needs identified in this study.

Social media forensics applied to assessment of post-critical incident social reaction: The case of the 2017 Manchester Arena terrorist attack.

Forensic science is constantly evolving and transforming, reflecting the numerous technological innovations of recent decades. There are, however, continuing issues with the use of digital data, such as the difficulty of handling large-scale collections of text data. As one way of dealing with this problem, we used machine-learning techniques, particularly natural language processing and Latent Dirichlet Allocation (LDA) topic modeling, to create an unsupervised text reduction method that was then used to study social reactions in the aftermath of the 2017 Manchester Arena bombing. Our database was a set of millions of messages posted on Twitter in the first 24 h after the attack. The findings show that our method improves on the tools presently used by law enforcement and other agencies to monitor social media, particularly following an event that is likely to create widespread social reaction. For example, it makes it possible to track different types of social reactions over time and to identify subevents that have a significant impact on public perceptions.

Non-Contrast CT and CT-Angiogram for Late Window Ischemic Stroke Treatment Selection.

INTRODUCTION: The benefit of late window endovascular treatment (EVT) for anterior circulation ischemic stroke has been demonstrated using perfusion-based neuroimaging. We evaluated whether non-contrast CT (NCCT) and CT-angiogram (CTA) alone can select late-presenting patients for EVT. METHODS: We performed a retrospective comparison of all patients undergoing EVT at a single comprehensive stroke center from January 2016 to April 2017. Patients planned for EVT were divided into early (<6 hours from onset) and late (≥6 hours from onset or last time seen normal) window groups. Incidence of symptomatic hemorrhagic transformations (sHTs) at 24 hours and 3-month modified Rankin scores (mRSs) were compared. RESULTS: During the study period, 204 (82%) patients underwent EVT in the early and 44 (18%) in the late window. Median (interquartile range) NIH Stroke Scale Score was similar between groups (early: 18 [15-23] vs. late: 17 [13-21]), as were median ASPECT scores (early: 9 [8-10] vs. late: 9 [7-9]). In the late window, 42 (95%) strokes were of unknown onset. Similar proportions of sHT occurred at 24 hours (early: 12 [6%] vs. late: 4 [9%], p = 0.43). At 3 months, the proportion of patients achieving functional independence (mRS 0-2) were comparable in the early (80/192 [42%]) and late (16/41 [39%]) windows (p = 0.76). CONCLUSION: NCCT- and CTA-based patient selection led to similar functional independence outcomes and low proportions of sHT in the early and late windows. In centers without access to perfusion-based neuroimaging, this pragmatic approach could be safe, particularly for strokes of unknown onset.

Sexual Interests of Child Sexual Exploitation Material (CSEM) Consumers: Four Patterns of Severity Over Time.

This study analyzed the evolution over time of the activity of consumers of child sexual exploitation material (CSEM). To this end, images and metadata were extracted from the hard drives of 40 individuals convicted of possession of child pornography and analyzed. A sample of these images ( N = 61,244) was categorized by the age of the subjects depicted and-using the Combating Paedophile Information Networks in Europe (COPINE) scale-by severity of the acts depicted. Collecting activity was observed to follow four patterns. The most prevalent pattern was a progressive decrease in the age of the person depicted and a progressive increase in the severity of the sexual acts. In light of the results, we propose four explanations of the nature of, and variations in, child-pornography collections.