bluuebunny/crossref_metadata_2025 huggingface dataset:
Exosomes From Women With Preeclampsia Induced Vascular Dysfunction by Delivering sFlt (Soluble Fms-Like Tyrosine Kinase)-1 and sEng (Soluble Endoglin) to Endothelial Cells
Authors: Chang Xinwen , Yao Julei , He Qizhi , Liu Ming , Duan Tao , Wang Kai
Published: October 2018

Preeclampsia is a unique multiple system disorder that affects 5% to 8% of pregnancies. Exosomes, membrane-encapsulated vesicles that are released into the extracellular environment by many cell types, can carry signals to the recipient cells to affect inflammation, apoptosis, and angiogenesis. We hypothesize that exosomes from women with preeclampsia complications impair vascular development by delivering antiangiogenic factors to endothelial cells. In the current study, plasma samples from gestational age-matched preeclampsia and normal pregnancies were used to isolate circulating exosomes by commercial kits. Next, application of transwell and matrigel tube formation assays showed that exosomes from preeclampsia patients impaired angiogenesis of human umbilical vein endothelial cells. We found that exosomes from preeclampsia expressed abundant sFlt-1 (soluble fms-like tyrosine kinase-1) and sEng (soluble endoglin). Considering the possibility that extracellular sFlt and sEng were horizontally transferred to human umbilical vein endothelial cells, we successfully collected exosomes containing high levels of sFlt-1 and sEng by overexpressing them in human embryonic kidney 293 cells. Furthermore, we demonstrated that these exosomes can attenuate the proliferation, migration, and tube formation of human umbilical vein endothelial cells in vitro. In a mouse model, exosomes from preeclampsia patients caused vascular dysfunction directly resulted in adverse preeclampsia-like birth outcomes. Thus, we proposed that exosomes mediated efficient transfer of sFlt-1 and sEng to endothelial cells to damage vascular functions and induce complications in preeclampsia patients.
Minimally Invasive Surgery for Intracerebral Hemorrhage
Authors: Scaggiante Jacopo , Zhang Xiangnan , Mocco J , Kellner Christopher P.
Published: October 2018

Background and Purpose—

Minimally invasive surgery (MIS) for intracerebral hemorrhage (ICH) has been evaluated in numerous clinical trials. Although meta-analyses for this strategy have been performed in the past, recent trials add important information to results of the comparison and permit strategy-specific analyses, including evaluation of endoscopic evacuation and stereotactic thrombolysis.

Methods—

Major scientific databases including but not limited to Pubmed, the CENTRAL (Cochrane Central Register of Controlled Trials), Embase, Web of Science, Scopus, the ICTRP (International Clinical Trials Registry Platform), the Internet Stroke Center, and the CNKI (Chinese National Knowledge Infrastructure) were searched in October of 2017 for randomized controlled trials of MIS treatment of supratentorial spontaneous ICH. The primary outcome was defined as death or dependence at the end of follow-up, and the secondary outcome was defined as death.

Results—

The initial search yielded 958 reports, which were reduced to 15 high-quality randomized controlled trials involving 2152 patients. We analyzed odds ratios for MIS overall, endoscopic surgery, and stereotactic thrombolysis compared with conventional treatment, including medical treatment and conventional craniotomy. The odds ratio and CIs of the primary and secondary outcomes were 0.46 (0.36–0.57) and 0.59 (0.45–0.76) for MIS versus conventional treatment; 0.40 (0.25–0.66) and 0.37 (0.20–0.67) for endoscopic surgery versus conventional treatment; 0.47 (0.34–0.65) and 0.76 (0.56–1.04) for stereotactic thrombolysis versus conventional treatment; and 0.44 (0.29–0.67) and 0.56 (0.37–0.84) for MIS versus craniotomy. We also conducted subgroup analyses focusing on time to evacuation for MIS versus conventional treatment and found 0.36 (0.22–0.59) and 0.59 (0.34–1.00) for evacuations performed within 24 hours and 0.49 (0.38–0.63) and 0.57 (0.43–0.76) for evacuations performed within 72 hours.

Conclusions—

This meta-analysis demonstrates that select patients with supratentorial ICH benefit from MIS over other treatments. This beneficial effect remains true when analyzing specific techniques and evacuation timing subgroups.
Decline in the Severity of Carotid Atherosclerosis and Associated Risk Factors From 2002 to 2014
Authors: Hackam Daniel G. , Spence J. David
Published: October 2018

Background and Purpose—

Several recent studies suggest declining rates of carotid revascularization for patients with carotid stenosis. We investigated whether carotid atherosclerosis severity has declined in recent years.

Methods—

We used carotid ultrasound to evaluate stenosis and plaque area in 6039 patients presenting to vascular medicine clinics in 3 eras: 2002 to 2005, 2006 to 2009, and 2010 to 2014.

Results—

The total plaque area at the time of referral to the clinics declined by 24% between 2002 and 2014; the percentage of patients presenting with carotid stenosis >60% declined by 29.9%, and the number presenting with >80% stenosis declined by 36.4%. There were significant reductions in plasma lipids and blood pressure during the same interval.

Conclusions—

Atherosclerosis severity seems to be declining over time. Better treatment of risk factors in the community may be responsible.
Neuroimaging Determinants of Poststroke Cognitive Performance
Authors: Puy Laurent , Barbay Mélanie , Roussel Martine , Canaple Sandrine , Lamy Chantal , Arnoux Audrey , Leclercq Claire , Mas Jean-Louis , Tasseel-Ponche Sophie , Constans Jean-Marc , Godefroy Olivier ,   GRECogVASC Study Group
Published: October 2018

Background and Purpose—

We aimed to define the neuroimaging determinants of poststroke cognitive performance and their relative contributions among a spectrum of magnetic resonance imaging markers, including lesion burden and strategic locations.

Methods—

We prospectively included patients with stroke from the GRECogVASC study (Groupe de Réflexion pour l’Évaluation Cognitive Vasculaire) who underwent 3-T magnetic resonance imaging and a comprehensive standardized battery of neuropsychological tests 6 months after the index event. An optimized global cognitive score and neuroimaging markers, including stroke characteristics, cerebral atrophy markers, and small vessel diseases markers, were assessed. Location of strategic strokes was determined using a specifically designed method taking into account stroke size and cerebral atrophy. A stepwise multivariable linear regression model was used to identify magnetic resonance imaging determinants of cognitive performance.

Results—

Data were available for 356 patients (mean age: 63.67±10.6 years; 326 [91.6%] of the patients had experienced an ischemic stroke). Six months poststroke, 50.8% of patients presented with a neurocognitive disorder. Strategic strokes (right corticospinal tract, left antero-middle thalamus, left arcuate fasciculus, left middle frontal gyrus, and left postero-inferior cerebellum;
R
2
=0.225;
P
=0.0001), medial temporal lobe atrophy (
R
2
=0.077;
P
=0.0001), total brain tissue volume (
R
2
=0.028;
P
=0.004), and stroke volume (
R
2
=0.013;
P
=0.005) were independent determinants of cognitive performance. Strategic strokes accounted for the largest proportion of the variance in the cognitive score (22.5%). The white matter hyperintensity burden, brain microbleeds, and dilated perivascular spaces were not independent determinants.

Conclusions—

Optimized global cognitive score and combined approach of both quantitative measures related to structure loss and qualitative measures related to the presence of strategic lesion are required to improve the determination of structure-function relationship of cognitive performance after stroke.
Validation of the Simplified Stroke-Thrombolytic Predictive Instrument to Predict Functional Outcomes in Chinese Patients
Authors: Wang Chunjuan , Yang Yingying , Pan Yuesong , Liao Xiaoling , Huo Xiaochuan , Miao Zhongrong , Wang Yongjun , Wang Yilong
Published: October 2018

Background and Purpose—

The simplified stroke-thrombolytic predictive instrument (s-Stroke-TPI) is useful for predicting the outcomes in thrombolysis-treated patients in Western populations. We aimed to validate its predictive value in Chinese patients.

Methods—

Data from thrombolysis implementation and monitor of acute ischemic stroke in China were analyzed. Patients with acute ischemic stroke and treated with thrombolysis within 4.5 hours of symptom onset were included. The 3-month functional outcomes were assessed with the modified Rankin Scale (mRS). Model discrimination was quantified by calculating the area under receiver operating characteristic curve. s-Stroke-TPI was compared with dense artery sign, mRS score, age, glucose, onset to treatment time, and National Institutes of Health Stroke Scale or stroke prognostication using age and National Institutes of Health Stroke Scale.

Results—

A total of 1102 patients who received thrombolysis were enrolled. The area under receiver operating characteristic curve of s-Stroke-TPI for predicting a catastrophic outcome (mRS score, 5–6), a normal/near-normal outcome (mRS score, 0–1), and independent outcome (mRS score, 0–2) at 3 months were 0.80, 0.73, and 0.75, respectively, which were significantly higher than or similar to those of dense artery sign, mRS score, age, glucose, onset to treatment time, and National Institutes of Health Stroke Scale or stroke prognostication using age and National Institutes of Health Stroke Scale. The calibration analysis of the s-Stroke-TPI showed a high correlation between the predicted and observed probabilities of the functional outcomes at 3 months.

Conclusions—

The s-Stroke-TPI reliably predicted the 3-month functional outcomes, especially catastrophic outcomes, in Chinese stroke patients with thrombolysis. Further validation is needed to confirm outcome predictions in patients both with and without thrombolysis.
Higher Incidence of Ischemic Stroke in Patients Taking Novel Oral Anticoagulants
Authors: Shpak Max , Ramakrishnan Anurekha , Nadasdy Zoltan , Cowperthwaite Matthew , Fanale Christopher
Published: October 2018

Background and Purpose—

The increased use of novel oral anticoagulants (NOACs) to control atrial fibrillation is largely driven by the assumption that they are equally effective as warfarin at preventing ischemic stroke while putting patients at lower risk of hemorrhages. To test this hypothesis, a retrospective study of the relative incidence of strokes among patients taking NOACs versus those taking warfarin is performed.

Methods—

Relative stroke incidence in the 2 groups of patients was compared using odds ratios and Fisher exact tests for significance using a data set of 71 365 on NOACs and 59 546 patients on warfarin. In addition, the 7033 patients with a record of both warfarin and NOAC use were analyzed as a separate cohort.

Results—

There is a significantly higher (odds ratio=1.29, <0.001) frequency of ischemic strokes among patients prescribed NOACs compared with those on warfarin. The relative frequency of ischemic strokes was also higher for every individual NOAC compared with warfarin (these higher frequencies are statistically significant for dabigatran and apixaban, though not for edoxaban and rivaroxaban). There is a lower incidence of intracranial hemorrhages and nontraumatic hemorrhages in general among patients taking NOACs, consistent with the published literature. Comparisons of the demographic and clinical profiles of the patients taking NOACs to those on warfarin do not show significantly higher background stroke risk in NOAC patients; in fact, patients on NOACs tend to be at lower background risk overall for ischemic strokes.

Conclusions—

Because NOAC use is associated with higher ischemic stroke risk together with a lower risk of hemorrhages than warfarin use, it can be concluded that patients on warfarin are more strongly anticoagulated. The observed effect could be a secondary consequence of dosage control or alternatively a result of different anticoagulant effects among the different medications.
Genetically Determined FXI (Factor XI) Levels and Risk of Stroke
Authors: Gill Dipender , Georgakis Marios K. , Laffan Mike , Sabater-Lleal Maria , Malik Rainer , Tzoulaki Ioanna , Veltkamp Roland , Dehghan Abbas
Published: October 2018

Background and Purpose—

FXI (factor XI) is involved in thrombus propagation and stabilization. It is unknown whether lower FXI levels have a protective effect on risk of ischemic stroke (IS) or myocardial infarction. This study investigated the effect of genetically determined FXI levels on risk of IS, myocardial infarction, and intracerebral hemorrhage.

Methods—

Two-sample Mendelian randomization analysis was performed. Instruments and genetic association estimates for FXI levels were obtained from a genome-wide association study of 16 169 individuals. Genetic association estimates for IS and its etiological subtypes were obtained from a study of 16 851 cases and 32 473 controls. For myocardial infarction, estimates were obtained from a study of 43 676 cases and 123 504 controls and for intracerebral hemorrhage from a study of 1545 cases and 1481 controls.

Results—

After applying a Bonferroni correction for multiple testing, the Mendelian randomization analysis supported a causal effect of higher, genetically determined FXI levels on risk of any IS (odds ratio [OR] per 1-unit increase in natural logarithm-transformed FXI levels, 2.54; 95% CI, 1.68–3.84;
P
=1×10
−5
) but not myocardial infarction (OR, 1.01; 95% CI, 0.76–1.34;
P
=0.94) or intracerebral hemorrhage (OR, 1.81; 95% CI, 0.44–7.38;
P
=0.41). Examining IS subtypes, the main results supported an effect of higher, genetically determined FXI levels on risk of cardioembolism (OR, 4.23; 95% CI, 1.94–9.19;
P
=3×10
−4
) and IS of undetermined cause (OR, 3.44; 95% CI, 1.79–6.60;
P
=2×10
−4
) but not large artery atherosclerosis (OR, 2.73; 95% CI, 1.15–6.45;
P
=0.02) or small artery occlusion (OR, 1.19; 95% CI, 0.50–2.82;
P
=0.69). However, the statistically significant result for IS of undetermined cause was not replicated in all sensitivity analyses.

Conclusions—

We find Mendelian randomization evidence supporting FXI as a possible target to reduce risk of the cardioembolic subtype of IS.
Endovascular Thrombectomy
Authors: Wu Yuefei , Yin Congguo , Yang Jianhong , Jiang Lin , Parsons Mark W. , Lin Longting
Published: October 2018

Background and Purpose—

This study aimed to explore safety of tirofiban in endovascular treatment of acute ischemic stroke.

Methods—

Two hundred eighteen ischemic stroke patients receiving endovascular thrombectomy were prospectively recruited, with 94 treated with intra-arterial tirofiban and 124 were not. The 2 groups were compared in terms of symptomatic intracranial hemorrhage (ICH) and fatal ICH rate by the χ
2
test and logistic regression.

Results—

Patients treated with tirofiban compared with those without tirofiban had significantly higher rate of symptomatic ICH (14.6% versus 5.7%;
P
=0.027) and fatal ICH (8.8% versus 1.6%;
P
=0.014). Tirofiban-treated patients had increased odds of symptomatic ICH by 2.9-fold (95% CI, 1.1–7.5), and odds of fatal ICH increased by 5.9-fold (95% CI, 1.2–28.4).

Conclusions—

Tirofiban treatment increases risk of major ICH after endovascular thrombectomy for acute ischemic stroke in this nonrandomized study.
Decline in Regional Trends in Mortality of Stroke Subtypes in Germany From 1998 to 2015
Authors: Rücker Viktoria , Wiedmann Silke , O’Flaherty Martin , Busch Markus A. , Heuschmann Peter U.
Published: October 2018

Background and Purpose—

Data on recent time trends in stroke mortality by subtypes and regions are lacking for Germany. We investigated sex- and age-standardized trends in stroke mortality in Germany for different stroke subtypes from 1998 to 2015 and assessed potential regional variations between the former Eastern and former Western part of Germany.

Methods—

Mortality and population data from the German Federal Statistical Office were used to calculate sex- and age-standardized mortality rates for hemorrhagic stroke, ischemic stroke, and total strokes from 1998 to 2015 for all age groups. Joinpoint regression was used to examine trends and its changes. Estimations were stratified for Eastern and Western part of Germany.

Results—

From 1998 to 2015, age-standardized total stroke mortality decreased by >50% in men (from 78.0 to 34.1 per 100 000) and women (from 62.1 to 28.4 women per 100 000). The decrease was more pronounced for ischemic stroke mortality (rate change: men, −66%; women, −63%) than for hemorrhagic stroke mortality (men, −40%; women, −31%). Total and ischemic stroke mortality declined more in Eastern than in Western part of Germany. From 1998 to 2015, there were no differences in the decline between the regions in hemorrhagic stroke mortality. Total stroke mortality was higher in Eastern compared with Western part of Germany throughout the study period. Differences in subtype- and sex-specific mortality between the regions decreased from 1998 to 2015.

Conclusions—

Between 1998 and 2015, stroke mortality declined substantially in Germany with differing time trends in stroke subtypes between sexes and regions. Differences in stroke mortality rates between East and West Germany are negligible 24 years after the German reunification.
Attentional Facilitation of Constituent Features of an Object Does Not Spread Automatically along Object-defining Cortical Boundaries
Authors: Brummerloh Berit , Gundlach Christopher , Müller Matthias M.
Published: October 2018

The integrated object account predicts that attention is spread across all features that constitute one object, regardless of their task relevance. We challenge that prediction with a novel stimulation technique that allows for simultaneous electrophysiological measurements of the allocation of attention to two distinct features within one object. A rotating square that flickers in different colors evoked two distinct steady-state visual evoked potentials (SSVEPs) for rotation and color, respectively. If the integrated object account were true, we would expect identical SSVEP amplitudes regardless of what feature participants attended. We found greater SSVEP amplitudes for the to-be-attended feature compared with the to-be-ignored feature. SSVEP amplitudes averaged across both features were significantly reduced when participants attended to both features, which was mirrored in behavioral costs, implying competitive interactions or a division of attentional resources. Surprisingly, this reduction in amplitude was mainly driven by the SSVEP amplitude elicited by color changes. In conclusion, our results challenge the integrated object account and highlight the extent to which color is “special” within feature space.
Vertical Velocity Dynamics and Mixing in an Anticyclone near the Canary Islands
Authors: Estrada-Allis S. N. , Barceló-Llull B. , Pallàs-Sanz E. , Rodríguez-Santana A. , Souza J. M. A. C. , Mason E. , McWilliams J. C. , Sangrà P.
Published: October 2018

The complex structure of the vertical velocity field inside an anticyclonic eddy located just south of the Canary Islands is analyzed through a high-resolution ocean model. Based on the flow divergence, vertical velocity is decomposed into various forcing components. The analysis reveals that advection and stretching of vorticity are the most important forcing contributions to the vertical velocity within the eddy. In the mixed layer, a small-scale multipolar vertical velocity pattern dominates. This is the result of vertical mixing effects that enhance the surface vertical velocity by increasing the ageostrophic velocity profile. As a result, an ageostrophic secondary circulation arises that acts to restore thermal-wind balance, inducing strong vertical motions. Nonlinear Ekman pumping/suction patterns resemble the small-scale vertical velocity field, suggesting that nonlinear Ekman effects are important in explaining the complex vertical velocity, despite an overestimate of its magnitude. In the eddy thermocline, the vertical velocity is characterized by a dipolar pattern, which experiences changes in intensity and axisymmetrization with time. The dipolar vertical velocity distribution arises from the imbalance between the advection and stretching of the vorticity forcing terms. A vertical velocity dipole is also obtained by solving a generalized omega equation from density and horizontal velocity fields, which also shows a preponderance of the ageostrophic term. The ubiquity of dipolar vertical velocity distributions inside isolated anticyclones is supported by recent observational findings in the same oceanic region.
Contrast-Induced Nephropathy and Long-Term Mortality After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction
Authors: Sun Guoli , Chen Pengyuan , Wang Kun , Li Hualong , Chen Shiqun , Liu Jin , He Yibo , Song Feier , Liu Yong , Chen Ji-yan
Published: October 2018

Abnormal hemodynamics is thought to contribute to the increased risk of contrast-induced nephropathy (CIN) and mortality. However, few studies focused on patients without abnormal hemodynamics (defined as hypotension, intra-aortic balloon pump usage) and reduced left ventricular ejection fraction (LVEF < 40%). Our study was to explore the impact of CIN on mortality in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) with relative stable hemodynamics. In this observational study, we included 696 patients with AMI undergoing PCI without reduced LVEF and abnormal hemodynamics. The end point was long-term, all-cause mortality. During the mean follow-up of 2.79 years, CIN was detected in 110 (15.8%) patients. The total all-cause mortality was higher in CIN group than that in non-CIN group (24% vs 3.4%, P < .001). In the multivariate Cox analysis, CIN was an independent predictor of worse outcomes (adjusted hazard ratio [HR]: 2.97, 95% confidence interval: 1.46-6.06, P < .001) and significantly associated with long-term mortality, so did renal insufficiency (adjusted HR: 4.40, P < .001) and use of β-blockers (adjusted HR: 0.33, P < .001). Among patients with AMI, CIN independently predicted long-term mortality following PCI, regardless of LVEF impairment and abnormal hemodynamics.
Multisensory Influences on Driver Steering During Curve Navigation
Authors: Macuga Kristen L.
Published: October 2018

Objective:

The effects of inertial (vestibular and somatosensory) information on driver steering during curve navigation were investigated, using an electric four-wheel mobility vehicle outfitted with a steering wheel and a portable virtual reality system.

Background:

When driving, multiple sources of perceptual information are available. Researchers have focused on visual information, which plays a critical role in steering control. However, it is not yet well established how inertial information might contribute.

Methods:

I biased inertial cues by varying visual/inertial gains (doubled, halved, reversed), as drivers negotiated curving paths, and measured steering accuracy and efficiency. I also assessed whether being exposed to inertial biases had an impact on postbias steering by comparing pre- and posttest session performance measures.

Results:

Doubling or halving inertial cues had little effect on steering performance. Inertial information only disrupted steering when it was reversed with respect to visual information. Over time, the influence of this extreme inertial bias was reduced though not eliminated. Postbias curve navigation performance was not impacted, likely because participants had learned to disregard, rather than integrate, biased inertial cues.

Conclusion:

Results suggest that biased inertial information has little influence on curve navigation performance when visual information is available.

Application:

Though inertial cues may be important for open-loop steering, when visual cues are unavailable, their role in closed-loop steering seems less influential. This has implications for driving simulation and suggests that inertial discrepancies due to limitations in motion-cuing capabilities may not be all that problematic for the simulation of closed-loop curve steering tasks.
Imitation in a Second Language Relies on Phonological Categories but Does Not Reflect the Productive Usage of Difficult Sound Contrasts
Authors: Llompart Miquel , Reinisch Eva
Published: October 2018

This study investigated the relationship between imitation and both the perception and production abilities of second language (L2) learners for two non-native contrasts differing in their expected degree of difficulty. German learners of English were tested on perceptual categorization, imitation and a word reading task for the difficult English /ɛ/-/æ/ contrast, which tends not to be well encoded in the learners’ phonological inventories, and the easy, near-native /i/-/ɪ/ contrast. As expected, within-task comparisons between contrasts revealed more robust perception and better differentiation during production for /i/-/ɪ/ than /ɛ/-/æ/. Imitation also followed this pattern, suggesting that imitation is modulated by the phonological encoding of L2 categories. Moreover, learners’ ability to imitate /ɛ/ and /æ/ was related to their perception of that contrast, confirming a tight perception-production link at the phonological level for difficult L2 sound contrasts. However, no relationship was observed between acoustic measures for imitated and read-aloud tokens of /ɛ/ and /æ/. This dissociation is mostly attributed to the influence of inaccurate non-native lexical representations in the word reading task. We conclude that imitation is strongly related to the phonological representation of L2 sound contrasts, but does not need to reflect the learners’ productive usage of such non-native distinctions.
Modes of Eating and Phased Routinisation: Insect-Based Food Practices in the Netherlands
Authors: House Jonas
Published: October 2018

Sociological research on sustainable consumption has seen widespread application of theories of practice (‘practice theories’) as a means of transcending the limitations of epistemologically individualistic ‘behaviour change’ approaches. While in many ways the central insights of practice theories vis-a-vis consumption are now well established, this article argues that the approach holds further insights for sociological analysis of food consumption in general, and of novel foods in particular. Based on empirical research with consumers of a range of insect-based convenience foods in the Netherlands, this article introduces two practice-theoretic concepts – ‘modes of eating’ and ‘phased routinisation’ – which contribute to sociological theorisations of how food practices are established, maintained, interdepend and change. Beyond its theoretical contribution, the article substantively extends research literatures on the introduction, uptake and normalisation of insect-based and other novel foods.
The Impact of Culturally Inclusive Pedagogy on Student Achievement in a Multicultural Urban School Setting
Authors: Yu Eunjyu
Published: October 2018

In response to a critical need for culturally inclusive pedagogy for multicultural, urban classrooms, this study describes a project in which 43 in-service and preservice teachers and 175 multicultural urban public school students participated. This study found that the culturally relevant pedagogy significantly enhanced the student attitude toward math and science. The pedagogy also improved student achievement in math and science. In addition, parents or guardians were reported to be a primary human resource for academic support. These findings call for the transformation of teacher education programs and further research on other educational resources for multicultural urban classrooms.
Clinical profile of measles in children with special reference to infants
Authors: Sindhu TG , Geeta MG , Krishnakumar P , Sabitha S , Ajina KK
Published: October 2018

This study was conducted to analyse the clinical characteristics of measles in infants and to compare them with those in older children. Clinical and sociodemographic details of all hospitalised children with suspected measles were recorded and confirmed cases were analysed further. Twenty-four infants and 34 children aged >1 year were included. Most infants were boys and 15 (62.5%) of them were aged <9 months. Early onset of rash (within three days of fever in 62.5% of cases) occurred in infants. The complications of measles in infants included bronchopneumonia (n = 17, 71%), acute diarrhoea (n = 8, 33%), meningitis (n = 1, 4%) and staphylococcal sepsis (n = 2, 8%). The number of infants with complications was significantly high (88% and 65%; P = 0.05). Measles in infants can have atypical presentations, a greater risk for complications and may occur before they are due to receive the conventional first dose of measles vaccine.
Distributed adaptive dynamic surface formation control for uncertain multiple quadrotor systems with interval type-2 fuzzy neural networks
Authors: Liao Teh-Lu , Chan Wei-Shou , Yan Jun-Juh
Published: October 2018

This paper presents a distributed adaptive formation control method for uncertain multiple quadrotor systems under a directed graph that characterizes the interaction among the leader and followers. The proposed approach is based on an adaptive dynamic surface control, consensus algorithm and graph theory, where the system uncertainties are approximately modelled by interval type-2 fuzzy neural networks. The adaptive laws of interval type-2 fuzzy neural network parameters are derived from the stability analysis. In this study, the robust stability of the closed-loop system is guaranteed by the Lyapunov theorem, and the leader-follower formation goal can be asymptotically achieved. The developed control scheme is applied to the followers of quadrotor systems for performance evaluations. Simulation results are also provided to compare with the existing methods and reveal the superiority of the proposed adaptive formation controller.
Time-limited Gramians-based model order reduction for second-order form systems
Authors: Haider Shafiq , Ghafoor Abdul , Imran Muhammad , Malik Fahad Mumtaz
Published: October 2018

A new scheme for model order reduction of large-scale second-order systems in time-limited intervals is presented. Time-limited Gramians that are solutions of continuous-time algebraic Lyapunov equations for second-order form systems are introduced. Time-limited second-order balanced truncation procedures with provision of balancing position and velocity Gramians are formulated. Stability conditions for reduced-order models are stated and algorithms that preserve stability in reduced-order models are discussed. Numerical examples are presented to validate the superiority of the proposed scheme compared with the infinite-time Gramians technique for time-limited applications.
Leader-follower multi-agent flocking with bounded missing data and random communication radius
Authors: Mu Xiaowu , He Yuehua
Published: October 2018

In this paper, the leader-follower Cucker–Smale flocking system with bounded missing data and random communication radius is studied. The communication network is determined by the stochastic distance radii between agents. The process by which data are lost in the communication network is independent and identically distributed. The goal of this paper is to determine a lower bound on the probability that the agents asymptotically achieve a flocking behaviour, i.e. the relative velocities between the leader agent and other agents asymptotically vanish and the relative positions converge. Finally, a numerical simulation example is provided to illustrate the obtained results.
Robust dynamic sliding mode control of robot manipulators using the Fourier series expansion
Authors: Shokoohinia Mohammad Reza , Fateh Mohammad Mehdi
Published: October 2018

This paper presents a robust dynamic sliding mode control for electrically driven robot manipulators. The control law computes the motor voltages based on the voltage control strategy. Uncertainties are estimated using the Fourier series expansion and the truncation error is compensated. The Fourier coefficients are tuned based on the stability analysis. The contribution of this paper is designing a robust controller using a novel adaptive Fourier series expansion. In comparison with previous related works based on the Fourier series expansion, the superiority of this paper is presenting an adaptation law for the fundamental frequency of the Fourier series expansion and, consequently, relaxing the need for trial and error procedure in its tuning. The case study is a SCARA (Selective Compliant Articulated Robot for Assembly) robot manipulator actuated by permanent magnet DC electrical motors. The influence of uncertainty estimation based on the Fourier series expansion instead of using sign function is studied. Simulation results verify robust and satisfactory performance of the proposed controller.
Design and implementation of multichannel adaptive active vibration control with online secondary path modeling using piezoelectric transducers patches
Authors: Yuxue Pu , Zeng Meng , Huanlin Zhou
Published: October 2018

Adaptive active vibration control (AAVC) is an effective way for reducing structure vibration at low frequency. AAVC methodology is preferred in AVC system due to its self-adjustment ability to adapt to varying dynamics of the structure. The Filtered-X Least Mean Square (FXLMS) algorithm is widely implemented in active control applications. Accurate secondary path models are very crucial for the implementation in multichannel AAVC system based on FXLMS algorithm. The auxiliary random noise technique is often applied to achieve secondary path modeling (SPM) during online operation. This paper proposes a new multichannel AAVC methodology based on online SPM method. The online SPM error is estimated indirectly to reduce the interaction between the AAVC controller and the online SPM filter. A new variable step-size (VSS) strategy for online SPM filter is proposed based on the estimated online SPM error. A simple but effective auxiliary noise power scheduling (ANPS) method is proposed to eliminate the contribution of the auxiliary noise on the residual vibration. A series of multi-channel AAVC experiments on a cantilever epoxy resin plate with PZT sensors and actuators are presented to demonstrate the performance of the proposed methodology. Experiment results indicate that the proposed method provides very good online SPM accuracy, and the vibration of the smart cantilever plate has been effectively attenuated with high convergence rate.
Exponential synchronization of a Markovian jump complex dynamic network with piecewise-constant transition rates and distributed delay
Authors: Akbari Nasim , Sadr Ali , Kazemy Ali
Published: October 2018

The exponential synchronization of a Markovian jump complex dynamical network with piecewise-constant transition rates is investigated. Two distinct types of time-varying delay are considered for the system; one is distributed time-delay for each node, the other is discrete coupling time-delay. Based on an augmented Lyapunov–Krasovskii functional, some sufficient conditions are derived and expressed in the form of linear matrix inequalities, which are formulated in such a manner as to determine the controller gain matrices. Finally, an example is given to illustrate the effectiveness and validity of the proposed method.
Learning to manage public service organisations better: A scenario for teaching public administration
Authors: Glennon Russ , Hodgkinson Ian , Knowles Joanne
Published: October 2018

In the context of public value, it is argued that there is a need to adopt the learning organisation philosophy to manage public service organisations better. For collaborative work with public sector managers or in management education, a fictitious scenario is presented to develop the concept of the learning organisation as paradox. Faced with multiple and conflicting demands, public managers find it difficult to change organisational behaviour in response to new knowledge. The scenario demonstrates how learning organisation philosophy can be used to translate new knowledge into new behaviours. Key skills required for public managers to exploit the knowledge of all organisational members and confront the challenges of a contested concept, such as public value, are developed and comprise summarising evidence, making judgements, sharing thought processes on a contentious issue, and arriving at a consensus together. Contributions to public administration theory and practice are discussed.
What Can Be Learned From Empirical Evaluations of Nonexperimental Methods?
Authors: Wong Vivian C. , Steiner Peter M. , Anglin Kylie L.
Published: October 2018

Given the widespread use of nonexperimental (NE) methods for assessing program impacts, there is a strong need to know whether NE approaches yield causally valid results in field settings. In within-study comparison (WSC) designs, the researcher compares treatment effects from an NE with those obtained from a randomized experiment that shares the same target population. The goal is to assess whether the stringent assumptions required for NE methods are likely to be met in practice. This essay provides an overview of recent efforts to empirically evaluate NE method performance in field settings. We discuss a brief history of the design, highlighting methodological innovations along the way. We also describe papers that are included in this two-volume special issue on WSC approaches and suggest future areas for consideration in the design, implementation, and analysis of WSCs.
‘Just trying to talk to people … It’s the hardest’: Perspectives of adolescents with high-functioning autism spectrum disorder on their social communication skills
Authors: Kelly Rachel , O’Malley Mary-Pat , Antonijevic Stanislava
Published: October 2018

Difficulty with social communication is the most pervasive difficulty experienced by individuals with high-functioning autism spectrum disorder (HF-ASD). Communication difficulties are often magnified in adolescence as social demands become more intricate. This puts adolescents with HF-ASD at increased risk of social isolation and depression, as they have difficulty developing positive social identity. Yet, there is a dearth of literature addressing the communication issues of this population and even fewer studies including the voice of adolescents with HF-ASD themselves.

This study aimed to (1) explore the perspectives of adolescents with HF-ASD as to their social communication skills, (2) explore what (if any) difficulties they perceive themselves as having when talking with their peers, (3) explore if they would like help with social communication skills and (4) determine what kind of help they think may be useful to them and establish if they already use self-initiated strategies. This study was qualitative in nature, using thematic analysis to analyse data collected from 10 semi-structured interviews with 5 adolescents with HF-ASD. Qualitative research underpins the idea that one must understand the significance and explanation that people give to situations, experiences, their own actions and to the actions of others, for one to comprehend human behaviours and actions. A qualitative design allowed us to gain the most in depth insight into how adolescents with HF-ASD understand and perceive their experiences. Three themes emerged revealing the participants’ perceptions of their difficulties communicating, challenging feelings that they experience about communication, and their perspectives about the support for developing communication skills. The participants indicated a need for support to aid their desire to improve communication skills and interactions with typically developing peers. In educational settings, adolescents with HF-ASD may benefit from a peer mentor system to give them opportunities to practice social communication skills with typically developing peers and to encourage inclusion amongst their classmates.
Acute ingestion of rosemary water: Evidence of cognitive and cerebrovascular effects in healthy adults
Authors: Moss Mark , Smith Ellen , Milner Matthew , McCready Jemma
Published: October 2018

Background:

The use of herbal extracts and supplements to enhance health and wellbeing is increasing in western society.

Aims:

This study investigated the impact of the acute ingestion of a commercially available water containing an extract and hydrolat of rosemary ( Rosmarinus officinalis L. syn. Salvia rosmarinus Schleid.). Aspects of cognitive functioning, mood and cerebrovascular response measured by near-infrared spectroscopy provided the dependent variables.

Methods:

Eighty healthy adults were randomly allocated to consume either 250 mL of rosemary water or plain mineral water. They then completed a series of computerised cognitive tasks, followed by subjective measures of alertness and fatigue. Near-infrared spectroscopy monitored levels of total, oxygenated and deoxygenated haemoglobin at baseline and throughout the cognitive testing procedure.

Results:

Analysis of the data revealed a number of statistically significant, small, beneficial effects of rosemary water on cognition, consistent with those found previously for the inhalation of the aroma of rosemary essential oil. Of particular interest here are the cerebrovascular effects noted for deoxygenated haemoglobin levels during cognitive task performance that were significantly higher in the rosemary water condition. This represents a novel finding in this area, and may indicate a facilitation of oxygen extraction at times of cognitive demand.

Conclusion:

Taken together the data suggest potential beneficial properties of acute consumption of rosemary water. The findings are discussed in terms of putative metabolic and cholinergic mechanisms.
A Tutorial on Evaluating the Time-Varying Discrimination Accuracy of Survival Models Used in Dynamic Decision Making
Authors: Bansal Aasthaa , Heagerty Patrick J.
Published: October 2018

Many medical decisions involve the use of dynamic information collected on individual patients toward predicting likely transitions in their future health status. If accurate predictions are developed, then a prognostic model can identify patients at greatest risk for future adverse events and may be used clinically to define populations appropriate for targeted intervention. In practice, a prognostic model is often used to guide decisions at multiple time points over the course of disease, and classification performance (i.e., sensitivity and specificity) for distinguishing high-risk v. low-risk individuals may vary over time as an individual’s disease status and prognostic information change. In this tutorial, we detail contemporary statistical methods that can characterize the time-varying accuracy of prognostic survival models when used for dynamic decision making. Although statistical methods for evaluating prognostic models with simple binary outcomes are well established, methods appropriate for survival outcomes are less well known and require time-dependent extensions of sensitivity and specificity to fully characterize longitudinal biomarkers or models. The methods we review are particularly important in that they allow for appropriate handling of censored outcomes commonly encountered with event time data. We highlight the importance of determining whether clinical interest is in predicting cumulative (or prevalent) cases over a fixed future time interval v. predicting incident cases over a range of follow-up times and whether patient information is static or updated over time. We discuss implementation of time-dependent receiver operating characteristic approaches using relevant R statistical software packages. The statistical summaries are illustrated using a liver prognostic model to guide transplantation in primary biliary cirrhosis.
Effect of simultaneous surgical treatment of severe coronary artery disease and lung cancer
Authors: Li Zhi , Liu Ban , Ge Wen , Zhang Wei , Gu Chang , Liu Jingjing , Ke Xianting , Zhang Yangyang
Published: October 2018

Objective

The co-incidence of lung cancer and coronary artery disease (CAD) is increasing in patients of advanced age. This study was performed to demonstrate the efficiency and safety of simultaneous coronary artery bypass grafting and lung cancer surgery in a selected group of older patients.

Methods

Twenty patients with severe CAD and coexisting lung cancer underwent simultaneous surgical interventions (Group A), and 20 patients with lung cancer underwent an isolated lung cancer operation (Group B). In Group A, the combined operations were carried out through 2 incisions in 3 patients, a single incision in 14 patients, and median sternotomy for heart surgery and thoracoscopic lobectomy for lung cancer in 3 patients. The single-incision approach was used in all patients in Group B.

Results

The operation time was longer and the blood loss volume was larger in Group A than B. No significant between-group differences were found in the 5-year relapse-free survival rate or 5-year survival rate.

Conclusions

The simultaneous performance of lung cancer surgery and cardiac surgery was effective and evidently safe in Group A. This treatment approach enabled earlier lung cancer resection and avoidance of the eventual complications associated with further surgical procedures.
Goldsmiths Musical Sophistication Index (Gold-MSI): Portuguese version and associations with socio-demographic factors, personality and music preferences
Authors: Lima César F. , Correia Ana Isabel , Müllensiefen Daniel , Castro São Luís
Published: October 2018

The Goldsmiths Musical Sophistication Index (Gold-MSI) was recently proposed as a self-report measure of musical skills and behaviors in the general population. Although it is becoming a widely used tool, relatively little is known about its correlates, and adaptations into different languages will be crucial for cross-cultural comparisons and to allow for use beyond the original validation context. In this study, we adapted the Gold-MSI for use with Portuguese speaking individuals and evaluated it with a Portuguese sample ( N = 408; age range = 17–66 years; 306 women). We demonstrate that the Portuguese version of the Gold-MSI has appropriate psychometric properties, including good internal consistency and very good test–retest reliability. This was observed for the five subscales and for the general musical sophistication index (α values ⩾ 0.82, r values ⩾ 0.84). Using confirmatory factor analysis, the expected underlying factor structure was also confirmed. In addition, we identified associations between individual differences on the Gold-MSI and socio-demographic factors (age, sex, education, socio-economic status), personality traits, and music preferences. The Portuguese Gold-MSI is freely available, and it offers a reliable and valid tool that can contribute to the refined assessment of musical sophistication in a range of research contexts.
Health geographies II: The posthuman turn
Authors: Andrews Gavin J
Published: October 2018

This report, the second of three, discusses the nature of a recent turn in health geography towards a posthuman theoretical orientation. This is an ontological turn that challenges basic categories leading to the understanding that health is not solely a human condition, but one created within assemblages of multiple human and nonhuman actors and forces. This is a turn concerned with the immediate and processual emergence of health, hence one that recognises the critical roles of pre-personal and more-than-representational events and forces. These facets are explored along with the extent to which the new ‘posthuman geography of health’ is a departure, and the forms of enquiry and ethics it brings forth.