bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary metastasis from renal epithelioid angiomyolipoma in the setting of breast cancer
Authors: MacCraith Eoin , McCarthy Aoife , Swan Niall , Quinlan David
Published: April 2017

A 68-year-old woman presented with visible haematuria. Ultrasonography and triphasic CT revealed a 2.6 cm mass in the lower pole of the left kidney. A biopsy suggested low-grade renal cell carcinoma. Radical nephrectomy was performed and revealed an epithelioid angiomyolipoma. At year 3, the patient developed ductal carcinoma of the right breast and underwent a wide local excision and sentinel lymph node biopsy followed by chemotherapy and radiotherapy. 4 months later, she was noted to have a 1.6 cm nodule in the middle lobe of her right lung. The primary differential diagnosis was a breast cancer metastasis. Biopsy revealed a metastatic renal epithelioid angiomyolipoma. The patient elected to have stereotactic radiotherapy over surgical excision. Renal angiomyolipomata are generally regarded as benign tumours. In the present report, we describe the first case of pulmonary metastasis from renal epithelioid angiomyolipoma in the setting of breast cancer.
Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment
Authors: Hsu Chun Liang , Best John R , Davis Jennifer C , Nagamatsu Lindsay S , Wang Shirley , Boyd Lara A , Hsiung GY Robin , Voss Michelle W , Eng Janice Jennifer , Liu-Ambrose Teresa
Published: April 2017

Background

Vascular cognitive impairment (VCI) results from cerebrovascular disease, and worldwide, it is the second most common type of cognitive dysfunction. While targeted aerobic training is a promising approach to delay the progression of VCI by reducing cardiometabolic risk factors, few randomised controlled trials to date have specifically assessed the efficacy of aerobic training on cognitive and brain outcomes in this group at risk for functional decline.

Aim

To examine the effect of moderate-intensity aerobic training on executive functions and functional neural activity among older adults with mild subcortical ischaemic VCI (SIVCI).

Methods

Older adults with mild SIVCI were randomly assigned to: (1) 6-month, 3×/week aerobic training (n=10) or (2) usual care (control; n=11). Participants completed functional MRI (fMRI) at baseline and trial completion. During the fMRI sessions, behavioural performance on the Eriksen flanker task and task-evoked neural activity were assessed.

Results

At trial completion, after adjusting for baseline general cognition, total white matter lesion volume and flanker performance, compared with the control group, the aerobic training group significantly improved flanker task reaction time. Moreover, compared with the controls, the aerobic training group demonstrated reduced activation in the left lateral occipital cortex and right superior temporal gyrus. Reduced activity in these brain regions was significantly associated with improved (ie, faster) flanker task performance at trial completion.

Aerobic training among older adults with mild SIVCI can improve executive functions and neural efficiency of associated brain areas. Future studies with greater sample size should be completed to replicate and extend these findings.
A realist review to explore how low-income pregnant women use food vouchers from the UK’s Healthy Start programme
Authors: Ohly Heather , Crossland Nicola , Dykes Fiona , Lowe Nicola , Hall-Moran Victoria
Published: April 2017

Objectives

To explore how low-income pregnant women use Healthy Start food vouchers, the potential impacts of the programme, and which women might experience these impacts and why.

Design

A realist review.

Eligibility criteria for selecting studies

Primary or empirical studies (of any design) were included if they contributed relevant evidence or insights about how low-income women use food vouchers from the Healthy Start (UK) or the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) programmes. The assessment of ‘relevance’ was deliberately broad to ensure that reviewers remained open to new ideas from a variety of sources of evidence.

Analysis

A combination of evidence synthesis and realist analysis techniques was used to modify, refine and substantiate programme theories, which were constructed as explanatory ‘context–mechanism–outcome’–configurations.

Results

38 primary studies were included in this review: four studies on Healthy Start and 34 studies on WIC. Two main outcome strands were identified: dietary improvements (intended) and financial assistance (unintended). Three evidence-informed programme theories were proposed to explain how aspects of context (and mechanisms) may generate these outcomes: the ‘relative value’ of healthy eating (prioritisation of resources); retailer discretion (pressure to ‘bend the rules’); the influence of other family members (disempowerment).

Conclusions

This realist review suggests that some low-income pregnant women may use Healthy Start vouchers to increase their consumption of fruits and vegetables and plain cow’s milk, whereas others may use them to reduce food expenditure and save money for other things.
Preparing future doctors for palliative care: views of course organisers
Authors: Walker Steven , Gibbins Jane , Paes Paul , Barclay Stephen , Adams Astrid , Chandratilake Madawa , Gishen Faye , Lodge Philip , Wee Bee
Published: April 2017

Background

Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown.

Objective

To survey attitudes of PC course organisers regarding their course, organisation, the adequacy of training provided and level of personal satisfaction.

Methods

An anonymised, multifactorial, web-based questionnaire was devised, tested, modified and then sent to lead PC course organisers at all UK medical schools.

Results

Data were obtained from all 30 UK medical schools. Organisers agreed/strongly agreed (=agreed) that their PC course was highly rated by students (26, 87%). 25 (83%) agreed their course ‘enabled misconceptions and fears about PC, death, dying and bereavement to be addressed’, ‘delivered quality PC training’ (23, 77%), ‘fulfilled General Medical Council requirements’ (19, 63%), ‘prepared students well to care for patients with PC/EOLC needs’ (18, 60%) and ‘enabled students to visit a hospice and see the role of doctors in caring for the dying’ (17, 57%). Concerns were limited capacity to accommodate students (agreed 20, 66%) and variability in teaching according to location (15, 50%). Most agreed their institution recognised PC training as important (22, 73%), they felt supported by colleagues (21, 70%) and experienced cooperation between stakeholders (20, 67%). All agreed that PC training was essential for undergraduates, while 29 (97%) supported inclusion of a hospice visit in the curriculum. 27 agreed that their role was satisfying (90%), 3 disagreed (10%).

Conclusions

Approximately two-thirds of organisers were generally positive about their PC course, institution and role. A minority expressed concerns; these may reflect suboptimal PC training at their medical school and poor preparation of new doctors.
Comparing two regimens of intravaginal misoprostol with intravaginal gemeprost for second-trimester pregnancy termination: a randomised controlled trial
Authors: Koh Daniel Seow Choon , Ang Esther Pei Jing , Coyuco Jurja Chua , Teo Hua Zhen , Huang Xiaoling , Wei Xing , Ng Mor Jack , Lim Serene Liqing , Tan Kok Hian
Published: April 2017

Aim

To compare the efficacy and safety of intravaginal misoprostol 200 µg, 400 µg and gemeprost regimens for second-trimester termination of pregnancy (TOP).

Methods

A three- armed randomi sed controlled trial (Clinical Trial Certificate 1100015) where 116 women undergoing second-trimester TOP were given intravaginal misoprostol 200 µ g (n=37), misoprostol 400 µg (n=40) or gemeprost 1 mg (n=39) at 4- hour intervals until abortion occurred with a maximum of five doses.

Results

The misoprostol 400 µg group had the highest incidence of successful abortions (92.5%) compared to the misoprostol 200 µg (70.3%;p=0.017) and gemeprost 1 mg (74.4%;p=0.037) within 48 hours. There was no significant difference in abortion rate between misoprostol 200 µg and gemeprost. The misoprostol 400 µg group had the highest incidence of fever (70.0%) compared to misoprostol 200 µg (24.3%;p<0.001) and gemeprost 1 mg (46.2%;p=0.041). The gemeprost group had the highest incidence of diarrhoea (38.5%) compared to misoprostol 400 µg (10.0%;p=0.004) and misoprostol 200 µg (8.1%;p=0.003) groups.

Conclusions

Intravaginal misoprostol 400 µ g at 4- hour intervals was the most effective regimen but was associated with a high incidence of fever. Misoprostol 200 µg demonstrated similar effectiveness as gemeprost and had lower incidence of diarrhoea. Gemeprost should not be first line for medical therapy given the cost, storage requirements and lower efficacy.
A randomised controlled trial of a complex intervention to reduce children’s exposure to secondhand smoke in the home
Authors: Ratschen Elena , Thorley Rebecca , Jones Laura , Opazo Breton Magdalena , Cook Juliette , McNeill Ann , Britton John , Coleman Tim , Lewis Sarah
Published: April 2017

Objectives

Exposing children to secondhand tobacco smoke (SHS) causes significant harm and occurs predominantly through smoking by caregivers in the family home. We report a trial of a complex intervention designed to reduce secondhand smoke exposure of children whose primary caregiver feels unable or unwilling to quit smoking.

Design

An open-label, parallel, randomised controlled trial.

Setting

Deprived communities in Nottingham City and County, England

Participants

Caregivers resident in Nottingham City and County in England who were at least 18 years old, the main caregiver of a child aged under 5 years living in their household, and reported that they were smoking tobacco inside their home.

Interventions

We compared a complex intervention combining personalised feedback on home air quality, behavioural support and nicotine replacement therapy for temporary abstinence with usual care.

Main outcomes

The primary outcome was change in air quality in the home, measured as average 16–24  hours levels of particulate matter of  < 2.5  µm diameter (PM2.5), between baseline and 12 weeks. Secondary outcomes included changes in maximum PM2.5, proportion of time PM2.5 exceeded WHO recommended levels of maximum exposure of 25  µg/mg3, child salivary cotinine, caregivers’ cigarette consumption, nicotine dependence, determination to stop smoking, quit attempts and quitting altogether during the intervention.

Results

Arithmetic mean PM2.5 decreased significantly more (by 35.2 %; 95%  CI 12.7% to 51.9 %) in intervention than in usual care households, as did the proportion of time PM2.5 exceeded 25  µg/mg3, child salivary cotinine concentrations, caregivers’ cigarette consumption in the home, nicotine dependence, determination to quit and likelihood of having made a quit attempt.

Conclusions

By reducing exposure to SHS in the homes of children who live with smokers unable or unwilling to quit, this intervention offers huge potential to reduce children’s’ tobacco-related harm.

Trial registration number

ISRCTN81701383.

This trial was funded by the UK National Institute for Health Research (NIHR): RP-PG-0608-10020
Hydraulic properties of the Paskapoo Formation in west-central Alberta
Authors: Hughes Alexandra T. , Smerdon Brian D. , Alessi Daniel S.
Published: April 2017

In an effort to better understand the hydraulic properties of the Paskapoo Formation, hydraulic conductivity and porosity were evaluated for a region in west-central Alberta. Whereas previous studies have focused mainly on sandstone units in the lower portion of the Paskapoo Formation, in southern and central parts of the province, this study focuses on the middle to upper portions. Hydraulic conductivity values were determined by air permeametry for seven drill cores from the area between Hinton and Fox Creek, Alberta. Thin-section petrology and porosity analyses using photomicrographs were also conducted for three of the seven drill cores. Results confirm previous findings that the Paskapoo Formation has heterogeneous hydraulic properties, with horizontal hydraulic conductivity values ranging from 10−10to 10−5m/s (determined by air permeametry) and porosity values ranging from 0.02% to 15.3%. The first measurements for the upper sandstone units are provided (1.1 × 10−9– 2.6 × 10−5m/s and 0.08%–15.3%) and numerous measurements of the middle siltstone–mudstone unit (1.1 × 10−10– 4.9 × 10−8m/s and 0.02%–1.8%) for the northwestern portion of the Paskapoo Formation. Qualitative petrologic analysis suggests that the degree of cementation, rather than grain size, is the dominant control on the hydraulic properties of this portion of the formation. This study determined primary hydraulic properties for both the highly conductive units often considered as aquifers and the low-conductivity units considered as aquitards or confining layers. When combined with previous findings, this study helps expand the understanding of the Paskapoo Formation and provides critical data for assessing groundwater resources.
Presenting Little q-Schur Algebras uk(2; r)
Authors: Bian Zhihao , Liu Mingqiang
Published: April 2017

Little q-Schur algebras were introduced as homomorphic images of the infinitesimal quantum groups by Du, Fu and Wang. In this paper, we obtain a presentation by generators and relations for little q-Schur algebras uk(2, r).
Simulation of subseismic joint and fault networks using a heuristic mechanical model
Authors: Gillespie Paul , Casini Giulio , Iben Hayley , O'Brien James F.
Published: April 2017

Flow simulations of fractured and faulted reservoirs require representation of subseismic structures about which subsurface data are limited. We describe a method for simulating fracture growth that is mechanically based but heuristic, allowing for realistic modelling of fracture networks with reasonable run times. The method takes a triangulated meshed surface as input, together with an initial stress field. Fractures initiate and grow based on the stress field, and the growing fractures relieve the stress in the mesh. We show that a wide range of bedding-plane joint networks can be modelled simply by varying the distribution and anisotropy of the initial stress field. The results are in good qualitative agreement with natural joint patterns. We then apply the method to a set of parallel veins and demonstrate how the variations in thickness of the veins can be represented. Lastly, we apply the method to the simulation of normal fault patterns on salt domes. We derive the stress field on the bedding surface using the horizon curvature. The modelled fault network shows both radial and concentric faults. The new method provides an effective means of modelling joint and fault networks that can be imported to the flow simulator.
Toll-like receptor 2 dominance over Toll-like receptor 4 in stressful conditions for its detrimental role in the heart
Authors: Bagchi Ashim K. , Akolkar Gauri , Mandal Soma , Ayyappan Prathapan , Yang Xi , Singal Pawan K.
Published: April 2017

It has been suggested that Toll-like receptor (TLR)4 promotes IL-10-mediated cardiac cell survival, whereas another receptor, TLR2, from the same family, is detrimental. Here, we examined the interactive role of these two innate signaling molecules under stressful conditions, including IL-10 knockout (IL-10−/−) mice, global ischemia-reperfusion (I/R) injury in rat hearts, and in vitro short hairpin RNA experimental models in the presence or absence of IL-10 (10 ng/ml). Circulating and myocardial levels of TNF-α as well as apoptosis and fibrosis were higher in IL-10−/−mice. The increase in TLR2 in IL-10−/−hearts indicated its negative regulation by IL-10. Ex vivo I/R also caused a marked upregulation of TLR2 and TNF-α as well as apoptotic and fibrotic signals. However, a 40-min reperfusion with IL-10 triggered an increase in TLR4 expression and improved recovery of cardiac function. The increase in IL-1 receptor-associated kinase (IRAK)-M and IRAK-2 activity during I/R injury suggested their role in TLR2 signaling. In vitro inhibition of TLR4 activity as a consequence of RNA inhibition-mediated suppression of myeloid differentiation gene (MyD)88 suggested MyD88-dependent activation of TLR4. The inclusion of IL-10 during reperfusion also downregulated the expression of IRAK-2, TNF-α receptor-associated factor 1-interacting protein (TRAIP) and apoptotic signals, caspase-3, and the Bax-to-Bcl-xLratio. IL-10 reduced the TNF-α receptor-associated increase in TRAIP-induced apoptosis during I/R injury, which led to an increase in IL-1β to mitigate transforming growth factor-β receptor type I-mediated fibrosis. The IL-10 mitigation of these changes suggests that the stimulation through TLR4 signaling promotes IRAK-4 and phosphorylates IRAK-1 instead of IRAK-2 and may be an important therapeutic approach in restoring heart health in stress.

NEW & NOTEWORTHY Under stress conditions such as downregulation of the IL-10 gene or ischemia-reperfusion injury, Toll-like receptor (TLR)4 and IL-1 receptor-associated kinase (IRAK)-1 activation is suppressed, along with the upregulation of TLR-2 and IRAK-2, resulting in fibrosis and apoptosis. It is suggested that IL-10 helps to maintain heart function during stress via myeloid differentiation gene 88/IRAK-4/IRAK-1-dependent TLR4 signaling.
Strength and Durability Assessment of Portland Cement Mortars Formulated from Hydrogen-Rich Water
Authors: Jo Byung Wan , Sikandar Muhammad Ali , Chakraborty Sumit , Baloch Zafar
Published: April 2017

We investigated the effects of hydrogen-rich water (HRW) on the strength and durability of Portland cement mortars. We comparatively assessed the performances of HRW-based mortars (HWMs) with respect to cement mortars fabricated from control water (CWM). The results indicate that the use of HRW significantly improves the compressive, flexural, and splitting tensile strength of mortars at both the early and later ages of curing. Durability was assessed in terms of capillary absorption, ultrasonic pulse velocity (UPV), dynamic elastic modulus (DEM), and electrical resistivity (ER). We attribute the generally improved mechanical and durability properties of HWMs to the formation of more cement hydrates with fewer voids in the hydrogen-rich environment. Based on X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscope (SEM) analyses, we deduce that the use of HRW in Portland cement mortars produces a more compact, dense, and durable microstructure with fewer voids due to a higher degree of hydration.
Microwave Imaging Using CMOS Integrated Circuits with Rotating 4 × 4 Antenna Array on a Breast Phantom
Authors: Song Hang , Azhari Afreen , Xiao Xia , Suematsu Eiji , Watanabe Hiromasa , Kikkawa Takamaro
Published: April 2017

A digital breast cancer detection system using 65 nm technology complementary metal oxide semiconductor (CMOS) integrated circuits with rotating 4 × 4 antenna array is presented. Gaussian monocycle pulses are generated by CMOS logic circuits and transmitted by a 4 × 4 matrix antenna array via two CMOS single-pole-eight-throw (SP8T) switching matrices. Radar signals are received and converted to digital signals by CMOS equivalent time sampling circuits. By rotating the 4 × 4 antenna array, the reference signal is obtained by averaging the waveforms from various positions to extract the breast phantom target response. A signal alignment algorithm is proposed to compensate the phase shift of the signals caused by the system jitter. After extracting the scattered signal from the target, a bandpass filter is applied to reduce the noise caused by imperfect subtraction between original and the reference signals. The confocal imaging algorithm for rotating antennas is utilized to reconstruct the breast image. A 1 cm3 bacon block as a cancer phantom target in a rubber substrate as a breast fat phantom can be detected with reduced artifacts.
Effects of Voids on Concrete Tensile Fracturing: A Mesoscale Study
Authors: Xu Lei , Huang Yefei
Published: April 2017

A two-dimensional mesoscale modeling framework, which considers concrete as a four-phase material including voids, is developed for studying the effects of voids on concrete tensile fracturing under the plane stress condition. Aggregate is assumed to behave elastically, while a continuum damaged plasticity model is employed to describe the mechanical behaviors of mortar and ITZ. The effects of voids on the fracture mechanism of concrete under uniaxial tension are first detailed, followed by an extensive investigation of the effects of void volume fraction on concrete tensile fracturing. It is found that both the prepeak and postpeak mesoscale cracking in concrete are highly affected by voids, and there is not a straightforward relation between void volume fraction and the postpeak behavior due to the randomness of void distribution. The fracture pattern of concrete specimen with voids is controlled by both the aggregate arrangement and the distribution of voids, and two types of failure modes are identified for concrete specimens under uniaxial tension. It is suggested that voids should be explicitly modeled for the accurate fracturing simulation of concrete on the mesoscale.
The Effect of Yaw Angle on a Compressible Rectangular Cavity Flow
Authors: Lee Kuan-Huang , Chung Kung-Ming , Chang Keh-Chin
Published: April 2017

Experiments are performed to determine the characteristics of a compressible flow over yawed rectangular cavities for Mach numbers of 0.64, 0.70, and 0.83. The cavity’s length-to-depth ratio varies from 4.43 to 21.50 and the length-to-width ratio is unity. The yaw angle is 0°–45°. The upstream compression and downstream expansion near the front and rear corners of a cavity decrease when the value of the yaw angle increases. The amplitude of the fluctuating pressure is a maximum for an open cavity with a yaw angle of 15°. An increase in the yaw angle results in a reduction in the pressure fluctuations for both open and transitional cavities. In the span-wise direction, variations in the mean and fluctuating pressure are less significant than those in the chord-wise direction. The oscillating frequency of resonance varies slightly with the yaw angle, but the amplitudes for the power spectral density are significantly reduced when the yaw angle is larger than 30°. For lower Mach numbers, the lower mode plays an important role in self-sustained oscillations for an open cavity when there is an increase in the yaw angle.
A Phase I Study of the CDK4/6 Inhibitor Ribociclib (LEE011) in Pediatric Patients with Malignant Rhabdoid Tumors, Neuroblastoma, and Other Solid Tumors
Authors: Geoerger Birgit , Bourdeaut Franck , DuBois Steven G. , Fischer Matthias , Geller James I. , Gottardo Nicholas G. , Marabelle Aurélien , Pearson Andrew D.J. , Modak Shakeel , Cash Thomas , Robinson Giles W. , Motta Marlyane , Matano Alessandro , Bhansali Suraj G. , Dobson Jason R. , Parasuraman Sudha , Chi Susan N.
Published: April 2017

Purpose: The cyclin-dependent kinase (CDK) 4/6 inhibitor, ribociclib (LEE011), displayed preclinical activity in neuroblastoma and malignant rhabdoid tumor (MRT) models. In this phase I study, the maximum tolerated dose (MTD) and recommended phase II dose (RP2D), safety, pharmacokinetics (PK), and preliminary activity of single-agent ribociclib were investigated in pediatric patients with neuroblastoma, MRT, or other cyclin D–CDK4/6–INK4–retinoblastoma pathway-altered tumors.

Experimental Design: Patients (aged 1–21 years) received escalating once-daily oral doses of ribociclib (3-weeks-on/1-week-off). Dose escalation was guided by a Bayesian logistic regression model with overdose control and real-time PK.

Results: Thirty-two patients (median age, 5.5 years) received ribociclib 280, 350, or 470 mg/m2. Three patients had dose-limiting toxicities of grade 3 fatigue (280 mg/m2; n = 1) or grade 4 thrombocytopenia (470 mg/m2; n = 2). Most common treatment-related adverse events (AE) were hematologic: neutropenia (72% all-grade/63% grade 3/4), leukopenia (63%/38%), anemia (44%/3%), thrombocytopenia (44%/28%), and lymphopenia (38%/19%), followed by vomiting (38%/0%), fatigue (25%/3%), nausea (25%/0%), and QTc prolongation (22%/0%). Ribociclib exposure was dose-dependent at 350 and 470 mg/m2 [equivalent to 600 (RP2D)–900 mg in adults], with high interpatient variability. Best overall response was stable disease (SD) in nine patients (seven with neuroblastoma, two with primary CNS MRT); five patients achieved SD for more than 6, 6, 8, 12, and 13 cycles, respectively.

Conclusions: Ribociclib demonstrated acceptable safety and PK in pediatric patients. MTD (470 mg/m2) and RP2D (350 mg/m2) were equivalent to those in adults. Observations of prolonged SD support further investigation of ribociclib combined with other agents in neuroblastoma and MRT. Clin Cancer Res; 23(10); 2433–41. ©2017 AACR.
Systolic Blood Pressure Trajectory, Frailty, and All-Cause Mortality >80 Years of Age
Authors: Ravindrarajah Rathi , Hazra Nisha C. , Hamada Shota , Charlton Judith , Jackson Stephen H.D. , Dregan Alex , Gulliford Martin C.
Published: April 2017

Background:

Clinical trials show benefit from lowering systolic blood pressure (SBP) in people ≥80 years of age, but nonrandomized epidemiological studies suggest lower SBP may be associated with higher mortality. This study aimed to evaluate associations of SBP with all-cause mortality by frailty category >80 years of age and to evaluate SBP trajectories before death.

Methods:

A population-based cohort study was conducted using electronic health records of 144 403 participants ≥80 years of age registered with family practices in the United Kingdom from 2001 to 2014. Participants were followed for ≤5 years. Clinical records of SBP were analyzed. Frailty status was classified using the e-Frailty Index into the categories of fit, mild, moderate, and severe. All-cause mortality was evaluated by frailty status and mean SBP in Cox proportional-hazards models. SBP trajectories were evaluated using person months as observations, with mean SBP and antihypertensive treatment status estimated for each person month. Fractional polynomial models were used to estimate SBP trajectories over 5 years before death.

Results:

During follow-up, 51 808 deaths occurred. Mortality rates increased with frailty level and were greatest at SBP <110 mm Hg. In fit women, mortality was 7.7 per 100 person years at SBP 120 to 139 mm Hg, 15.2 at SBP 110 to 119 mm Hg, and 22.7 at SBP <110 mm Hg. For women with severe frailty, rates were 16.8, 25.2, and 39.6, respectively. SBP trajectories showed an accelerated decline in the last 2 years of life. The relative odds of SBP <120 mm Hg were higher in the last 3 months of life than 5 years previously in both treated (odds ratio, 6.06; 95% confidence interval, 5.40–6.81) and untreated (odds ratio, 6.31; 95% confidence interval, 5.30–7.52) patients. There was no evidence of intensification of antihypertensive therapy in the final 2 years of life.

Conclusions:

A terminal decline of SBP in the final 2 years of life suggests that nonrandomized epidemiological associations of low SBP with higher mortality may be accounted for by reverse causation if participants with lower blood pressure values are closer, on average, to the end of life.
Incidence of First Stroke in Pregnant and Nonpregnant Women of Childbearing Age: A Population‐Based Cohort Study From England
Authors: Ban Lu , Sprigg Nikola , Abdul Sultan Alyshah , Nelson‐Piercy Catherine , Bath Philip M. , Ludvigsson Jonas F. , Stephansson Olof , Tata Laila J.
Published: April 2017

Background

Pregnant women may have an increased risk of stroke compared with nonpregnant women of similar age, but the magnitude and the timing of such risk are unclear. We examined the risk of a first stroke event in women of childbearing age and compared the risk during pregnancy and in the early postpartum period with the background risk outside these periods.

Methods and Results

We conducted an open cohort study of 2 046 048 women aged 15 to 49 years between April 1, 1997, and March 31, 2014, using linked primary (Clinical Practice Research Datalink) and secondary (Hospital Episode Statistics) care records in England. Risk of first stroke was assessed by calculating the incidence rate of stroke in antepartum, peripartum (2 days before until 1 day after delivery), and early (first 6 weeks) and late (second 6 weeks) postpartum periods compared with nonpregnant time using a Poisson regression model with adjustment for maternal age, socioeconomic group, and calendar time. A total of 2511 women had a first stroke. The incidence rate of stroke was 25.0 per 100 000 person‐years (95% CI 24.0–26.0) in nonpregnant time. The rate was lower antepartum (10.7 per 100 000 person‐years, 95% CI 7.6–15.1) but 9‐fold higher peripartum (161.1 per 100 000 person‐years, 95% CI 80.6–322.1) and 3‐fold higher early postpartum (47.1 per 100 000 person‐years, 95% CI 31.3–70.9). Rates of ischemic and hemorrhagic stroke both increased peripartum and early postpartum.

Conclusions

Although the absolute risk of first stroke is low in women of childbearing age, healthcare professionals should be aware of a considerable increase in relative risk during the peripartum and early postpartum periods.
ARTEMIDA Trial (A Randomized Trial of Efficacy, 12 Months International Double-Blind Actovegin)
Authors: Guekht Alla , Skoog Ingmar , Edmundson Sally , Zakharov Vladimir , Korczyn Amos D.
Published: April 2017

Background and Purpose—

Poststroke cognitive impairment is a debilitating consequence of stroke. The aim of this study was to assess whether Actovegin confers cognitive benefit in patients who have had an ischemic stroke.

Methods—

This was a 12-month, parallel-group, randomized, multicenter, double-blind, placebo-controlled study. Eligible patients were ≥60 years of age with a Montreal Cognitive Assessment test score of ≤25 points. Patients were randomized into 2 groups within 1 week of acute supratentorial ischemic stroke in a 1:1 ratio: Actovegin (a deproteinized hemoderivative of calf blood, 2000 mg/d for ≤20 intravenous infusions followed by 1200 mg/d orally) or placebo for 6 months. Patients were treated in accordance with standard clinical practice for a further 6 months. The primary end point was the change from baseline in Alzheimer’s Disease Assessment Scale, cognitive subscale, extended version at 6 months.

Results—

Two-hundred forty-eight patients were randomized to Actovegin and 255 patients to placebo. At month 6, the least squares mean change from baseline in Alzheimer’s Disease Assessment Scale, cognitive subscale, extended version was −6.8 for Actovegin and −4.6 for placebo; the estimated treatment difference was −2.3 (95% confidence interval, −3.9, −0.7;
P
=0.005). Recurrent ischemic stroke was the most frequently reported serious adverse event, with a nonsignificantly higher number for Actovegin versus placebo.

Conclusions—

Actovegin had a beneficial effect on cognitive outcomes in patients with poststroke cognitive impairment. The safety experience was consistent with the known safety and tolerability profile of the drug. These results warrant confirmation in additional robustly designed studies.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01582854.
Quantitative Imaging of Cerebral Thromboemboli In Vivo
Authors: Kim Dong-Eog , Kim Jeong-Yeon , Schellingerhout Dawid , Ryu Ju Hee , Lee Su-Kyoung , Jeon Sangmin , Lee Ji Sung , Kim Jiwon , Jang Hee Jeong , Park Jung E. , Kim Eo Jin , Kwon Ick Chan , Ahn Cheol-Hee , Nahrendorf Matthias , Kim Kwangmeyung
Published: April 2017

Background and Purpose—

Quantitative imaging for the noninvasive assessment of thrombolysis is needed to advance basic and clinical thrombosis-related research and tailor tissue-type plasminogen activator (tPA) treatment for stroke patients. We quantified the evolution of cerebral thromboemboli using fibrin-targeted glycol chitosan–coated gold nanoparticles and microcomputed tomography, with/without tPA therapy.

Methods—

We injected thrombi into the distal internal carotid artery in mice (n=50). Fifty-five minutes later, we injected fibrin-targeted glycol chitosan–coated gold nanoparticles, and 5 minutes after that, we treated animals with tPA or not (25 mg/kg). We acquired serial microcomputed tomography images for 24 hours posttreatment.

Results—

Thrombus burden at baseline was 784×10
3
±59×10
3
μm
2
for the tPA group (n=42) and 655×10
3
±103×10
3
μm
2
for the saline group (n=8;
P
=0.37). Thrombus shrinkage began at 0.5 to 1 hour after tPA therapy, with a maximum initial rate of change at 4603±957 μm
2
/min. The rate of change lowered to ≈61% level of the initial in hours 1 to 2, followed by ≈29% and ≈1% in hours 2 to 3 and 3 to 24, respectively. Thus, 85% of total thrombolysis over 24 hours (≈500 μm
2
, equivalent to 64% of the baseline thrombus burden) occurred within the first 3 hours of treatment. Thrombus burden at 24 hours could be predicted at around 1.5 to 2 hours. Saline treatment was not associated with significant changes in the thrombus burden. Infarct size was smaller in the tPA group versus saline group (18.1±2.3 versus 45.8±3.3 mm
2
;
P
<0.01). Infarct size correlated to final thrombus burden (
r
=0.71;
P
<0.01). Time to thrombolysis, completeness of thrombolysis, and tPA therapy were independent predictors of infarct size.

Conclusions—

Thromboembolic burden and the efficacy of tPA therapy can be assessed serially, noninvasively, and quantitatively using high-resolution microcomputed tomography and a fibrin-binding nanoparticle imaging agent.
The Making of One Belt, One Road and Dilemmas in South Asia
Authors: Das Khanindra Ch.
Published: April 2017

China’s One Belt, One Road (OBOR) initiative has attracted worldwide attention, and a solid foundation for the initiative has been laid at home and in the neighbouring regions of Southeast Asia. While many countries may not have imagined the possibility of reviving the Silk Route, China has not only coined the term OBOR but also taken steps to bring it close to reality. Despite the various challenges posed by the initiative to their national strategies and to the regional security order, developing countries along the OBOR have an opportunity to improve connectivity and transform their economic conditions by exploring complementarities through trade, investment and greater people-to-people exchanges. From the South Asian point of view, OBOR presents multiple opportunities as well as dilemmas. The puzzles need to be addressed to shape the connectivity agenda of the region and to harness the benefits of integration, which may require joint development and sharing of responsibility among economically stronger countries. Greater cooperation among South Asian countries will be critical in shaping the connectivity agenda, through OBOR or otherwise, in the South Asian region.
If You Can’t Beat ’em, Join ’em
Authors: Garlick Jeremy
Published: April 2017

China’s ‘One Belt, One Road’ (OBOR) initiative is a grand plan to connect Asia, Europe and East Africa economically. However, from India’s point of view, China’s attempt at what it describes as geo-economic expansion appears as a geopolitical threat because of China’s activity in the Indian Ocean Region (IOR). This essay assesses the extent to which OBOR is (i) realistic and achievable, (ii) a genuine threat to India and (iii) amenable to possible Indian involvement. It concludes that India should continue to be wary of its neighbour in national security terms, but has no option but to cooperate with China economically by participating in OBOR if it seriously wishes to increase economic growth and bring the ‘Make in India’ and Sagarmala projects to fruition. In particular, India should seriously consider allowing Chinese companies to develop one or more Indian ports with associated infrastructure and manufacturing.
China–India Relations under Modi
Authors: Jha Prem Shankar
Published: April 2017

The sweeping changes in the foreign policy of Narendra Modi’s government in India reflect several departures from previous year. Most prominent shift was from non alignment that was designed to steer India clear of involvements that could harm the country by diverting its resources from development and social consolidation into militarisation and war. Another shift is from the policy of equidistance which was not a refusal to get involved but an assertion that India would choose when, where and how to get involved, reflecting the rise of India’s soft power. These shifts have ramifications on bilateral relations of India and China and carry substantial impact on future trends of engagements between the two.
OBOR and EuroAsia’s New Great Game
Authors: Sheng Andrew
Published: April 2017

The Chinese One Belt, One Road (OBOR) strategy will have profound implications for the emerging EuroAsia Great Game. This article suggests that the geopolitical risks are such that it may be better for the fast-growing South and East Asia to work more closely together to achieve development in an environment of cooperative peace.
Scholarly Heroism: A Transdisciplinary Perspective on David Bohm’s Transformative Scholarship and Intellectual Exile
Authors: le Breton Peter
Published: April 2017

In this article, I claim that the best scholars—individuals who achieve the most important advances or breakthroughs in knowledge and understanding—are often heroic. I argue that David Bohm exemplifies scholarly heroism, and my remarks are focused on his ideas and heroic qualities. I define a heroic scholar as a scientist or nonscientist whose commitment to the pursuit of truth is so strong, and whose achievements are so important, that he or she is willing to navigate professional difficulties, even give up income, security, and status, to stay true to themselves and their calling. Such scholars are virtuous, competent, and courageous, which are—according to heroism researchers Goethals and Allison—the three essential characteristics of heroism. Heroic scholars are morally fearless, not willing to compromise their principles (the pursuit of truth in service of good), and sell their souls for the spoils of office.
Affective and Cognitive Orientations in Intergroup Perception
Authors: Wolf Lukas J. , von Hecker Ulrich , Maio Gregory R.
Published: April 2017

Three studies examined the role of need for affect (NFA) and need for cognition (NFC) in intergroup perception. We hypothesized that NFA predicts a preference for stereotypically warm groups over stereotypically cold groups, whereas NFC predicts a preference for stereotypically competent groups over stereotypically incompetent groups. Study 1 supported these hypotheses for attitudes toward stereotypically ambivalent groups, which are stereotyped as high on one of the trait dimensions (e.g., high warmth) and low on the other (e.g., low competence), but not for stereotypically univalent groups, which are seen as high or low on both dimensions. Studies 2 and 3 replicated this pattern for stereotypically ambivalent groups, and yielded provocative evidence regarding several putative mechanisms underlying these associations. Together, these findings help integrate and extend past evidence on attitude-relevant individual differences with research on intergroup perception.
Detection and characterization of small infarcts in the caudate nucleus on 7 Tesla MRI: The SMART-MR study
Authors: Ghaznawi Rashid , de Bresser Jeroen , van der Graaf Yolanda , Zwartbol Maarten HT , Witkamp Theo D , Geerlings Mirjam I , Hendrikse Jeroen
Published: April 2017

Small infarcts are among the key imaging features of cerebral small vessel disease (CSVD), but remain largely undetected on conventional MRI. We aimed to evaluate (1) imaging criteria for the detection of small infarcts in the caudate nucleus on 7T MRI, (2) intra- and inter-rater agreement, (3) frequency and (4) detection rate on 7T versus 1.5T MRI. In 90 patients (68 ± 8 years) with a history of vascular disease from the SMART-MR study, we defined 7T imaging criteria for cavitated and non-cavitated small infarcts in the caudate nucleus. In a separate set of 23 patients from the SMART study, intra-rater and inter-rater agreement was excellent for presence, number, and individual locations (Kappa’s, ICCs, and Dice similarity coefficients ranged from 0.85 to 1.00). In the 90 patients, 21 infarcts (20 cavitated) in 12 patients were detected on 7T (13%) compared to 7 infarcts in 6 patients on 1.5T (7%). In conclusion, we established reproducible imaging criteria for the detection of small infarcts in the caudate nucleus on 7T MRI and showed that 7T MRI allows for a higher detection rate than conventional 1.5T MRI. These imaging criteria can be used in future studies to provide new insights into the pathophysiology of CSVD.
Pneumatic jigging: Influence of operating parameters on separation efficiency of solid waste materials
Authors: Abd Aziz Mohd Aizudin , Md Isa Khairuddin , Ab Rashid Radzuwan
Published: April 2017

This article aims to provide insights into the factors that contribute to the separation efficiency of solid particles. In this study, a pneumatic jigging technique was used to assess the separation of solid waste materials that consisted of copper, glass and rubber insulator. Several initial experiments were carried out to evaluate the strengths and limitations of the technique. It is found that despite some limitations of the technique, all the samples prepared for the experiments were successfully separated. The follow-up experiments were then carried out to further assess the separation of copper wire and rubber insulator. The effects of air flow and pulse rates on the separation process were examined. The data for these follow-up experiments were analysed using a sink float analysis technique. The analysis shows that the air flow rate was very important in determining the separation efficiency. However, the separation efficiency may be influenced by the type of materials used.
Incremental Validity of Self- and Informant Report of Personality Disorders in Later Life
Authors: Cruitt Patrick J. , Oltmanns Thomas F.
Published: April 2017

Research shows moderate agreement between different sources of information when assessing personality disorders (PDs) in older adults. The differences between measurement methods appear to be not only the result of measurement error, but also an indication that each source holds nonredundant information relevant to PD diagnosis. The current article examines three sources of diagnostic information (self-report, informant report, and clinical interview) and the utility of these instruments in predicting important outcomes in older adulthood. We analyzed data from 1,630 adults between the ages of 55 and 64 years participating in a longitudinal study of later life. PD symptomatology was assessed using multiple methods, which were then used to predict health, marital satisfaction, and cognitive decline. All three sources contributed significantly to the prediction of these outcomes, with important implications for the assessment of older adults in research and clinical settings.
Proyek Sepaham: An Experiment in Cross-cultural and Collaborative Journalism Education
Authors: Dodd Andrew , Pasandaran Camelia C. , Green Sue , Octavianto Adi Wibowo , Mardjianto F.X. Lilik Dwi
Published: April 2017

Proyek Sepaham, or Project Understanding, brought together staff and students at the journalism schools at Swinburne University in Melbourne, Australia, and Universitas Multimedia Nusantara in Tangerang, Indonesia, for an exercise in cross-cultural journalism education in which each university separately wrote feature stories and produced multimedia reports in response to questions provided by the other university’s students. The questions reflected topics about which the students felt they lacked understanding about the other country. Once the questions were exchanged, the students produced journalism for readers at the other country’s university, seeking to generate greater understanding of the topics concerned. The results were then published on two inter-connected websites under the banner Proyek Sepaham. This paper explores the nature of the collaboration and discusses the key lessons learnt about the design and scope of the project and its practical day-to-day operation. It also considers how the model might be improved for future collaborative exercises.
Virtual Partnerships: Engaging Students in E-service Learning Using Computer-mediated Communication
Authors: Harris Usha S.
Published: April 2017

Computer-mediated communication has important implications for future classroom learning which is no longer spatially bound or centred around text books. It has the ability to incorporate real-life learning whereby students can make important contributions towards solving global problems without having to leave the campus. This study looked at the impact of virtual communication processes and online tools on student and partner engagement in an on-campus undergraduate unit which enables Australian students to create communication campaigns for a non-government organization in India. The study found that the communication exchanges provided students with opportunities for intercultural dialogue, both in real and virtual spaces, and how to use Information and Communications Technology (ICT) and media within a social justice framework within a transnational working environment. Internet technologies have become part of the daily communication pattern of a new generation of students, who see it as their natural environment in which to learn, play and work. It is thus important to expand students’ use of the global digital network from superficial social interactions towards activities which enable them to become active and informed global citizens.
Is it personal? Teacher’s personality and the principal’s role in professional learning communities
Authors: Benoliel Pascale , Schechter Chen
Published: April 2017

Research results have provided evidence of the potential contribution that professional learning communities (PLCs) can make to enhance school outcomes. While numerous organizational and cultural aspects of schools have been recognized as key requirements for PLC success, researchers have noted that a teacher’s ability to share knowledge in the context of school learning interactions requires certain skills. Our goal is to extend the theoretical understanding and practical implications of individual factors that may support and/or constrain PLC development. Specifically, we discuss teachers’ personality traits from the big five typology, namely, extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience, as a possible explanation for differences in motivation toward social interactions, knowledge sharing, and the general position of the individual teacher in the PLC network. We also address the principal’s role in promoting the process of knowledge sharing and social relationships in PLCs. Practical implications for school members and principals are suggested.
Constructing a ‘first’ First Lady through memory: The case of China’s Peng Liyuan
Authors: Ling Qi , Berkowitz Dan
Published: April 2017

Our study analyzed how cultural memory of previous and contemporary First Ladies was used as a journalistic device by US media to make sense of the unusual case of Peng Liyuan, the current First Lady of China. A textual analysis showed that news coverage of Peng relied on a Western and gendered conception of the First Lady while distancing her from her predecessors. We found that resonance with the idealized First Lady template served to signal Peng’s progressiveness in both the general and the political sense. Although Peng’s performance as a ‘first’ First Lady was celebrated in international politics, it is important to be aware that cultural values and gender norms associated with the First Lady identity can become rhetorical tools that sustain the existing political order between the West and the non-West.