bluuebunny/crossref_metadata_2025 huggingface dataset:
The “Elderly” in Medicine: Ethical Issues Surrounding This Outdated and Discriminatory Term
Authors: Hekmat-panah Javad
Published: June 2019

The objective of this study was to investigate and describe how the use of the term “elderly” contributes to bias and problems within the medical system. A systematic review of the relevant literature and history was conducted. The term “elderly” does not define age accurately and carries bias and prejudice that lead to harm through discriminatory practices, institutional prejudices, and “ageist” policies in society and medicine. Doctors and healthcare providers seldom intentionally try to harm any patient, but might do so through unconscious anti-elderly bias. Studies indicate that medical students already demonstrate anti-elderly bias; researchers may lump patients aged 65 and over together, confounding specific information needed for individualized treatments; and out of unwarranted concern, medical and surgical treatments may be denied, despite minimal increased risk of mortality. When the cost of healthcare rises, it is the elderly against whom rationing is suggested. The term “elderly” has no place in medicine. Anti-elderly health care rationing is as unethical as rationing targeted against any group. It is reverse paternalism to make rules that limit others’ medical care, happiness, and life span without their consent. Medicine is the science and art of individual communication, evaluation and treatment. Once we deny care to any one group, we open the door to denial to others.
Stability and L2–Gain analysis of linear switched singular systems by using multiple discontinuous Lyapunov function approach
Authors: Wei Jumei , Zhi Huimin , Liu Kai
Published: June 2019

In this paper, the problem of the E-exponential stability and [Formula: see text] analysis of linear switched singular systems is investigated in discrete-time case. By using a multiple discontinuous Lyapunov function approach and adopting the mode-dependent average dwell time (MDADT) switching signals, new sufficient conditions of E-exponential stability and [Formula: see text] analysis for linear switched singular systems are presented. Based on the above results, we also derive the weighted [Formula: see text] performance index. In addition, by utilizing our proposed method, tighter bounds on average dwell time can be obtained for our considered systems. At last, a numerical example is given to show the effectiveness of the results.
Governmentality and Statification: Towards a Foucauldian Theory of the State
Authors: Jessen Mathias Hein , von Eggers Nicolai
Published: June 2019

This article contributes to governmentality studies and state theory by discussing how to understand the centrality and importance of the state from a governmentality perspective. It uses Giorgio Agamben’s critique of Michel Foucault’s governmentality approach as a point of departure for re-investigating Foucault as a thinker of the state. It focuses on Foucault’s notion of the state as a process of ‘statification’ which emphasizes the state as something constantly produced and reproduced by processes and practices of government, administration and acclamation. As a result of this, the state appears as a given entity which is necessary for the multiplicity of governmental technologies and practices in modern society to function. Only by reference to the state can governmental practices be effective and legitimized. Finally, the article conceptualizes the centrality of the state through Foucault’s (preliminary) notions of the state as a ‘practico-reflexive prism’ and a ‘principle of intelligibility’.
Use of high-sensitivity cardiac troponin I levels for early diagnosis of myocardial injury after neonatal asphyxia
Authors: Jiang Li , Li Yuning , Zhang Zhi , Lin Lixing , Liu Xiaoli
Published: June 2019

Objective

Low-cost diagnostic and prognostic biomarkers could help guide clinical management of neonates with myocardial injury after asphyxia. This study aimed to assess the utility of creatine kinase (CK)-MB, high-sensitivity cardiac troponin I (hs-cTnI), brain natriuretic peptide (BNP), and myoglobin in the early diagnosis of myocardial injury following neonatal asphyxia.

Methods

Eighteen neonates with asphyxia and myocardial injury, 22 neonates with asphyxia and no myocardial injury, and 19 neonates without asphyxia (controls) were enrolled consecutively at the Neonatology Department, First Hospital of Lanzhou University (August 2013 to December 2014). Serum CK-MB, hs-cTnI, BNP, and myoglobin levels were evaluated at 12 hours and 7 days after birth. Their diagnostic value for myocardial injury was assessed by receiver operating characteristic (ROC) curve analysis.

Results

Levels of all four markers were higher in neonates with asphyxia and myocardial injury than in neonates with asphyxia and no myocardial injury or controls 12 hours after birth. The marker hs-cTnI had the highest diagnostic value. Using a cutoff value of 0.087 µg/L for hs-cTnI, the sensitivity, specificity, and diagnostic accuracy for asphyxia-induced myocardial injury were 55.6%, 95.5%, and 77.5%, respectively.

Conclusions

Serum hs-cTnI levels can predict myocardial injury caused by neonatal asphyxia at an early stage.
An exact deflection solution to a type of cantilever with partially built-in end using strong boundary conditions
Authors: Lim Teik-Cheng
Published: June 2019

The problem of cantilever deflection is a classic worked example in most elasticity textbooks. Due to the inability for the displacement field to completely satisfy the boundary condition of zero displacement at the entire built-in end from the top surface to the bottom surface, the best solution so far is attained from weak boundary conditions. This paper proposes a modified problem in which the boundary is partially built-in, i.e. the cantilever is clamped on the top and bottom but free on the other two sides. Therefore, the cantilever’s displacement is prohibited only at the top and bottom surfaces at the partially built-in end. By implementing zero displacement therein, the displacement solution can be obtained based on strong boundary conditions. Furthermore, the condition of zero horizontal displacement at the mid-point of the partially built-in end is also achieved through the prescribed boundary conditions. Results also reveal that the displacement at the partially built-in end can be reduced by selecting materials with negative Poisson’s ratio. As an alternative to being a worked example, the proposed problem can be used as an assessment question.
Flexural Capacity Enhancement of Timber Beams Partially Confining the Principal Compression Arch using Carbon Fiber Reinforced Polymer Composites
Authors: Islam Md. Mashfiqul , Siddique Ashfia , Pourhassan Alireza , Chowdhury Md. Arman , Tasnim Jarin
Published: June 2019

Timber is widely used as a structural element because of its engineering and mechanical properties. This study focuses on the flexural behavior of timber beams externally reinforced with carbon fiber reinforced polymer (CFRP) composites at the tension face and the responses of the fundamental principal compression arch because of confinement from end anchorage. Beams of three different types of timber are studied. All the beams had the same length, width, and span length and were tested under four-point loading. Different CFRP lamination techniques were adopted, with and without U-clamp confinement as end anchorage, to investigate the flexural capacity enhancement of CFRP strips as reinforcement for timber beams. The profile of the principal compression arch is estimated experimentally from fundamental flexural strain-along-depth phenomena by post-processing high definition images extracted from test videos employing digital image correlation technique (DICT) in the MATLAB R2011a framework. Similar responses were found from finite element analysis using ANSYS 11.0. Effective confinement of the principal compression arch produced significant enhancements of flexural capacities and stiffness in the strengthened timber beams.
Development of Strategic Regional Employment Data Assessment using Google Places API
Authors: Noh Hyunsoo , Kramer Eric , Sun Aichong
Published: June 2019

Current and accurate site-specific employment data is a critical but vexing element in research on travel behavior patterns and trends in regional economic development. Typically, no single source of data provides comprehensive and reliable coverage for a regional metropolitan area. Developing multiple employment data sources is cumbersome and time-consuming, but a procedural approach can streamline data preparation and management. This study proposes a method to assess and integrate multiple sources of employment data using Google Places API and a business existence verification model. Other techniques, including data deduplication and prioritization, address standardization, and missing employer discovery, are addressed as means to improve data accuracy and coverage.
The everyday as the Soviet Gesamtkunstwerk
Authors: Vujošević Tijana
Published: June 2019

The notion of the Gesamtkunstwerk as a modern political phenomenon – the merging of art and life and the artistic transformation of life in its totality – has been limited to public political spectacle and the theatrical enactments of state programs. In contrast, this article about the Soviet 1920s and 1930s looks at everyday life or, in Russian, byt, as the primary domain of modern aesthetico-political intervention. The successful ordering of everyday life according to the principles of communism would mean that even the most intimate aspects of citizens’ lives become part of a total work of art, which now encompasses not only the public but also the private sphere. The author traces the evolution of byt reform from the aesthetic associations between bureaucrats and artists of the 1920s to the 1930s mobilization of ordinary citizens as artists who mould their everyday environments in accordance with Stalinist politics.
My utopia is your utopia? William Morris, utopian theory and the claims of the past
Authors: Davidson Joe P.L.
Published: June 2019

This article examines the relationship between utopian production and reception via a reading of the work of the great utopian author and theorist William Morris. This relationship has invariably been defined by an inequality: utopian producers have claimed unlimited freedom in their attempts to imagine new worlds, while utopian recipients have been asked to adopt such visions as their own without question. Morris’s work suggests two possible responses to this inequality. One response, associated with theorist Miguel Abensour, is to liberate reception, with Morris’s utopianism containing an invitation to readers to reformulate the vision proffered. However, this response, despite its dominance in contemporary utopian theory, not only misreads Morris but also undermines the political efficacy of utopianism. Consequently, I suggest that Morris responds to the problem of utopian inequality by constraining production, proposing a historical control on utopianising; new utopias are directed by an archive of visions articulated in past struggles.
Impact of Adverse Childhood Experiences on Language Skills and Promising School Interventions
Authors: Segal Aviva , Collin-Vézina Delphine
Published: June 2019

The influence of adverse childhood experiences (ACEs) on the developing child across several domains of functioning has much theoretical and empirical support. Yet, surprisingly, the impact of ACEs on the development of language skills specifically remains somewhat understudied. The present report provides a brief review of research on ACEs and associated impacts on brain functioning and on language skills development specifically. Trauma-informed practices are discussed, with a specific focus on school-based trauma-informed programs. Next steps to explore in future research are then provided.
Experience-Projection Methods in Theory-of-Mind Research: Their Limits and Strengths
Authors: Lurz Robert , Krachun Carla
Published: June 2019

The capacity to predict the behavior of other individuals is vital to the well-being and reproductive success of many species. There are two main strategies animals can use to make such predictions: (a) infer from observable cues that another agent is in a mental state and use this information to predict the agent’s behavior or (b) use the observable cues alone to predict the agent’s behavior. The first strategy is called theory of mind, the second behavior reading. A long-standing methodological issue has been how to determine experimentally whether animals use theory of mind or behavior reading to predict others’ behavior. One experimental method, called experience projection, may be capable of resolving this issue.
Knowledge and Determinants of Health Consequences of Cigarette Smoking Among Vietnamese Adults, 2015
Authors: Minh Dao An Thi , Thi Thu Nguyen Huong , Kim Giang Bao , Phan Hai Thi , Van Nguyen Huy , Doan Huyen Thu , Luong Khue Ngoc , Nguyen Lam Tuan , Van Hoang Minh , Pham Nga Thi Quynh , Nguyen Quan The
Published: June 2019

Background. Vietnam was one of 16 countries that implemented the second round of the GATS (Global Adult Tobacco Survey) in 2015. Aims. To assess knowledge and determinants of health consequences of different types of cigarette smoking among Vietnamese adults. Methods. A cross-sectional study among adults aged 15 years combined with using 15% of the master sample from the national sampling frame of the population and housing census was conducted. Multilevel analysis using Poisson regression was undertaken. Results. Knowledge on the health consequences of cigarette smoking has not significantly improved in the GATS-2015. Adults believe that active smoking had more of an impact on health than secondhand smoking and 24.5% and 43% of them answered that smoking light and e-cigarettes, respectively, causes less harm than regular cigarettes, and 17.3% and 18.1% of adults are not aware of the difference between them, respectively. Conclusion. Household and community’s role had little impact in the adult knowledge of smoking health consequences. It is necessary to disseminate information on the “other tobacco product” and to improve public knowledge on specific health consequences, to enhance household and community’s role in conveying health education messages to individuals.
Skills capital and inclusivity in men’s roller derby
Authors: Fletcher Dawn
Published: June 2019

Engaging with debates on the potential of sports to be inclusive, this research presents an analysis of the impact of capital on inclusivity in men’s roller derby, an alternative sport. Through qualitative interviews and participant observation of a men’s roller derby team based in South Yorkshire, skills capital is shown to have a detrimental impact on the goal of inclusivity. Skills capital is a form of symbolic capital that grants the bearer significant freedom to engage in non-conforming behaviour within a group setting. Given the commitment to inclusivity within the sport, this non-conforming behaviour has the potential to be transformative, but more frequently replicates the hegemonic masculine practices of mainstream sport. This renders the goal to be more inclusive problematic and difficult to achieve in practice even within alternative sporting spaces.
Concept and experimental validation of piezoelectric motor–based acceleration sensor in shock environment
Authors: Sun Dong , Tang Yu-juan , Wang Jiong , Wang Xin-jie
Published: June 2019

In traveling-wave rotary piezoelectric motor, the ring-shaped piezoelectric sheet is divided into three parts: group A, group B, and single-electrode. Single-electrode offers auto frequency tracking signal to maintain speed stability of motor in traditional applications. In ammunition system, it is necessary to identify the launching environment and service processing environment with sensors. During the process of applying ultrasonic motor to ammunition system, a novel concept that single-electrode can be used as acceleration sensor is proposed. The theoretical analysis and experimental verification of this concept are carried out in this article. The theory shows the charge Q in single-electrode is proportional to the amplitude of acceleration when the frequency of acceleration is much less than the resonance frequency of stator. Theoretical and experimental results also indicate that there are interference signals from single-electrode in shock environment. So a conditioning circuit is designed to eliminate useless signal. Calibration experiment results show that single-electrode has a good linear output characteristic in shock environment, which proves the feasibility of single-electrode acceleration sensor. The sensitivities of single-electrodes in two tested stators are 4.5 and 3.88 mV/g respectively. The research achievements realize the function expansion of single-electrode and promote the application of piezoelectric motor in shock environment.
Rethinking Social Justice: A Contemporary Challenge for Social Good
Authors: Levin Lia
Published: June 2019

Social justice’s special relationship with the social work profession has recently been confirmed by new definitions of social good that identify the promotion of social justice as a primary goal of social work research and practice. This contemporary use of the ideas and ideals of social justice creates an opportunity to reexamine it in the context of modern societies and postmodern knowledge. This article presents four steps for reassessing existing definitions of social justice, as reflected by three cases documented by international institutions that define themselves as promoters of social justice. Through this reassessment, this article seeks to contribute to the regeneration and advancement of interdisciplinary debate over the contents and nature of social justice, under the presumption that any effort toward social good aimed at enhancing social justice should first identify or discuss to what sort of social justice it aspires.
Employers and the Reintegration of Formerly Incarcerated Persons
Authors: Goodstein Jerry D.
Published: June 2019

In this initial submission, I argue for the importance of management researchers pursuing scholarly inquiry and research on the topic of employer reintegration of the formerly incarcerated. Around the world, there is growing political and social interest in criminal justice reform and rising expectations for businesses to respond to these changes. While criminologists have documented significant barriers contributing to employer resistance to hiring the formerly incarcerated, far less attention has been paid to employer hiring and retention of formerly incarcerated individuals. I suggest some possibilities for how understanding the dynamics and implications of employer hiring and retention of formerly incarcerated individuals can generate new conceptual and empirical insights of academic and practical relevance.
Initial Development and Validation of the Multilingual Education Scale
Authors: Dogan Fatma , Aydin Hasan
Published: June 2019

Applicability of multilingual education, which is applied in many countries, has increasingly proficiency and learning been a question of debate in Turkey because of the inclusion of living languages and dialects lessons into educational institutions. The purpose of this study is to develop a valid and reliable Likert-type scale to determine the perception of multilingual education of teachers with the inclusion of living languages and dialects lesson into curricula. For this purpose, a study was conducted with teachers in Turkey. After the instrument was constructed based on the literature, field experts evaluated it, and revisions were made to clarify the language and the design. Following this process, a pilot study was conducted among 150 teachers, resulting in a scale comprising 28 items after the alterations were made. Then, the instrument was sent to 898 teachers utilizing a snowball technique. Exploratory factor analysis was applied to determine the validity of the scale. Factor analysis showed that the scale had a single factor explaining 72.4% of the total variance. The scale’s KMO (Kaiser-Meyer-Olkin) was .974; and the Barlett test was 21828.8. For the sake of validity and reliability, the Cronbach’s alpha internal consistency coefficient for the scale (content validity, construct validity, distinctiveness validity, internal consistency and reliability) was determined as 0.97. Thus, the conclusion can be made that the scale is applicable and reliable enough for future development.
School Leaders’ Contribution to Social Justice: A Review
Authors: Shaked Haim
Published: June 2019

Purpose: The purpose of this review is to examine what is known as well as what we still seek to know in terms of principals’ potential contribution to social justice in their schools. Design/methodology/approach: This review provides an evaluative report of the current knowledge in the literature related to the influence of principals on social justice at the school building level. Findings: The current review reveals that there is solid evidence of the significant impact of school leaders on student learning. This impact constitutes the conceptual basis for social justice school leadership, where school leaders ascertain that all students are provided equal opportunities for quality education. However, the available knowledge regarding the optimal way to prepare social justice school leaders is still limited. Research implications: In as much as recent literature does not provide satisfactory answers to the question of how to train social justice school leaders, workable approaches to developing leaders who are effective in achieving social justice, equity, and excellence should be explored. Originality/value: In today’s Western school systems, non-White, LGBT, poor, or differently-abled students often lag behind their peers in academic achievement and acquisition of higher education while leading in school dropout rates. The review seeks to understand how school principals can bring about a real change in this undesirable situation, creating a social justice educational system.
Public Engagement for Regulatory Reform: A Case Study of Autologous Stem Cell Therapy Regulation in Australia
Authors: Dempster Georgia , Sutherland Georgina , Keogh Louise
Published: June 2019

As a method of science communication, public consultations have the potential to offer members of society the opportunity to influence government policy. An important component of public consultations is the evaluation of stakeholder submissions (from individuals to large organizations). As a case study, we investigated an Australian public consultation on the regulation of autologous stem cell therapies (ASCT) facilitated by the Therapeutic Goods Administration. Our results showed a divide between stakeholders who wanted ASCT to remain unregulated and stakeholders who wanted ASCT to become regulated. Since the consultation, the Therapeutic Goods Administration has decided to implement stringent regulation of most ASCT.
Polypharmacy and potentially inappropriate medication use is highly prevalent in multiple myeloma patients and is improved by a collaborative physician–pharmacist clinic
Authors: Sweiss Karen , Calip Gregory S , Wirth Scott , Rondelli Damiano , Patel Pritesh
Published: June 2019

Objective

To compare polypharmacy and potentially inappropriate medication use in multiple myeloma patients receiving care under a traditional, physician-managed, or collaborative physician–pharmacist clinic.

Design

Retrospective chart review.

Setting

Urban academic cancer center.

Data source

Computerized electronic record.

Patients

Forty-four patients in the traditional physician-managed clinic and 57 patients in the collaborative physician-pharmacist clinic.

Measurements and main results

Patients in the collaborative clinic took fewer medications on average (9 vs. 7, p = 0.045). Although the median number of myeloma-related medications was higher (2 vs. 4, p < 0.0001), the number of non-myeloma-related medications was lower (7 vs. 3, p < 0.0001) in the collaborative clinic. Polypharmacy rates were high in both clinics (93% vs. 84%, p = 0.22). However, the collaborative clinic had a lower rate of polypharmacy of non-myeloma medications (71 vs. 33%, p = 0.0003), including both minor (five to nine medications, 48 vs. 28%, p = 0.06) and major (≥10 medications, 23 vs. 5%, p = 0.02) polypharmacy. Minor polypharmacy of myeloma-related medications was higher in the collaborative clinic (32 vs. 2%; p = 0.0002). Multivariate analysis showed a reduced risk of having a higher number of medications (Relative risk (RR) 0.79, 95% confidence interval 0.67–0.93; p = 0.004), a lower risk of having any polypharmacy of non-myeloma-related medications (RR 0.41, 95% confidence interval 0.25–0.67; p < 0.001) and a lower risk of receiving potentially inappropriate medication (RR 0.62, 95% confidence interval 0.41–0.95; p = 0.029) in the collaborative clinic.

Conclusions

Multiple myeloma patients have a high rate of polypharmacy but comanagement with a pharmacist reduced the number of all medications, but in particular the number of non-myeloma-related medications.
Acute upward gaze palsy: Not always Parinaud syndrome
Authors: Rossi Salvatore , Frisullo Giovanni , Iorio Raffaele
Published: June 2019

Introduction:

Parinaud syndrome, caused by midbrain infarction, usually manifests as an ocular conjugate upgaze palsy. However, this sign should not point out straightforwardly to Parinaud syndrome, as other lesions in the central nervous system could cause it.

Case description:

The case of a 47-year-old woman showing acute onset of diplopia with bilateral upward gaze palsy is described. Parinaud syndrome was suspected on clinical grounds. However, brain magnetic resonance imaging displayed an acute ischemic lesion in the right anteromedial thalamus.

Conclusions:

Bilateral upward gaze palsy may be caused by unilateral thalamic infarction. The mechanism by which a unilateral thalamic lesion causes bilateral gaze palsy is discussed.
Introduction of Procalcitonin Testing and Antibiotic Utilization for Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Authors: Ulrich Robert J , McClung Daniel , Wang Bonnie R , Winters Spencer , Flanders Scott A , Rao Krishna
Published: June 2019

Background:

The majority of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are triggered by nonbacterial causes, yet most patients receive antibiotics. Treatment guided by procalcitonin (PCT), a sensitive biomarker of bacterial infection, safely decreases antibiotic use in many controlled trials. We evaluated PCT implementation for inpatients with AECOPD at a large academic hospital.

Methods:

All patients admitted for AECOPD during the first 6 months of PCT-guided therapy were eligible for inclusion in this retrospective cohort study. Patients with PCT performed were compared with those without PCT. The primary outcome was antibiotic days of therapy (DOT). Secondary outcomes included 30-day readmission and mortality.

Results:

Of the 238 AECOPD admissions, 73 (31%) had PCT performed. Procalcitonin-tested patients were more likely to meet systemic inflammatory response syndrome (SIRS) criteria, require intensive care unit (ICU)-level care, and have a longer length of stay (LOS) compared with those without PCT. Even after adjustment for these factors, PCT-tested patients received more inpatient DOT and there was no difference in total DOT. However, a low PCT value (<0.25 ng/mL) was associated with a 25.5% ( P ⩽ .001) decrease in intravenous (IV) antibiotic DOT. Guideline-recommended follow-up testing was rare (12%). Procalcitonin measurement had no effect on 30-day readmission or mortality.

Conclusions:

In this real-world analysis of inpatients with AECOPD, PCT-guided therapy was poorly adopted by providers and was not associated with a decrease in total antibiotic DOT. However, a low PCT level was associated with a 25.5% decrease in IV antibiotic DOT, suggesting increased comfort stepping down from IV to PO therapy.
Acute Interstitial Nephritis With Karyomegalic Epithelial Cells After Nivolumab Treatment—Two Case Reports
Authors: Ryuzaki Masaki , Tokuyama Hirobumi , Uchiyama Kiyotaka , Nakaya Hideaki , Hasegawa Kazuhiro , Miyashita Kazutoshi , Konishi Kohnosuke , Hashiguchi Akinori , Wakino Shu , Itoh Hiroshi
Published: June 2019

Clinical application of immune checkpoint inhibitors (CPIs) including nivolumab is expanding in the field of oncology treatment. Nivolumab is an anti-programmed death 1 protein (PD-1) antibody designed to augment an immunologic reaction against cancer cells. On the contrary, CPIs are known to cause a unique variety of side effects termed as immune-related adverse events, which can affect any organ including kidney. However, the characteristics of renal disorders by nivolumab treatment are poorly described. We describe two cases of acute kidney injury that were treated with nivolumab. Two patients, one with renal-cell carcinoma and the other with lung cancer, exhibited progressive renal dysfunction after the initiation of nivolumab treatment. By kidney biopsy, each case was diagnosed as acute interstitial nephritis (AIN). Of note, tubular epithelial cells enlarged with hyperchromatic nuclei were focally observed, and this finding was consistent with karyomegalic tubular epithelial cells. In immunostaining, most of the enlarged tubular epithelial cells were positive for Ki-67, which suggested regeneration of tubular epithelial cells. Clinically, in one case, renal function was partially recovered with the discontinuation of nivolumab, while in another case renal function was fully recovered with additional corticosteroid treatment. We presented nivolumab-induced AIN with karyomegalic changes of tubular epithelia. We propose that immunosuppressive therapy may be necessary for the full recovery from renal impairment.
Brain and lesion segmentation in multiple sclerosis using fully convolutional neural networks: A large-scale study
Authors: Gabr Refaat E , Coronado Ivan , Robinson Melvin , Sujit Sheeba J , Datta Sushmita , Sun Xiaojun , Allen William J , Lublin Fred D , Wolinsky Jerry S , Narayana Ponnada A
Published: June 2019

Objective:

To investigate the performance of deep learning (DL) based on fully convolutional neural network (FCNN) in segmenting brain tissues in a large cohort of multiple sclerosis (MS) patients.

Methods:

We developed a FCNN model to segment brain tissues, including T2-hyperintense MS lesions. The training, validation, and testing of FCNN were based on ~1000 magnetic resonance imaging (MRI) datasets acquired on relapsing–remitting MS patients, as a part of a phase 3 randomized clinical trial. Multimodal MRI data (dual-echo, FLAIR, and T1-weighted images) served as input to the network. Expert validated segmentation was used as the target for training the FCNN. We cross-validated our results using the leave-one-center-out approach.

Results:

We observed a high average (95% confidence limits) Dice similarity coefficient for all the segmented tissues: 0.95 (0.92–0.98) for white matter, 0.96 (0.93–0.98) for gray matter, 0.99 (0.98–0.99) for cerebrospinal fluid, and 0.82 (0.63–1.0) for T2 lesions. High correlations between the DL segmented tissue volumes and ground truth were observed ( R2 > 0.92 for all tissues). The cross validation showed consistent results across the centers for all tissues.

Conclusion:

The results from this large-scale study suggest that deep FCNN can automatically segment MS brain tissues, including lesions, with high accuracy.
Holographically-Guided Endovascular Aneurysm Repair
Authors: Rynio Paweł , Witowski Jan , Kamiński Jakub , Serafin Jakub , Kazimierczak Arkadiusz , Gutowski Piotr
Published: June 2019

Purpose: To demonstrate the feasibility of augmented reality visualization in planning and navigating endovascular aortic repair. Technique: A 77-year-old patient with abdominal aortic aneurysm was treated with endovascular repair. An augmented reality head-mounted display was used during the procedure. The aneurysm and bones were projected as 3-dimensional holograms. The operator controlled the device with gestures and voice commands (movement, rotation, cutting through, and zooming). Moreover, the hologram was placed in front of the angiography monitor and manually registered with fluoroscopy. Conclusion: Augmented reality with holographic rendering is feasible and helpful during endovascular aortic repair. Its routine use could possibly lead to shorter operating time, reduced contrast volume, and lower radiation dose; however, larger studies are required to obtain statistically significant results on the outcomes.
Psychiatric Residue of Epilepsy Surgery: De Novo or Not
Authors: Salpekar Jay
Published: June 2019

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Evidence-Based Spiritual Care Practice in the Canadian Context: Twenty Years Later
Authors: Snider Erin , Erenay Ayse , St. James O’Connor Thomas , Dotzert Colleen , Hong Stephanie , Smith Ruth , Dolson Lisa , Foulger Michael P.
Published: June 2019

Reviews developments, strengths and challenges in evidence-based spiritual care practice (EBSCP) using a hermeneutical method which compares and interprets a variety of written texts. EBSCP originated from evidence-based medicine (EBM) developed at McMaster University and was adopted as evidence-based practice (EBP) by multiple professional disciplines. EBSCP was first addressed in Canada and American spiritual care researchers in the US have since advanced EBSCP. Questions are raised about processes of integrating EBSCP in a Canadian context as well as areas for future research.
Efforts to Overcome Countertransference in Pastoral Counseling Relationships
Authors: Pedhu Yoseph
Published: June 2019

Countertransference is considered as a negative factor that may impede counseling relations but some assume that countertransference is a normal reaction. The purpose of this article is to explore countertransference in pastoral counseling and efforts to overcome it. The author examines the concepts, approaches, and structure of countertransference. Previous research is also reviewed. Based on this review, the author elaborates some strategies that can help pastoral counselors to overcome countertransference in their counseling practice.
A Qualitative Pilot Study of Spirituality in Long-term Recovery in Acquired Brain Injury
Authors: Gillespie Elena
Published: June 2019

Increased spirituality occurring after acquired brain injury is a part of post traumatic growth (PTG). Participants were asked about their spirituality, and their responses were analyzed. Eighty-one percent exhibited a moderate spiritual impact on their recovery. Studies suggest that patients’ spiritual needs are not being met, and chaplains are being underutilized. Trust and a sense of presence are essential to encouraging PTG, and, by fully utilizing the skills of our chaplain colleagues, could improve PTG.
Simulation-based design and optimization and fatigue characteristics for high-speed backplane connector
Authors: Yuan Rong , Li Haiqing , Wang Qingyuan
Published: June 2019

In high-speed interconnect systems, high-speed backplane connectors are widely utilized. Its mechanical reliability is related to the stability of entire application systems directly. Insertion–extraction force and fatigue characteristics are important factors that affect the reliability of high-speed backplane connectors. To enhance the reliability of high-speed backplane connectors, in this study, a single CAD/CAE parametric model of the contacts is established. Not only the dynamic analysis of the insertion and extraction process but also the electro-thermal-structure coupling of the contacts are carried out using finite element analysis. By changing the insertion position of male terminal, the length of female terminal, and the thickness of male terminal, the insertion–extraction force can be optimized. According to the simulation of the insertion–extraction force and the electric-thermal-structure coupling results, both the mechanical life of this connector and the thermal-mechanical fatigue life under electrifying condition are evaluated. The results show that the mechanical life and thermal-mechanical fatigue life were 376 cycles and 286 cycles, respectively. The design solutions can provide the reference for the structural design, optimization, and fatigue life prediction of high-speed backplane connector.
Analysis and design of the plug-in type repetitive control system based on steady-state residual convergence ratio
Authors: Jiang Xianliang , Hong Huajie
Published: June 2019

In the feedback control robotic systems, the repetitive control method has a high control performance for the track or elimination of the periodic signals. The promotion of the plug-in type configuration of the controller broadens the application range and applicability of the control method. In this article, a novel design algorithm based on the steady-state residual convergence ratio of the repetitive control system is proposed to improve the performance of the stabilized platform to resist the periodic perturbation. The basic structure and stable condition of the plug-in type repetitive control method are first introduced by applying the small gain theorem and the stability theorem for time-lag systems. Then the analysis of the convergence rate is utilized in constructing the basic index of the design algorithm of a plug-in type repetitive control system based on a steady-state residual convergence ratio. The parameters of the designed controller are checked by the validity condition of the plug-in type repetitive control system, and a simulation example is given to verify the effectiveness of the design algorithm. The article provides basic design guidelines and schemes for the design of the periodic disturbance suppression performance of the feedback control system. In the final physical prototype experiment, the prospective steady-state residual convergence ratio is basically achieved within the allowable range of error.
Linear model predictive control of automatic parking path tracking with soft constraints
Authors: Ye Hao , Jiang Haobin , Ma Shidian , Tang Bin , Wahab Lukuman
Published: June 2019

This study examines how to improve the accuracy of auto parking path tracking control; therefore, a linear model predictive control with softening constraints path tracking control strategy is proposed. Firstly, a linear time-varying predictive model of vehicle is established, and the future state of the vehicle can be predicted. The designed objective function fully considers the deviation between the predictor variable and the reference variable. Also, the relaxation factors are added to the optimization process, and the control increment of each cycle is calculated by the quadratic programming. Through rolling optimization and feedback correction, all kinds of deviations in the control process can be corrected in time. Then, the Simulink/CarSim simulation is carried out jointly. Furthermore, the path tracking simulation based on proportion–integration–differentiation control and no control is also carried out to compare with the model predictive control. Finally, a real vehicle test is carried out for model predictive control algorithm, and a comparative experiment based on proportion–integration–differentiation control and no control is carried out.
Model-based sensorless robot collision detection under model uncertainties with a fast dynamics identification
Authors: Cao Pengfei , Gan Yahui , Dai Xianzhong
Published: June 2019

This article presents a novel model-based sensorless collision detection scheme for human–robot interaction. In order to recognize external impacts exerted on the manipulator with sensitivity and robustness without additional exteroceptive sensors, the method based on torque residual, which is the difference between nominal and actual torque, is adopted using only motor-side information. In contrast to classic dynamics identification procedure which requires complicated symbolic derivation, a sequential dynamics identification was proposed by decomposing robot dynamics into gravity and friction item, which is simple in symbolic expression and easy to identify with least squares method, and the remaining structure-complex torque effect. Subsequently, the remaining torque effect was reformulated to overcome the structural complexity of original expression and experimentally recovered using a machine learning approach named Lasso while keeping the involving candidates number reduced to a certain degree. Moreover, a state-dependent dynamic threshold was developed to handle the abnormal peaks in residual due to model uncertainties. The effectiveness of the proposed method was experimentally validated on a conventional industrial manipulator, which illustrates the feasibility and simplicity of the collision detection method.
The ‘totality-of-the-evidence’ approach in the development of PF-06438179/GP1111, an infliximab biosimilar, and in support of its use in all indications of the reference product
Authors: McClellan Joseph E. , Conlon Hugh D. , Bolt Michael W. , Kalfayan Vatche , Palaparthy Rameshraja , Rehman Muhammad I. , Kirchhoff Carol F.
Published: June 2019

The ‘totality-of-the-evidence’ biosimilarity concept requires that sufficient structural, functional, nonclinical, and clinical data are acquired in a stepwise manner, to demonstrate that no clinically meaningful differences in quality, safety, or efficacy are observed compared with the reference product. We describe the totality of the evidence for PF-06438179/GP1111 (PF-SZ-IFX; IXIFI™ [infliximab-qbtx]/Zessly®) that supported its approval as an infliximab (IFX) biosimilar for all eligible indications of reference IFX (ref-IFX; Remicade®) in Europe and in the US. Analytical similarity involving in vitro assays capable of distinguishing structural or functional differences between PF-SZ-IFX and ref-IFX formed a foundation for the biosimilarity exercise. Differences identified in N-glycosylation and charge heterogeneity were found not to impact the results in in vitro biological assays reflective of the pharmacology underlying the mechanisms of action (tumor necrosis factor binding, reverse signaling, antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity) of IFX across disease indications. Similarity was assessed in a comparative clinical pharmacokinetic study and in a clinical efficacy and safety study in patients with rheumatoid arthritis, where therapeutic equivalence between PF-SZ-IFX and ref-IFX provided confirmatory evidence of biosimilarity, and, when coupled with the analytical similarity already established, supported extrapolation to all eligible disease indications of ref-IFX.
A systematic review of the relationship between rigidity/flexibility and transdiagnostic cognitive and behavioral processes that maintain psychopathology
Authors: Morris Lydia , Mansell Warren
Published: June 2019

An ever-growing number of transdiagnostic processes that maintain psychopathology across disorders have been identified. However, such processes are not consistently associated with psychological distress and symptoms. An understanding of what makes such processes pathological is required. One possibility is that individual differences in rigidity in the implementation of these processes determine the degree of psychopathology. The aim of this article is to examine the relationship between rigidity/flexibility and transdiagnostic maintenance processes. Initial searches were made for research examining relationships between 18 transdiagnostic processes and rigidity/flexibility. Relationships between rumination, perfectionism, impulsivity and compulsivity, and rigidity/flexibility were systemically reviewed; 50 studies met inclusion criteria. The majority of studies indicated that transdiagnostic cognitive and behavioral maintenance processes and rigidity were correlated, co-occurring, or predictive of each other. Findings are consistent with the hypothesis that it is inflexibility in the manner in which processes are employed that makes them pathologically problematic. However, further research is required to test and establish this.
The moderating role of anxiety sensitivity in the co-occurrence of anxiety and depression symptoms among clinically anxious children
Authors: Viana Andres G. , Woodward Emma C. , Hanna Abigail E. , Raines Elizabeth M. , Alfano Candice A. , Zvolensky Michael J.
Published: June 2019

The co-occurrence between anxiety and depression symptoms among children with anxiety disorders is well-known, yet there is considerable heterogeneity in terms of explanatory factors. Although cognitive–affective processes have been hypothesized to play a prominent role, surprisingly, no research to date has examined the role of anxiety sensitivity in this co-occurrence. The present investigation examined the role of anxiety sensitivity in the co-occurrence of anxiety and depression symptoms among clinically anxious children. We expected that anxiety sensitivity would moderate the co-occurrence between anxiety and depression symptoms, such that higher anxiety would be related to higher depression among boys and girls with high (but not low) anxiety sensitivity. Participants ( N = 44, age range = 8–12 years; 52% female; 52% African American) were interviewed with the Anxiety Disorders Interview Schedule-IV: Children and Parent Versions and completed self-report measures of anxiety sensitivity, anxiety, and depression symptom severity. Controlling for child age, moderation analyses revealed that higher anxiety was related to higher depression only among girls with high anxiety sensitivity. Among girls with low anxiety sensitivity, the relation between anxiety and depression symptoms was not significant. Anxiety and depression symptoms were strongly correlated among clinically anxious boys irrespective of their levels of anxiety sensitivity. Anxiety sensitivity is an important factor related to anxiety–depression symptom co-occurrence among clinically anxious females in particular. Targeted interventions focused on anxiety sensitivity reduction may prove useful for reducing anxiety–depression symptom co-occurrence among clinically anxious girls. Future research should explore additional moderators that may explain the high correlation between anxiety and depressive symptoms observed among clinically anxious boys.
Exploring the effects of cognitive remediation on metacognition in people with schizophrenia
Authors: Cella Matteo , Edwards Clementine , Swan Sarah , Elliot Kay , Reeder Clare , Wykes Til
Published: June 2019

Background:

Interventions targeting cognition in people with schizophrenia have shown moderate effects on improving functioning. Recent cognitive remediation (CR) approaches have begun to target metacognition to improve functioning outcomes. This study aims to develop a novel measure of metacognition and assess whether metacognitive-based CR (mCR) can improve metacognition.

Method:

We use data from a single-blinded randomized controlled trial comparing mCR plus treatment as usual (TAU) to TAU alone in people with schizophrenia. Participants were assessed with measures of cognition, functioning, and a new measure of metacognition at three time points: Week 0 (baseline), Week 12, and Week 24.

Results:

The evaluation of the novel metacognition assessment suggests that it is a reliable and valid measure. The measure positively correlates with cognitive measures, in particular with executive function and IQ but also with a measure of functioning. We found that a course of mCR was able to increase metacognition compared to TAU by Week 24.

Conclusions:

Metacognition may be an important mechanism to explain how CR affects functioning outcomes in people with psychosis. The systematic assessment of metacognition as part of CR studies may help to evaluate more clearly its role and relevance to functioning.