bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-sectional survey of surrogate decision-making in Japanese medical practice
Authors: Tanaka Masashi , Bito Seiji , Enzo Aya , Okita Takethoshi , Atsushi Asai
Published: September 2021

Background

Instances of surrogate decision-making are expected to increase with the rise in hospitalised older adults in Japan. Few large-scale studies have comprehensively examined the entire surrogate decision-making process. This study aimed to gather information to assess the current state of surrogate decision-making in Japan.

Methods

A cross-sectional survey was conducted using online questionnaires. A total of 1000 surrogate decision-makers responded to the questionnaire. We examined the characteristics of surrogate decision-makers and patients, content of surrogate decision-making meeting regarding life-sustaining treatment between the doctors and surrogate decision-makers, extent of involvement of the various parties in the surrogate decision-making process, judgement grounds for surrogate decision-making, and frequency of involvement in the surrogate decision-making process.

Results

Of the participants, 70.5% were male and 48.3% were eldest sons. Only 7.6% of the patients had left a written record of their preferences and 48.8% of the surrogates reported no knowledge of the patient having expressed their prior intentions regarding medical care in any form. Respondents indicated that their family meetings with healthcare professionals mostly included the information recommended by guidelines in a surrogate decision-making meeting in Japan. Most participants reported a good understanding of the meeting content. Although many participants based their decisions on multiple grounds, surrogates’ considerations may not adequately reflect respect for patient autonomy in Japan. Specifically, the eldest son considered his own preference more frequently than that of the other surrogate decision-makers. In 26.1% of the cases, either zero or one family meeting with healthcare professionals was held. In these cases, significantly fewer decisions involved the participation of healthcare professionals other than the doctor compared to cases with multiple meetings.

Conclusions

Surrogate decisions in Japan are most commonly made by eldest sons and may not frequently consider the perspectives of other surrogates. The finding that patient preferences were rarely known suggests a role for increased advance care planning.
Effects of vitamin D supplementation on the functional outcome in patients with osteoporotic vertebral compression fracture and vitamin D deficiency
Authors: Ko Sangbong , Jun ChungMu , Nam Junho
Published: September 2021

Background

In osteoporotic vertebral compression fractures, supplementation using vitamin D preparations and maintenance of blood vitamin D level within the normal range are necessary for proper fracture union, enhancement of muscle strength, and maintenance of body balance. The purpose of this study is to investigate the effects of vitamin D supplementation on blood vitamin D level, pain relief, union time, and functional outcome in patients with osteoporotic vertebral compression fracture and vitamin D deficiency.

Methods

One hundred thirty patients who were deficient in blood vitamin D level and had osteoporotic vertebral compression fracture were divided into supplementation group and non-supplementation group. Initially, 3 months, 6 months, and 12 months after the injury, radiographs were taken to assess fracture union, and questionnaires were evaluated to evaluate the functional outcome and quality of life.

Results

The mean age of the 130 patients (36 males and 94 females) was 74.75 ± 7.25 years. There were no statistically significant differences in initial severity of low back pain, functional outcome, and quality of life between the insufficient group and the deficient group (all p values were > 0.05). There was no significant time-by-group interaction between the supplementation group and the non-supplementation group (p = 0.194). In terms of SF-36 physical component score, there was no significant time-by-group interaction between the supplementation group and the non-supplementation group (p = 0.934).

Conclusions

Fracture union was achieved in all patients regardless of serum vitamin D level, and there were significant improvements in severity of low back pain, functional outcome, and quality of life over 12 months in patients with osteoporotic vertebral compression fracture. Short-term vitamin D supplementation of patients with osteoporotic vertebral compression fracture and deficiency of vitamin D did not result in significant differences in fracture union status, functional outcome, and quality of life between the supplementation groups and the non-supplementation groups of patients.
Comprehensive analysis of mutations and clonal evolution patterns in a cohort of patients with cytogenetically normal acute myeloid leukemia
Authors: Mat Yusoff Yuslina , Ahid Fadly , Abu Seman Zahidah , Abdullah Julia , Kamaluddin Nor Rizan , Esa Ezalia , Zakaria Zubaidah
Published: September 2021

Background

Relapsed acute myeloid leukemia (AML) is associated with the acquisition of additional somatic mutations which are thought to drive phenotypic adaptability, clonal selection and evolution of leukemic clones during treatment. We performed high throughput exome sequencing of matched presentation and relapsed samples from 6 cytogenetically normal AML (CN-AML) patients treated with standard remission induction chemotherapy in order to contribute with the investigation of the mutational landscape of CN-AML and clonal evolution during AML treatment.

Result

A total of 24 and 32 somatic variants were identified in presentation and relapse samples respectively with an average of 4.0 variants per patient at presentation and 5.3 variants per patient at relapse, with SNVs being more frequent than indels at both disease stages. All patients have somatic variants in at least one gene that is frequently mutated in AML at both disease presentation and relapse, with most of these variants are classic AML and recurrent hotspot mutations including NPM1 p.W288fs, FLT3-ITD, NRAS p.G12D and IDH2 p.R140Q. In addition, we found two distinct clonal evolution patterns of relapse: (1) a leukemic clone at disease presentation acquires additional mutations and evolves into the relapse clone after the chemotherapy; (2) a leukemic clone at disease presentation persists at relapse without the addition of novel somatic mutations.

Conclusions

The findings of this study suggest that the relapse-initiating clones may pre-exist prior to therapy, which harbor or acquire mutations that confer selective advantage during chemotherapy, resulting in clonal expansion and eventually leading to relapse.
Impact of prediabetes on long-term cardiovascular outcomes in patients with myocardial infarction with nonobstructive coronary arteries
Authors: Gao Side , Ma Wenjian , Huang Sizhuang , Lin Xuze , Yu Mengyue
Published: September 2021

Background

Abnormal glucose metabolism including diabetes (DM) and prediabetes (pre-DM) have been reported as predictors of poorer outcomes after acute myocardial infarction (AMI). However, the prognostic value of pre-DM in patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) remains unclear.

Methods

A total of 1179 MINOCA patients were prospectively recruited and divided into normoglycemia (NG), pre-DM, and DM groups according to glycated hemoglobin (HbA1c) levels or past history. The primary endpoint was a composite of major adverse cardiovascular events (MACE), including all-cause death, nonfatal MI, nonfatal stroke, revascularization and hospitalization for unstable angina or heart failure. Kaplan–Meier and Cox regression analyses were performed.

Results

Patients with pre-DM and DM had a significantly higher incidence of MACE compared with NG group (10.8%, 16.1%, 19.4%; p = 0.003) over the median follow-up of 41.7 months. After multivariate adjustment, both pre-DM and DM were significantly associated with an increased risk of MACE (NG as reference; pre-DM: 1.45, 95% CI 1.03–2.09, p = 0.042; DM: HR 1.79, 95% CI 1.20–2.66, p = 0.005). At subgroup analysis, pre-DM remained a robust risk factor of MACE compared to NG. In addition, pre-DM had a similar impact as DM on long-term prognosis in patients with MINOCA.

Conclusions

Pre-DM defined as raised HbA1c was associated with a poor prognosis in patients with MINOCA. Routine assessment of HbA1c enables an early recognition of pre-DM and thus may facilitate risk stratification in this specific population.
Disparities in the participation and adherence of older adults in lifestyle-based multidomain dementia prevention and the motivational role of perceived disease risk and intervention benefits: an observational ancillary study to a randomised controlled trial
Authors: Coley Nicola , Coniasse-Brioude Delphine , Igier Valérie , Fournier Tristan , Poulain Jean-Pierre , Andrieu Sandrine ,   for the ACCEPT study group, Andrieu Sandrine , Coley Nicola , Gardette Virginie , Grand Alain , Igier Valérie , Brioude Delphine Coniasse , Sastre Maria Teresa Munoz , Poulain Jean Pierre , Fournier Tristan , Arandjelovic Christelle , Vellas Bruno , Oustric Stephane , Subra Julie
Published: September 2021

Background

Preventive interventions for dementia are urgently needed and must be tested in randomised controlled trials (RCTs). Selection (volunteer) bias may limit efficacy, particularly in trials testing multidomain interventions and may also be indicative of disparities in intervention uptake in real-world settings. We identified factors associated with participation and adherence in a 3-year RCT of multidomain lifestyle intervention and/or omega-3 supplementation for prevention of cognitive decline and explored reasons for (non-) participation.

Methods

Ancillary study during recruitment and follow-up of the 3-year Multidomain Alzheimer Preventive Trial (MAPT) conducted in in 13 memory centres in France and Monaco, involving 1630 community-dwelling dementia-free individuals aged ≥ 70 who were pre-screened for MAPT (1270 participated in MAPT; 360 declined to participate).

Results

Response rates were 76% amongst MAPT participants and 53% amongst non-participants. Older individuals (odds ratio 0.94 [95% confidence interval 0.91–0.98] and those with higher anxiety (0.61 [0.47–0.79]) were less likely to participate in the trial. Those with higher income (4.42 [2.12–9.19]) and family history (1.60 [1.10–2.32]) or greater fear (1.73 [1.30–2.29]) of dementia were more likely to participate, as were those recruited via an intermediary (e.g. pension funds, local Alzheimer’s associations, University of the 3rd Age, sports clubs) (2.15 [1.45–3.20]). MAPT participants living in larger towns (0.71 [0.55–0.92]) and with higher depressive symptoms (0.94 [0.90–0.99]) were less likely to adhere to the interventions. Greater perceived social support (1.21 [1.03–1.43]) and cognitive function (1.37 [1.13–1.67]) predicted better adherence. Descriptively, the most frequent reasons for accepting and refusing to participate were, respectively, altruism and logistical constraints, but underlying motivations mainly related to (lack of) perceived benefits.

Conclusions

Disparities in uptake of health interventions persist in older age. Those most at risk of dementia may not participate in or adhere to preventive interventions. Barriers to implementing lifestyle changes for dementia prevention include lack of knowledge about potential benefits, lack of support networks, and (perceived) financial costs.

Trial registration

NCT00672685(ClinicalTrials.gov)
Reduced B12 uptake and increased gastrointestinal formate are associated with archaeome-mediated breath methane emission in humans
Authors: Kumpitsch Christina , Fischmeister Florian Ph. S. , Mahnert Alexander , Lackner Sonja , Wilding Marilena , Sturm Corina , Springer Anna , Madl Tobias , Holasek Sandra , Högenauer Christoph , Berg Ivan A. , Schoepf Veronika , Moissl-Eichinger Christine
Published: September 2021

Background

Methane is an end product of microbial fermentation in the human gastrointestinal tract. This gas is solely produced by an archaeal subpopulation of the human microbiome. Increased methane production has been associated with abdominal pain, bloating, constipation, IBD, CRC or other conditions. Twenty percent of the (healthy) Western populations innately exhale substantially higher amounts (>5 ppm) of this gas. The underlying principle for differential methane emission and its effect on human health is not sufficiently understood.

Results

We assessed the breath methane content, the gastrointestinal microbiome, its function and metabolome, and dietary intake of one-hundred healthy young adults (female:n= 52, male:n= 48; mean age =24.1). On the basis of the amount of methane emitted, participants were grouped into high methane emitters (CH4breath content 5–75 ppm) and low emitters (CH4< 5 ppm).

The microbiomes of high methane emitters were characterized by a 1000-fold increase inMethanobrevibacter smithii. This archaeon co-occurred with a bacterial community specialized on dietary fibre degradation, which included members of Ruminococcaceae and Christensenellaceae. As confirmed by metagenomics and metabolomics, the biology of high methane producers was further characterized by increased formate and acetate levels in the gut. These metabolites were strongly correlated with dietary habits, such as vitamin, fat and fibre intake, and microbiome function, altogether driving archaeal methanogenesis.

Conclusions

This study enlightens the complex, multi-level interplay of host diet, genetics and microbiome composition/function leading to two fundamentally different gastrointestinal phenotypes and identifies novel points of therapeutic action in methane-associated disorders.
Unique traditional villages on the Loess Plateau of China: historic evolution and challenges to sustainable development of silo-caves
Authors: Zhang Li , Lu Peng , Lau Raymond , Yan Lijie , Li Xiang , Yang Ruixia , Leung Ho Hon , Chen Panpan , Wang Xia
Published: September 2021

Silo-cave is a unique human habitation form on the Loess Plateau in northern China, which consists of an excavated 6–7 m deep pit as the courtyard and cave dwellings in the surrounding four walls. This architecture has had a history of more than 7000 years, and yet such “living fossils for the history of dwellings” are now facing great crises and challenges during rapid social and economic development.
In this paper, remote sensing and GIS techniques are used to comprehensively and systematically investigate the spatial distributions and morphological characteristics of silo-caves at both the macro and micro scales. The research shows that silo-cave villages are mainly distributed in economically underdeveloped areas, such as West Henan (Yuxi), South Shanxi (Jinnan), Central Shaanxi (Guanzhong), and East Gansu (Longdong). The morphological evolution patterns of typical silo-cave villages are identified, including: (1) retaining the periphery and rebuilding the inner parts of the villages, (2) retaining the inner parts and expanding the periphery of the villages, and (3) rebuilding the inner parts and expanding the periphery of the villages. These patterns are demonstrated to be influenced by many factors, including landforms, traffic conditions, economic development, population growth, and administrative division adjustment. Sustainable development of these traditional silo-cave villages relies on administrative policy and planning, people’s awareness of cultural heritage protection, culture inheritance, industrial transformation, and public services.
An LSTM and GRU based trading strategy adapted to the Moroccan market
Authors: Touzani Yassine , Douzi Khadija
Published: September 2021

Forecasting stock prices is an extremely challenging job considering the high volatility and the number of variables that influence it (political, economical, social, etc.). Predicting the closing price provides useful information and helps the investor make the right decision. The use of deep learning and more precisely of recurrent neural networks (RNNs) in stock market forecasting is an increasingly common practice in the literature. Long Short Term Memory (LSTM) and Gated Recurrent Unit (GRU) architectures are among the most widely used types of RNNs, given their suitability for sequential data. In this paper, we propose a trading strategy designed for the Moroccan stock market, based on two deep learning models: LSTM and GRU to predict the closing price in the short and medium term respectively. Decision rules for buying and selling stocks are implemented based on the forecasting given by the two models, then over four 3-year periods, we simulate transactions using these decision rules with different settings for each stock. The returns obtained will be used to estimate an expected return. We only hold stocks that outperform a benchmark index (expected return > threshold). The random search is then used to choose one of the available parameters and the performance of the portfolio built from the selected stocks will be tested over a further period. The repetition of this process with a variation of portfolio size makes it possible to select the best possible combination of stock each with the optimized parameter for the decision rules. The proposed strategy produces very promising results and outperforms the performance of indices used as benchmarks in the local market. Indeed, the annualized return of our strategy proposed during the test period is 27.13%, while it is 0.43% for Moroccan all share Indice (MASI), 15.24% for the distributor sector indices, and 19.94% for the pharmaceutical industry indices. Noted that brokerage fees are estimated and subtracted for each transaction. which makes the performance found even more realistic.
A simple method to evaluate the air-to-ground coupling efficiency: a tool helping the assessment of seismic/infrasonic energy partitioning during an eruption
Authors: Ichihara Mie , Yamakawa Kazuya , Muramatsu Dan
Published: September 2021

A volcanic eruption transmits both seismic and infrasound signals. The seismo-acoustic power ratio is widely used to investigate the eruption behaviors and the source dynamics. It is often the case that seismic data during an eruption are significantly contaminated or even dominated by ground shaking due to infrasound (air-to-ground signals). To evaluate the contribution of infrasound-originated power in the seismic data, we need a response function of the seismic station to infrasound. It is rare to obtain a seismo-acoustic data set containing only infrasound signals, though it is ideal for calculating the response function. This study proposes a simple way to calculate the response function using seismo-acoustic data containing infrasound and independent seismic waves. The method requires data recorded at a single station and mainly uses the cross-correlation function between the infrasound data and the Hilbert transform of the seismic data. It is tested with data recorded by a station at Kirishima volcano, Japan, of which response function has been constrained. It is shown that the method calculates a proper response function even when the seismic data contain more significant seismic power (or noise) than the air-to-ground signals. The proposed method will be useful in monitoring and understanding eruption behaviors using seismo-acoustic observations.
Digital higher education: a divider or bridge builder? Leadership perspectives on edtech in a COVID-19 reality
Authors: Laufer Melissa , Leiser Anne , Deacon Bronwen , Perrin de Brichambaut Paola , Fecher Benedikt , Kobsda Christian , Hesse Friedrich
Published: September 2021

The edtech community has promoted claims that digital education enhances access, learning, and collaboration. The COVID-19 pandemic tested these claims like never before, as higher education systems seemingly overnight had to move teaching online. Through a sequential mixed-method approach, we investigated how 85 higher education leaders in 24 countries experienced this rapid digital transformation. Through their experiences, we identified the multiple and overlapping factors that contribute to an institution’s ability to realize the potential of digital education, in terms of access, learning and collaboration, whilst highlighting deeply rooted inequalities at the individual, institutional and system level. Drawing on these empirics, we put forth recommendations for closing the digital divides and pathways forward. Higher education leaders are uniquely positioned to move beyond the emergency adoption of online learning towards inclusive, long-term visions for digital education, which emphasize collaboration over individual gain.
Performance of a 3D convolutional neural network in the detection of hypoperfusion at CT pulmonary angiography in patients with chronic pulmonary embolism: a feasibility study
Authors: Vainio Tuomas , Mäkelä Teemu , Savolainen Sauli , Kangasniemi Marko
Published: September 2021

Background

Chronic pulmonary embolism (CPE) is a life-threatening disease easily misdiagnosed on computed tomography. We investigated a three-dimensional convolutional neural network (CNN) algorithm for detecting hypoperfusion in CPE from computed tomography pulmonary angiography (CTPA).

Methods

Preoperative CTPA of 25 patients with CPE and 25 without pulmonary embolism were selected. We applied a 48%–12%–40% training-validation-testing split (12 positive and 12 negative CTPA volumes for training, 3 positives and 3 negatives for validation, 10 positives and 10 negatives for testing). The median number of axial images per CTPA was 335 (min–max, 111–570). Expert manual segmentations were used as training and testing targets. The CNN output was compared to a method in which a Hounsfield unit (HU) threshold was used to detect hypoperfusion. Receiver operating characteristic area under the curve (AUC) and Matthew correlation coefficient (MCC) were calculated with their 95% confidence interval (CI).

Results

The predicted segmentations of CNN showed AUC 0.87 (95% CI 0.82–0.91), those of HU-threshold method 0.79 (95% CI 0.74–0.84). The optimal global threshold values were CNN output probability ≥ 0.37 and ≤ -850 HU. Using these values, MCC was 0.46 (95% CI 0.29–0.59) for CNN and 0.35 (95% CI 0.18–0.48) for HU-threshold method (average difference in MCC in the bootstrap samples 0.11 (95% CI 0.05–0.16). A high CNN prediction probability was a strong predictor of CPE.

Conclusions

We proposed a deep learning method for detecting hypoperfusion in CPE from CTPA. This model may help evaluating disease extent and supporting treatment planning.
Software toolchain to enhance the management and integration of a sustainable campus model
Authors: da Silva Luiz C. P. , Meira Paulo C. M. , Cypriano João G. I. , Azzini Hader A. D. , Santos Athila Q.
Published: September 2021

The aim of this article is to describe a novel ICT-centred methodology and software toolchain to enhance the management of a Smart Campus. The project will be implemented at the University of Campinas through a partnership between UNICAMP, CPFL (local Utility Distribution Company) and the University of Southern Denmark. This project was recently submitted to a strategic and priority call from the Brazilian Regulatory Agency (National Electric Energy Agency – ANEEL, acronym in Portuguese). The project integrates energy efficiency with research and development in distributed generation with an innovative IoT-based DMS energy management tool. These actions comply with the ISCN/GULF Sustainable Campus Chapter policies, signed by UNICAMP a few years ago. This paper is important because it will result in a replicable model for sustainable campuses, with a detailed step-by-step procedure covering local mini-grid EMS, IoT DMS, Mobility, real-time retrofitted efficiency and institutional energy governance.
Web-based platform for the management of citizen energy communities and their members
Authors: Pereira Helder , Gomes Luis , Faria Pedro , Vale Zita , Coelho Carlos
Published: September 2021

The appearance of citizen energy communities demands the conception, development, and testing of new management models for the community and its end-users. Citizen energy communities promote the active participation of end-users, including them in the management of the community. End-users are incentivized to participate in demand response programs and share their energy among peers, enabling a decrease in their energy costs. In this paper, it is proposed a platform for the management of citizen energy communities. The paper focuses and presents four services related to energy tariffs, end-users’ aggregation, price elasticity, and load response. The services are based on historical data and enable deep analysis of end-users’ energy profiles. As the platform allows the upload of different scenarios, it is possible to test and validate management models in multiple energy communities and scenarios and study their impact in different conditions. The paper presents a case study, where all the services are applied to a community with 996 end-users.
Adapting psychiatric research in the age of COVID-19: role of online studies
Authors: Novick Andrew M. , Stoddard Joel , Johnson Rachel L. , Sammel Mary D. , Berkowitz Lily , Epperson C. Neill
Published: September 2021

Virtual platforms can provide a socially distanced mechanism by which to promote ongoing research progress in the coronavirus disease 2019 (COVID-19) era and may change our approach to online research in the future. Understanding how to best utilise online research represents an important task for our field.
Female Surrogate Labor and White Corporeal Debt in Singin’ in the Rain
Authors: Kraut Anthea
Published: September 2021

This essay revisits the question of credit and debt in the celebrated 1952 film musical Singin’ in the Rain (dir. Gene Kelly and Stanley Donen, US) to show how white women's dancing bodies participate in the “talent relocations” that the movie both thematizes and suppresses. Specifically, it focuses on the relationship between Debbie Reynolds, who was a novice dancer when she was cast in the film, and the two other white women dancers who helped shape Reynolds's filmic body: assistant choreographer Carol Haney and dance-in Jeanne Coyne. Combining feminist and critical race perspectives with production studies, film studies, and dance and performance studies, the essay unites often disconnected gendered and racial analyses of the film by emphasizing the gendered forms of labor and the multiracial genealogies through which dance is reproduced. It also shows how the guise of white credibility enabled Reynolds to conceal her intercorporeal and multiracial debts. Finally, the essay argues that the presence of dancers of color in the film, most notably Rita Moreno, haunts the chains of white corporeal debt that bind Reynolds to Haney and Coyne.
Carolee Schneemann's Sonic Shadow
Authors: Phelan Peggy
Published: September 2021

This commemorative essay considers Carolee Schneemann's voice as expressed through performative utterances and written words, with particular focus on Interior Scroll (1975). The essay argues that the performance's documentation in photographs, the primary means of experiencing the work, has come at the expense of attention to Schneemann's voice. The essay reflects on the work of evoking Schneemann's voice through limited records in relation to the process of grief following the artist's death. Schneemann's “sonic shadow,” the essay argues, emerges through affirmative mourning. The essay was composed originally for the memorial service for Schneemann at Judson Memorial Church, New York, on 3 May 2019.
Toward Camden
Authors: Romero Mercy
Published: September 2021

In Toward Camden, Mercy Romero writes about the relationships that make and sustain the largely African American and Puerto Rican Cramer Hill neighborhood in New Jersey where she grew up. She walks the city and writes outdoors to think about the collapse and transformation of property. She revisits lost and empty houses—her family's house, the Walt Whitman House, and the landscape of a vacant lot. Throughout, Romero engages with the aesthetics of fragment and ruin; her writing juts against idioms of redevelopment. She resists narratives of the city that are inextricable from crime and decline and witnesses everyday lives lived at the intersection of spatial and Puerto Rican diasporic memory. Toward Camden travels between what official reports say and what the city's vacant lots withhold.

Duke University Press Scholars of Color First Book Award recipient
See How We Roll
Authors: Hinkson Melinda
Published: September 2021

In See How We Roll Melinda Hinkson follows the experiences of Nungarrayi, a Warlpiri woman from the Central Australian desert, as she struggles to establish a new life for herself in the city of Adelaide. Banished from her hometown, Nungarrayi energetically navigates promises of transformation as well as sedimented racialized expectations on the urban streets. Drawing on a decades-long friendship, Hinkson explores these circumstances through Nungarrayi's relationships: those between her country and kin that sustain and confound life beyond the desert, those that regulate her marginalized citizenship, and the new friendships called out by displacement and metropolitan life. An intimate ethnography, See How We Roll provides great insight into the enduring violence of the settler colonial state while illuminating the efforts of Indigenous people to create lives of dignity and shared purpose in the face of turbulence, grief, and tightening governmental controls.
Acute Physical and Mental Activity Influence on Concussion Recovery
Authors: BUCKLEY THOMAS A. , MUNKASY BARRY A. , EVANS KELSEY M. , CLOUSE BRANDY
Published: September 2021

Introduction

Physical activity (PA) and mental activity (MA) postconcussion has received renewed attention to improve concussion management; however, most protocols start after several days and do not assess the acute window. Therefore, the purpose of this study was to assess PA and MA in the first 48 h postconcussion on the time to symptom-free status and return to play.

Methods

We recruited 78 NCAA Division I athletes (male, 51.3%; age, 19.6 ± 1.4 yr; height, 173.7 ± 11.5 cm; weight, 80.1 ± 23.2 kg) who were diagnosed with a sports-related concussion. Participants completed a 0–5 PA and MA scale daily until fully cleared for return to participation (mean, 15.1 ± 6.9 d). A quadratic model regression assessed PA and MA over the first 2 d (acute) postconcussion on to time to symptom-free status and return to play.

Results

The overall model was significant for both time to symptom free (r
2 = 0.27, P = 0.004) and return to play (r
2 = 0.23, P = 0.019). Reported PA was the only significant predictor for time to symptom-free (P = 0.002) and return-to-participation (P = 0.006) day. Reported MA was not associated either outcome.

Conclusions

The primary finding of this study was that mild to moderate PA acutely postconcussion was associated with reduced time to symptom free and return to participation as opposed to either lower or higher levels of PA. Conversely, acute MA was not associated with recovery outcomes. These results further elucidate the role of postconcussion PA.
Evidence that Neuromuscular Fatigue Is not a Dogma in Patients with Parkinson’s Disease
Authors: MARTIGNON CAMILLA , LAGINESTRA FABIO GIUSEPPE , GIURIATO GAIA , PEDRINOLLA ANNA , BARBI CHIARA , DI VICO ILARIA ANTONELLA , TINAZZI MICHELE , SCHENA FEDERICO , VENTURELLI MASSIMO
Published: September 2021

Purpose

Given the increased level of fatigue frequently reported by patients with Parkinson’s disease (PD), this study investigated the interaction between central and peripheral components of neuromuscular fatigue (NF) in this population compared with healthy peers.

Methods

Changes in maximal voluntary activation (ΔVA, central fatigue) and potentiated twitch force (ΔQ
tw,pot, peripheral fatigue) pre–post exercise were determined via the interpolated twitch technique in 10 patients with PD and 10 healthy controls (CTRL) matched for age, sex, and physical activity. Pulmonary gas exchange, femoral blood flow, and quadriceps EMG were measured during a fatiguing exercise (85% of peak power output [PPO]). For a specific comparison, on another day, CTRL repeat the fatiguing test matching the time to failure (TTF) and PPO of PD.

Results

At 85% of PPO (PD, 21 ± 7 W; CTRL, 37 ± 22 W), both groups have similar TTF (~5.9 min), pulmonary gas exchange, femoral blood flow, and EMG. After this exercise, the maximal voluntary contraction (MVC) force and Q
twpot decreased equally in both groups (−16%, P = 0.483; −43%, P = 0.932), whereas VA decreased in PD compared with CTRL (−3.8% vs −1.1%, P = 0.040). At the same PPO and TTF of PD (21 W; 5.4 min), CTRL showed a constant drop in MVC, and Q
twpot (−14%, P = 0.854; −39%, P = 0.540), instead VA decreased more in PD than in CTRL (−3.8% vs −0.7%, P = 0.028).

Conclusions

In PD, central NF seems exacerbated by the fatiguing task which, however, does not alter peripheral fatigue. This, besides the TTF like CTRL, suggests that physical activity may limit NF and counterbalance PD-induced degeneration through peripheral adaptations.
Inter-rater and inter-session reliability of lumbar paraspinal muscle composition in a mobile MRI device
Authors: Schomöller Anne , Risch Lucie , Kaplick Hannes , Wochatz Monique , Engel Tilman , Schraplau Anne , Sonnenburg Dominik , Huppertz Alexander , Mayer Frank
Published: September 2021

Objective:

To assess the reliability of measurements of paraspinal muscle transverse relaxation times (T2 times) between two observers and within one observer on different time points.

Methods:

14 participants (9f/5m, 33 ± 5 years, 176 ± 10 cm, 73 ± 12 kg) underwent 2 consecutive MRI scans (M1,M2) on the same day, followed by 1 MRI scan 13–14 days later (M3) in a mobile 1.5 Tesla MRI. T2 times were calculated in T2 weighted turbo spin-echo-sequences at the spinal level of the third lumbar vertebrae (11 slices, 2 mm slice thickness, 1 mm interslice gap, echo times: 20, 40, 60, 80, 100 ms) for M. erector spinae (ES) and M. multifidius (MF). The following reliability parameter were calculated for the agreement of T2 times between two different investigators (OBS1 & OBS2) on the same MRI (inter-rater reliability, IR) and by one investigator between different MRI of the same participant (intersession variability, IS): Test–Retest Variability (TRV, Differences/Mean*100); Coefficient of Variation (CV, Standard deviation/Mean*100); Bland–Altman Analysis (systematic bias = Mean of the Differences; Upper/Lower Limits of Agreement = Bias+/−1.96*SD); Intraclass Correlation Coefficient 3.1 (ICC) with absolute agreement, as well as its 95% confidence interval.

Results:

Mean TRV for IR was 2.6% for ES and 4.2% for MF. Mean TRV for IS was 3.5% (ES) and 5.1% (MF). Mean CV for IR was 1.9 (ES) and 3.0 (MF). Mean CV for IS was 2.5% (ES) and 3.6% (MF). A systematic bias of 1.3 ms (ES) and 2.1 ms (MF) were detected for IR and a systematic bias of 0.4 ms (ES) and 0.07 ms (MF) for IS. ICC for IR was 0.94 (ES) and 0.87 (MF). ICC for IS was 0.88 (ES) and 0.82 (MF).

Conclusion:

Reliable assessment of paraspinal muscle T2 time justifies its use for scientific purposes. The applied technique could be recommended to use for future studies that aim to assess changes of T2 times, e.g. after an intense bout of eccentric exercises.
A grammatico-pragmatic analysis of the because X construction: Private expression within public expression
Authors: Kanetani Masaru
Published: September 2021

Background: This article investigates an innovative use of because, called the because X construction (e.g., because homework). Quantitative and qualitative research as well as research about the historical development of the construction have been conducted. The present article aims to determine what motivates the use of the construction. 

Methods: Based on the data collected from the literature and online sources, the grammar of the because X construction is described in detail. The construction is then analyzed  within Hirose’s (2015) three-tier model of language use. 

Results: A two-layered expressive structure is proposed: The X-element serves as a private expression, which is a speaker’s expression of thought with no intention of communication, whereas the whole construction functions publicly. The private nature of the X-element consistently accounts for the syntactic categories of the X-element and the restrictions on them observed in the literature. 

Conclusion: The proposed two-layered expressive structure reflects a metapragmatic function of the construction. A private, subjective expression embedded in a public expression has the function of connecting the hearer to the speaker, and it accordingly brings about a joint attention effect. With such a function, the proposed structure is effective especially (but not exclusively) in online communication because one can strategically indicate closeness or intimacy to others, particularly in an environment where nonverbal means are difficult to apply.
El verde metropolitano: una revisión de los espacios abiertos públicos en clave pandémica para el Área Metropolitana de Buenos Aires.
Authors: Fernández Leonardo
Published: September 2021

El texto reúne argumentos históricos, ecológicos y metropolitanos en la dotación de espacios abiertos públicos para el Área Metropolitana de Buenos Aires (AMBA) en perspectiva con el actual contexto pandémico. Primeramente, revisa antecedentes memorables sobre la temática contrastando ciertos imperativos higienistas epocales y contemporáneos frente al covid-19. En un segundo apartado, confluyente con el anterior, se define el concepto de “infraestructura ecológica’’ y se enumera a diferentes escalas diversos beneficios fisiológicos, sanitarios y ecológicos que esta noción supone. A modo de discusión, se mapean oportunidades en la geografía metropolitana, en el marco de la interfase pampeana y estuarina, para dotar de los espacios abiertos públicos.
Variaciones sobre el Eternauta. Analogías, escenas primarias y una poética para el mito en la primera versión de El Eternauta.
Authors: Roldán Julian
Published: September 2021

El presente artículo tiene como objetivo analizar críticamente la historieta El Eternauta haciendo referencia a algunos eventos sociopolíticos, económicos y urbanos del momento en que se publicó originalmente. Tal como marca Laura Vázquez (2010) algunos de estos hechos influyeron tanto en las políticas editoriales (que buscaban hacer rentables sus publicaciones en un contexto de adversidad económica y que incluso había repercutido en el mismo Oesterheld que había tenido que cerrar su proyecto editorial Frontera), como en los formatos de publicación, condiciones y medios de circulación (muchas se transformaron en quincenales o mensuales), “como también en los temas de estas historietas y en los modos de abordarlos como respuesta a determinada coyuntura” (Vázquez, 2010: 63). Esas condiciones socioeconómicas marcaron determinadas políticas y acciones en relación al modo de producción de lo urbano y esa nueva configuración de lo metropolitano estructuró dinámicas sociales y funcionó como escenario para nuevos actores urbanos producto de las posibilidades de ascenso social. La emergencia de las clases populares en la ciudad puede leerse críticamente en diversos textos del momento histórico y El Eternauta no queda exento. Sasturain (1995) marca la importancia del cambio del domicilio para el desarrollo de la aventura en la obra de Oesterheld. Una transformación que logra, complementada con la poética gráfica de Solano López, configurar una escena primaria (Berman, 1991) que adquiere la capacidad de resonar en el lector de un modo profundamente original que hace que El Eternauta se vuelva un clásico de la historieta, maleable a diversas interpretaciones. Analizaremos aquí algunas de esas analogías posibles.
Driver Positioning and Incentive Budgeting with an Escrow Mechanism for Ride-Sharing Platforms
Authors: Ong Hao Yi , Freund Daniel , Crapis Davide
Published: September 2021

Drivers on the Lyft ride-share platform do not always know where the areas of supply shortage are in real time. This lack of information hurts both riders trying to find a ride and drivers trying to determine how to maximize their earnings opportunities. Lyft’s Personal Power Zone (PPZ) product helps the company to maintain high levels of service on the platform by influencing the spatial distribution of drivers in real time via monetary incentives that encourage them to reposition their vehicles. The underlying system that powers the product has two main components: (1) a novel “escrow mechanism” that tracks available incentive budgets tied to locations within a city in real time, and (2) an algorithm that solves the stochastic driver-positioning problem to maximize short-run revenue from riders’ fares. The optimization problem is a multiagent dynamic program that is too complicated to solve optimally for our large-scale application. Our approach is to decompose it into two subproblems. The first determines the set of drivers to incentivize and where to incentivize them to position themselves. The second determines how to fund each incentive using the escrow budget. By formulating it as two convex programs, we are able to use commercial solvers that find the optimal solution in a matter of seconds. Rolled out to all 320 cities in which Lyft operates in a little more than a year, the system now generates millions of bonuses that incentivize hundreds of thousands of active drivers to optimally position themselves in anticipation of ride requests every week. Together, the PPZ product and its underlying algorithms represent a paradigm shift in how Lyft drivers drive and generate earnings on the platform. Its direct business impact has been a 0.5% increase in incremental bookings, amounting to tens of millions of dollars per year. In addition, the product has brought about significant improvements to the driver and rider experience on the platform. These include statistically significant reductions in pick-up times and ride cancellations. Finally, internal surveys reveal that the vast majority of drivers prefer PPZs over the legacy system.
Introduction
Authors: Dickson David
Published: September 2021

This chapter describes most of Ireland's larger towns, Viking seaports, and the process of urbanization in the country. It recounts the earlier cycle of urban growth in the thirteenth century when Anglo-Normans controlled the island, the slipping back of the urban share of Ireland's modest population in the early fourteenth century, and the large number of villages and small towns established during the seventeenth century in port hinterlands. Following this, the chapter presents the 'long' eighteenth century — from the 1660s to the 1820s — an era of deepening if unsteady commercialization of what had been a largely pre-market economy and, related to this, the transformation in size and function of a handful of very old urban centers. Finally, the chapter reviews North Munster and south-east Ireland's medieval urban system. It examines how the ports of London/Derry and Sligo developed strategically important urban functions during the eighteenth century within their respective hinterlands — west Ulster and north Connacht — and how they merit inclusion in the top group of urban communities.
Peopling the Cities
Authors: Dickson David
Published: September 2021

This chapter begins by describing the striking physical growth of Irish cities such as Dublin, Cork, and Belfast, then investigates the causes of such growth. It demonstrates how pre-industrial cities across Europe depended for their survival on attracting a constant flow of outsiders to come and settle. People came for a great variety of motives and faced very uncertain outcomes. The chapter then outlines the underlying demographic processes at work in Ireland and a rigorous investigation of the city population. It studies the urban-social enquiry in Ireland, and argues that all Irish cities and regional centers witnessed powerful long-term growth of population. The chapter discusses Ireland's urban life expectancy, the pernicious levels of infant and child death in the city environment, fertility change and levels, and migration and apprenticeships. It looks into the most compelling evidence on internal migration to the cities: the changing religious composition of most Irish cities.
The Keys of the Kingdom
Authors: Dickson David
Published: September 2021

This chapter highlights Bishop Berkeley's 'keys of the kingdom', in which he argued that the seaports of the south and east were lynchpins in an economy that had become highly export dependent. It notes that they were the conduits through which trade passed, where goods were assembled, processed and despatched, and where financial services were available. And 'merchants' did indeed possess the keys. The chapter examines the classic era of the merchant, the sedentary négotiant who dominated the business and usually the government of port cities, who dealt in a variety of import/export lines of trade with overseas correspondents, and who settled accounts by means of an internationally accepted set of protocols governing the use of bills of exchange across western Europe and the North Atlantic. It also describes the Irish merchant communities in Sligo, Galway, and Dublin who were overwhelmingly male and culturally diverse. Finally, the chapter assesses the Catholic merchants' pre-eminent position in this wholesale trade after the enormous setbacks of the seventeenth century.
Food For Thought
Authors: Dickson David
Published: September 2021

This chapter focuses on the emergence of a remarkable print culture in Dublin. It states that the capital city had become a major center of publishing in the English-speaking world by 1730. The chapter mentions John Smith, one of the leading importers of books directly from Holland and France for near forty years. Smith and his contemporaries had played a critical role in introducing some of the canonical writers of the French Enlightenment to Irish readers, both by sourcing foreign-language imports and by reprinting English translations at rates cheaper than London. The chapter also uncovers how the rise of the print culture resonated in provincial centers but less clearly so in rural Ireland. Critical to the growth of provincial print culture was the spread of newspapers. The chapter then assesses the implications of the great contraction of Dublin book publishing on booksellers, library societies in urban centers, and libraries in provincial centers.
Order and Disorder
Authors: Dickson David
Published: September 2021

This chapter spotlights the role of the state (via the army) in enforcing urban security and in creating professional policing for the capital city. It begins by describing the greatest building project in Dublin, the Royal Barracks. The creation within a capital city of such a vast military establishment was a consequence of the agreement by the (all Protestant) Irish Parliament to house and maintain on Irish soil the bulk of the English standing army during peacetime. The chapter then turns to study the logic behind the increased concentration of the military in the cities. It argues that the permanent presence of military manpower, albeit in largely open residential barracks, helped make the case for continuing the gradual process of urban de-fortification. The chapter also looks into the three collective threats to urban order: faction fights, scarcity riots and artisan protests. It focuses more on the severe food shortages across Ulster and the food protests in 1729 in which civic authorities turned to the military for help. Finally, the chapter reviews the implications of industrial protest — a collective action by producers taken against their masters, other traders or workers, or even against consumers.