bluuebunny/crossref_metadata_2025 huggingface dataset:
Smart applications for diabetes management: A comprehensive survey and ranking
Authors: Ubaid Ur Rehman Muhammad , Aleem Muhammad , Islam Muhammad Arshad , Ahmed Salman
Published: October 2019

Diabetes is a chronic disease, and its treatment requires intensive management of medication, diet, and exercise. Nowadays, information and communication technology provides diverse facilities to patients and medical specialists to manage different diseases in an efficient manner with the help of smartphone technology. Earlier studies have not ranked diabetes management apps by correlating each app feature, and their review is not comprehensive. Therefore, this study presents a comprehensive analysis of the existing diabetes-related smartphone applications. Moreover, we examine the factors based on which most of the users provide a higher rank to a particular application. We classify the diabetes mobile applications with respect to the application features and perform rigorous analysis of the top 15 applications. The results indicate that there exists a weak correlation between the number of downloads and user ratings. For evaluation, we calculate the normalized discounted cumulative gain score to rank applications based on its features. The results demonstrate that a higher normalized discounted cumulative gain score is attained by those mobile applications that contain the data-sharing feature.
Recognizing software names in biomedical literature using machine learning
Authors: Wei Qiang , Zhang Yaoyun , Amith Muhammad , Lin Rebecca , Lapeyrolerie Jenay , Tao Cui , Xu Hua
Published: October 2019

Software tools now are essential to research and applications in the biomedical domain. However, existing software repositories are mainly built using manual curation, which is time-consuming and unscalable. This study took the initiative to manually annotate software names in 1,120 MEDLINE abstracts and titles and used this corpus to develop and evaluate machine learning–based named entity recognition systems for biomedical software. Specifically, two strategies were proposed for feature engineering: (1) domain knowledge features and (2) unsupervised word representation features of clustered and binarized word embeddings. Our best system achieved an F-measure of 91.79% for recognizing software from titles and an F-measure of 86.35% for recognizing software from both titles and abstracts using inexact matching criteria. We then created a biomedical software catalog with 19,557 entries using the developed system. This study demonstrates the feasibility of using natural language processing methods to automatically build a high-quality software index from biomedical literature.
Experiments and modeling of a dual-mode, turbulent jet ignition engine
Authors: Tolou Sedigheh , Schock Harold
Published: October 2019

The dual-mode, turbulent jet ignition system is a promising combustion technology to achieve high diesel-like thermal efficiency at medium to high loads and potentially exceed diesel efficiency at low-load operating conditions. The dual-mode, turbulent jet ignition systems to date proved a high level of improvement in thermal efficiency compared to conventional internal combustion engines. However, some questions were still unanswered. The most frequent question regarded power requirements for delivering air to the pre-chamber of a dual-mode, turbulent jet ignition system. In addition, there was no study available to predict the expected efficiency of a dual-mode, turbulent jet ignition engine in a multi-cylinder configuration. This study, for the first time, predicts the ancillary work requirement to operate the dual-mode, turbulent jet ignition system. It also presents a novel, reduced order, and physics-based model of the dual-mode, turbulent jet ignition engine with a pre-chamber valve assembly. The developed model was calibrated based on experimental data from the Prototype II dual-mode, turbulent jet ignition engine. The simulation results were in good agreement with the experimental data. The validity of the model was observed based on the standard metric of the coefficient of determination as well as comparison plots for in-cylinder pressures. Numerical predictions were compared to experiments for three metrics of main chamber combustion: gross indicated mean effective pressure, main chamber peak pressure, and main chamber phasing for the peak pressure. Predictions were within 5% of experimental data, with one exception of 6%. In addition, the absolute root mean square errors of in-cylinder pressures for both pre- and main-combustion chambers were below 0.35. The calibrated model was further studied to introduce a predictive and generalized model for dual-mode, turbulent jet ignition engines. Such a model can project engine behavior in a multi-cylinder configuration over the entire engine fuel map.
Multi-class classification of biomechanical data: A functional LDA approach based on multi-class penalized functional PLS
Authors: Aguilera-Morillo M. Carmen , Aguilera Ana M.
Published: October 2019

A functional linear discriminant analysis approach to classify a set of kinematic data (human movement curves of individuals performing different physical activities) is performed. Kinematic data, usually collected in linear acceleration or angular rotation format, can be identified with functions in a continuous domain (time, percentage of gait cycle, etc.). Since kinematic curves are measured in the same sample of individuals performing different activities, they are a clear example of functional data with repeated measures. On the other hand, the sample curves are observed with noise. Then, a roughness penalty might be necessary in order to provide a smooth estimation of the discriminant functions, which would make them more interpretable. Moreover, because of the infinite dimension of functional data, a reduction dimension technique should be considered. To solve these problems, we propose a multi-class approach for penalized functional partial least squares (FPLS) regression. Then linear discriminant analysis (LDA) will be performed on the estimated FPLS components. This methodology is motivated by two case studies. The first study considers the linear acceleration recorded every two seconds in 30 subjects, related to three different activities (walking, climbing stairs and down stairs). The second study works with the triaxial angular rotation, for each joint, in 51 children when they completed a cycle walking under three conditions (walking, carrying a backpack and pulling a trolley). A simulation study is also developed for comparing the performance of the proposed functional LDA with respect to the corresponding multivariate and non-penalized approaches.
Male Vocal Quality and Its Relation to Females’ Preferences
Authors: Suire Alexandre , Raymond Michel , Barkat-Defradas Melissa
Published: October 2019

In both correlational and experimental settings, studies on women’s vocal preferences have reported negative relationships between perceived attractiveness and men’s vocal pitch, emphasizing the idea of an adaptive preference. However, such consensus on vocal attractiveness has been mostly conducted with native English speakers, but a few evidence suggest that it may be culture-dependent. Moreover, other overlooked acoustic components of vocal quality, such as intonation, perceived breathiness and roughness, may influence vocal attractiveness. In this context, the present study aims to contribute to the literature by investigating vocal attractiveness in an underrepresented language (i.e., French) as well as shedding light on its relationship with understudied acoustic components of vocal quality. More specifically, we investigated the relationships between attractiveness ratings as assessed by female raters and male voice pitch, its variation, the formants’ dispersion and position, and the harmonics-to-noise and jitter ratios. Results show that women were significantly more attracted to lower vocal pitch and higher intonation patterns. However, they did not show any directional preferences for all the other acoustic features. We discuss our results in light of the adaptive functions of vocal preferences in a mate choice context.
Sac Embolization and Side Branch Embolization for Preventing Type II Endoleaks After Endovascular Aneurysm Repair: A Meta-analysis
Authors: Li Qiyi , Hou Peiyong
Published: October 2019

Purpose:To investigate the efficacy and safety of preoperative side branch embolization or intraoperative sac embolization for preventing type II endoleaks after endovascular aneurysm repair (EVAR). Materials and Methods: A systematic literature search of MEDLINE and EMBASE was performed to identify studies that evaluated the outcomes of sac embolization vs no embolization or side branch embolization vs no embolization in patients who received EVAR. Among the 904 studies screened, 17 studies with 2084 participants were included in this review. Outcome measures included the type II endoleak rate, the reintervention rate for type II endoleaks, the incidence of types I/III endoleaks, and the rate of complications. Fixed (no heterogeneity) or random effects models were constructed for each outcome; the results are presented as the odds ratio (OR) with 95% confidence interval (CI). Results: The sac embolization group had significantly lower type II endoleak (OR 0.21, 95% CI 0.13 to 0.34, p<0.001) and reintervention (OR 0.15, 95% CI 0.07 to 0.33, p<0.001) rates than the no embolization group. No significant differences between the 2 groups were found for the type I/III endoleak rate (OR 0.57, 95% CI 0.23 to 1.37, p=0.21) or complication rate (OR 1.22, 95% CI 0.32 to 4.70, p=0.77). Compared with no embolization, side branch embolization was also associated with a decrease in type II endoleak (OR 0.35, 95% CI 0.21 to 0.60, p<0.001) and reinterventions (OR 0.10, 95% CI 0.04 to 0.27, p<0.001). One severe procedure-related complication (fatal colon ischemia) was reported in the side branch embolization group. Conclusion: Sac embolization and side branch embolization are safe and effective in preventing type II endoleaks. Further randomized trials are needed to directly compare the clinical outcomes of these procedures.
Naturopathic Oncology Care for Pediatric Cancers: A Practice Survey
Authors: Psihogios Athanasios , Ennis Jullie K. , Seely Dugald
Published: October 2019

Background: The majority of pediatric oncology patients report use of complementary and alternative medicine. Some naturopathic doctors (NDs) provide supportive pediatric oncology care; however, little information exists to formally describe this clinical practice. A survey was conducted with members of the Oncology Association of Naturopathic Physicians (OncANP.org) to describe recommendations across four therapeutic domains: natural health products (NHPs), nutrition, physical medicine, and mental/emotional support. Results: We had 99 respondents with a wide variance of clinical experience and aptitude to treat children with cancer. Of the majority (52.5%) of respondents who choose not to treat these children, the three primary reasons for this are lack of public demand (45.1%), institutional or clinic restrictions (21.6%), and personal reasons/comfort (19.6%). The 10 most frequently considered NHPs by all NDs are fish-derived omega-3 fatty acid (83.3%), vitamin D (83.3%), probiotics (82.1%), melatonin (73.8%), vitamin C (72.6%), homeopathic Arnica (69.0%), turmeric/curcumin (67.9%), glutamine (66.7%), Astragalus membranaceus (64.3%), and Coriolus versicolor/PSK (polysaccharide K) extracts (61.9%). The top 5 nutritional recommendations are anti-inflammatory diets (77.9%), dairy restriction (66.2%), Mediterranean diet (66.2%), gluten restriction (61.8%), and ketogenic diet (57.4%). The top 5 physical modality interventions are exercise (94.1%), acupuncture (77.9%), acupressure (72.1%), craniosacral therapy (69.1%), and yoga (69.1%). The top 5 mental/emotional interventions are meditation (79.4%), art therapy (77.9%), mindfulness-based stress reduction (70.6%), music therapy (70.6%), and visualization therapy (67.6%). Conclusion: The results of our clinical practice survey highlight naturopathic interventions across four domains with a strong rationale for further inquiry in the care of children with cancer.
Use of a Wearable EEG Headband as a Meditation Device for Women With Newly Diagnosed Breast Cancer: A Randomized Controlled Trial
Authors: Millstine Denise M. , Bhagra Anjali , Jenkins Sarah M. , Croghan Ivana T. , Stan Daniela L. , Boughey Judy C. , Nguyen Minh-Doan T. , Pruthi Sandhya
Published: October 2019

Background: Breast cancer diagnosis and treatment affect quality of life and stress and are associated with fatigue. Meditation interventions are effective strategies for patients with breast cancer but are often limited by poor access, high cost, substantial time commitment, and poor adherence. In this feasibility study, we investigated the use of a portable, wearable, electroencephalographic device for guided meditation practices by breast cancer patients during the period from breast cancer diagnosis until 3 months after surgical treatment. Methods: We enrolled women (age = 20-75 years) who had received a recent diagnosis of breast cancer and planned to undergo surgical treatment. Participants were randomly assigned to perform guided meditation with the device (intervention group) or receive CD-based stress-reduction education (control group). Surveys were used to measure stress, quality of life, and fatigue at baseline, within 4 days before surgery, up to 14 days after surgery, and at 3 months after surgery. Results: In the intervention group, 15 of 17 participants (88.2%) completed the study; in the control group, 13 of 13 participants completed the study (100%). Participants in both groups had less fatigue and stress and improved quality of life at 2 weeks and 3 months after surgery compared with baseline, but there were no significant intergroup differences at any time point. Conclusion: The use of this wearable electroencephalographic device for meditation is a feasible strategy for patients with breast cancer.
The role of cholesterol and cholesterol-driven membrane raft domains in prostate cancer
Authors: Hryniewicz-Jankowska Anita , Augoff Katarzyna , Sikorski Aleksander F
Published: October 2019

Membrane rafts are heterogeneous and dynamic domains that are characterized by tight packing of lipids. They are enriched in cholesterol, sphingolipids, and certain types of proteins. Among these are various cell signaling proteins, which indicate that rafts play an important role in cell signal transduction pathways, including some involved in cancer development, progression, and invasiveness. Due to their increased cholesterol content, raft domains exhibit lower fluidity than the surrounding membrane. The cell membranes of some solid tumors, such as breast and prostate cancer, contain higher levels of cholesterol, which means larger raft domain can form in those membranes. This may stimulate signaling pathways to promote tumor growth and progression. This review focuses on the known raft-dependent regulatory mechanisms that promote prostate cancer progression.

Impact statement

Prostate cancer remains the most common malignancy and second most frequent cause of cancer-related death in men. Cholesterol levels are usually higher in prostate cancer cells. This affects the cell membrane composition, with cholesterol and sphingolipid-containing raft membrane domains becoming a greater component. In addition to polar lipids, these domains recruit and regulate certain types of protein, including various cell signaling proteins that are critical to cancer cell survival and invasiveness. This suggests that membrane rafts have a regulatory role in tumor progression, making them a potential target in prostate cancer treatment.
Polymorphism of xenobiotic metabolizing gene and susceptibility of epithelial ovarian cancer with reference to organochlorine pesticides exposure
Authors: Sharma Tusha , Banerjee Basu D , Thakur Gaurav K , Guleria Kiran , Mazumdar Darshana
Published: October 2019

The transformation of ovarian surface epithelial cells, stromal cells, sex cord, or germ cells initiates ovarian malignancy. Epithelial ovarian cancer (EOC) is clinically silent with vague, non-specific symptomatology and is generally diagnosed at an advanced stage, resulting in a high mortality rate. The known main etiological factors are: age at menarche and menopause (early menarche or late menopause), use of oral contraception (estrogen and/or progesterone), family history, genetic factors, inflammation, occupational and environmental exposure. The study is intended to assess the association between blood organochlorine pesticide (OCP) levels and polymorphic status of phase I and phase II metabolizing enzymes (CYP1A1, GSTM1, and GSTT1) in the pathogenesis of epithelial ovarian cancer. The study included 200 subjects in total, of which 100 were epithelial ovarian cancer cases and 100 were controls. Estimation of blood organochlorine pesticide levels was carried out using gas chromatography and significantly high levels of beta-hexachlorocyclohexane (β-HCH), endosulfan-I, endosulfan-II, dichlorodiphenyltrichloroethane (pʹpʹ-DDT), dichlorodiphenyldichloroethylene (pʹpʹ-DDE) were observed in cases as compared to controls ( P-value = 0.029, 0.042, 0.044, 0.039 and 0.037 respectively). For studying the polymorphism of CYP1A1, GSTM1/T1, PCR-RFLP, AS-PCR and multiplexing were performed and the frequency of null deletion of GSTM1/T1 was significantly higher in epithelial ovarian cancer cases. Regression model testing was also performed to check the interactive effect of organochlorine pesticide levels and polymorphic variant of genes keeping CA-125 as the dependent variable and observed a statistically significant role of genotypic/environmental interaction in epithelial ovarian cancer cases in the North Indian population.

Impact statement

Among pervasive environmental toxins, OCPs are one of the largest and most hazardous classes of contaminants in use around the world. Because these compounds possess the estrogen mimicking properties, the accumulation of these compounds in the human body may be a risk for several hormone-dependent diseases. EOC is hormonally dependent cancer and the mortality rate due to this disease is increasingly prevalent, and it has become imperative to explore the role of OCPs in the disease pathogenesis. The present study highlights the significant association of high OCPs level in the disease pathogenesis. It is also observed that the polymorphism in xenobiotic metabolism enzymes alters the predisposition of OCPs. The synergistic effect of gene polymorphism (CYP1A1, GSTM1, and GSTT1) and non-occupational exposure to OCPs was also assessed considering CA125 level as dependent variable with the risk of EOC and concluded that there exist a potential role of genotypic/environmental interaction in the etiology of EOC.
Rescue Balloon Aortic Valvuloplasty After Sutureless Aortic Valve Replacement for Severe Paravalvular Leak
Authors: Nagaoka Eiki , Sato Keita , Hage Ali , Bagur Rodrigo , Harle Christopher , Asopa Sanjay , Kiaii Bob
Published: October 2019

Sutureless aortic valve replacement (AVR) is a wide-spreading new technology that provides short clamping time and excellent hemodynamic outcomes. However, among its possible complications is the risk of paravalvular leak. We present the case of a 63-year-old woman who underwent minimally invasive right mini-thoracotomy AVR) with Perceval S sutureless valve (LivaNova, London, UK). Intraoperative transesophageal echocardiography revealed severe paravalvular leak with stent distortion. Rescue balloon valvuloplasty was performed through the right femoral artery, and resulted in the resolution of the paravalvular leak. This case illustrates the utility and feasibility of balloon valvuloplasty in trouble-shooting sutureless aortic valve stent distortion, thus avoiding a repeat aortic cross-clamp and valve replacement.
Ambivalence among staff regarding ageing with intellectual disabilities: Experiences and reflections
Authors: Alftberg Åsa , Johansson Maria , Ahlström Gerd
Published: October 2019

This study explores the experiences and reflections of staff in intellectual disability (ID) services concerning ageing with ID. Qualitative interviews were conducted with 24 staff members in group homes and daily activity centres. The findings showed that the staff were uncertain about the signs of ageing in people with intellectual disabilities; they compared the life conditions of these people with conditions in older people without intellectual disabilities. Their emphasis on an active lifestyle was very strong. The staff members also mentioned uncertainty about how to facilitate assistive devices and whether ‘ageing in place’ was the best solution. The overall theme was manifested as ambivalence where notions of older people with intellectual disabilities seemed incompatible with notions of old age in general and could be explained by the theoretical concept of age coding. The findings of this study indicate the need to provide education about ageing to staff working in ID services.
Mechanical thrombectomy in patients with acute ischemic stroke: A cost-effectiveness and value of implementation analysis
Authors: Heggie Robert , Wu Olivia , White Phil , Ford Gary A , Wardlaw Joanna , Brown Martin M , Clifton Andrew , Muir Keith W
Published: October 2019

Background

Recent clinical trials have demonstrated the efficacy of mechanical thrombectomy in acute ischemic stroke.

Aims

To determine the cost-effectiveness, value of future research, and value of implementation of mechanical thrombectomy.

Methods

Using UK clinical and cost data from the Pragmatic Ischemic Stroke Thrombectomy Evaluation (PISTE) trial, we estimated the cost-effectiveness of mechanical thrombectomy over time horizons of 90-days and lifetime, based on a decision-analytic model, using all existing evidence. We performed a meta-analysis of seven clinical trials to estimate treatment effects. We used sensitivity analysis to address uncertainty. Value of implementation analysis was used to estimate the potential value of additional implementation activities to support routine delivery of mechanical thrombectomy.

Results

Over the trial period (90 days), compared with best medical care alone, mechanical thrombectomy incurred an incremental cost of £5207 and 0.025 gain in QALY (incremental cost-effectiveness ratio (ICER) £205,279), which would not be considered cost-effective. However, mechanical thrombectomy was shown to be cost-effective over a lifetime horizon, with an ICER of £3466 per QALY gained. The expected value of perfect information per patient eligible for mechanical thrombectomy in the UK is estimated at £3178. The expected value of full implementation of mechanical thrombectomy is estimated at £1.3 billion over five years.

Conclusion

Mechanical thrombectomy was cost-effective compared with best medical care alone over a patient’s lifetime. On the assumption of 30% implementation being achieved throughout the UK healthcare system, we estimate that the population health benefits obtained from this treatment are greater than the cost of implementation.

Trial registration

NCT01745692.
Predictive feedback augmentation for manual control of an unmanned aerial vehicle with latency
Authors: Cox Jeremy , Wong KC
Published: October 2019

Teleoperation of unmanned aerial vehicles is hampered by communication delay, which causes feedback from command inputs to take considerable time to be displayed to the operator. For an international internet connection, round trip latencies can reach 500 ms. The satellite connections used for military unmanned aerial vehicles can have latencies in the order of seconds. This delay presents a substantial control problem, which has been solved in the past by control abstraction (instead of “roll left” the aircraft might be instructed “go to these coordinates”). Manual control remains difficult. This study borrows the client-side prediction concept from multiplayer video games to attempt to address the control delay to allow manual control. An estimate of the change in the vehicle state due to the commands that are yet to affect the feedback is computed and then the feedback that the pilot receives is modified to reflect this predicted change. Because of this change, the pilot can see immediately the effect of the control inputs. This study has explored the concept and built a prototype system functional in real time for flight testing with qualitative results presented.
Long noncoding RNA LSINCT5 promotes endometrial carcinoma cell proliferation, cycle, and invasion by promoting the Wnt/β-catenin signaling pathway via HMGA2
Authors: Jiang Hongye , Li Yong , Li Jie , Zhang Xuyu , Niu Gang , Chen Shuqin , Yao Shuzhong
Published: October 2019

Background:

A review of the evidence has indicated the critical role of long noncoding RNA (lncRNA) LSINCT5 in a large number of human cancers. However, the mechanistic involvement of LSINCT5 in endometrial carcinoma (EC) is still unknown. Here the authors aim to characterize the expression status of LSINCT5 and elucidate its mechanistic relevance to EC.

Methods:

Relative expression of LSINCT5 and HMGA2 were quantified by a real-time polymerase chain reaction. SiRNAs were employed to specifically knockdown endogenous LSINCT5 in EC cells. Cell proliferation was measured with Cell Count Kit-8 kit (CCK-8, Dojindo, Kumamoto, Japan) and cell growth was assessed by a colony formation assay. The cell cycle was analyzed with propidium iodide (PI) staining. Apoptotic cells were determined by flow cytometry after Annexin V/PI double-staining. Cell migration was evaluated by a wound-healing assay, and cell invasion was assessed using a transwell migration assay. The protein levels of HMGA2, Wnt3a, p-β-catenin, c-myc, β-actin, and GAPDH were determined by western blot.

Results:

The authors observed positively correlated and aberrantly up-regulated LSINCT5 and HMGA2 in EC. LSINCT5 deficiency significantly inhibited cell proliferation, cell cycle progression, and induced apoptosis. Meanwhile, cell migration and invasion were greatly compromised by the LSINCT5 knockdown. LSINCT5 stabilized HMGA2, which subsequently stimulated activation of Wnt/β-catenin signaling and consequently contributed to the oncogenic properties of LSINCT5 in EC.

Conclusions:

Our data uncovered the oncogenic activities and highlighted the mechanistic contributions of the LSINCT5-HMGA2-Wnt/β-catenin signaling pathway in EC.
Sex-Based Differences in the Incidence of Sports-Related Concussion: Systematic Review and Meta-analysis
Authors: Cheng Jennifer , Ammerman Brittany , Santiago Kristen , Jivanelli Bridget , Lin Emerald , Casey Ellen , Ling Daphne
Published: October 2019

Context:

The incidence of sports-related concussion in females has been increasing in recent years.

Objective:

To conduct a meta-analysis on sex-based differences in concussion incidence in various sports and to determine the effects of study design (retrospective vs prospective), setting (competition vs practice), and population (university and above vs high school and below) via a meta-regression.

Data Sources:

PubMed (Medline), EMBASE, and Cochrane Library databases were searched from January 2000 to January 2018.

Study Selection:

Studies reporting sports-related concussion incidence data for both males and females (age ≥10 years) were included.

Study Design:

Systematic review with meta-analysis and meta-regression.

Level of Evidence:

Level 4.

Methods:

The rate ratio was calculated as the concussion rate in females/males. Data were pooled using the DerSimonian-Laird random-effects model.

Results:

Thirty-eight studies met the eligibility criteria and were included in the meta-analysis. Soccer and basketball demonstrated significantly higher incidence of concussions in females compared with males (rate ratio [95% CI], 1.76 [1.43-2.16] and 1.99 [1.56-2.54], respectively; P < 0.01). Sex-based differences in concussion incidence rates for baseball/softball, ice hockey, lacrosse, swimming/diving, and track and field were not statistically significant. In the meta-regression analysis, there were no significant effects on the rate ratio when evaluating study design, setting, and population.

Conclusion:

Concussion incidence rates were significantly higher in females than in males for soccer and basketball.
Follow-up Management of Patients After Transsphenoidal Approach for Resection of Pituitary Adenomas
Authors: Ikeda Allison K. , Luk Lauren J. , Patel Zara M. , Oyesiku Nelson M. , Solares C. Arturo , DelGaudio John M. , Levy Joshua M. , Wise Sarah K.
Published: October 2019

Background

Endoscopic transsphenoidal adenomectomy (eTSA) is widely utilized for resection of pituitary adenoma. eTSA patients undergo healing for weeks to months and are potentially at risk for complications. Multidisciplinary follow-up monitoring is necessary. We hypothesized that patients with deviations from the routine postoperative course, broadly termed complications of interest (COI) in this study, following eTSA would increase the duration of follow-up in the rhinology clinic.

Methods

Retrospective review was performed on patients undergoing eTSA for pituitary adenoma from August 2007 to May 2016 at a single tertiary care center. COIs were reviewed for their influence on follow-up time.

Results

A total of 985 patient records were reviewed (mean age 51.0 ± 15.7 years, 55.2% female), of which, 21.1% of patients had a deviation from the expected postoperative course (7.0% rhinologic, 10.8% surgical, 0.6% perioperative medical, and 2.7% endocrinologic COIs). The most common COI was cerebrospinal fluid leak 5.6% (n = 55) followed by sinusitis 5.0% (n = 49). Moreover, 935 patients (94.9%) attended rhinology follow-up (172 patients with COI). For patients seen postoperatively by the rhinology service, COIs significantly increased the number of rhinologic follow-up visits (median 2 [interquartile range, IQR: 2–3] vs 3 visits [IQR: 2–4], P < .001), duration of rhinologic follow-up (median 54.0 days [IQR: 43.0–104.0] vs 88.0 days [IQR: 54.5–242.0], P < .001), and duration of overall multidisciplinary follow-up (median 354.0 days [IQR: 104.0–789.0] vs 537.0 days [IQR: 171.5–1313.5], P < .001), compared to those without COIs.

Conclusions

Patients who develop postoperative complications after eTSA have significantly extended follow-up with the multidisciplinary team.
Advanced magnetic resonance imaging of cortical laminar necrosis in patients with stroke
Authors: Cannella Roberto , Sparacia Gianvincenzo , Lo Re Vincenzina , Oddo Elisa , Mamone Giuseppe , Miraglia Roberto
Published: October 2019

Purpose

The aim of this study was to assess the novel advanced magnetic resonance imaging findings of acute stage cortical laminar necrosis developing after complicated cardiovascular or abdominal surgery.

Materials and methods

This institutional review board-approved study included patients with postoperative stroke due to cortical laminar necrosis imaged with magnetic resonance in the acute stage. Brain magnetic resonance imaging examinations were obtained on a 3T magnetic resonance scanner within 48 hours of the neurological symptoms, including diffusion-weighted images (b value, 1000 s/mm2) and arterial spin labelling using a pseudo-continuous arterial spin labelling method in four patients. Conventional and advanced magnetic resonance images were analysed to assess the imaging features in acute stage cortical laminar necrosis.

Results

The final population consisted of 14 patients (seven men and seven women, mean age 61 years, range 32–79 years) diagnosed with stroke and acute phase cortical laminar necrosis. All the patients presented with cortical lesions showing restricted diffusion on diffusion-weighted images and hypointensity on the apparent diffusion coefficient map. Cortical hyperintensity on T2-weighted or fluid-attenuated inversion recovery images was found in three (21%) and six (43%) patients, respectively. Reduced perfusion was noted in three out of four patients imaged with arterial spin labelling, while in one case no corresponding perfusion abnormality was noted on the arterial spin labelling maps. Arterial spin labelling abnormalities were much more extensive than diffusion restriction in two patients, and they were associated with a poor outcome.

Conclusion

Cortical hyperintense abnormalities on diffusion-weighted imaging may be the only sign of developing cortical laminar necrosis injury. The acquisition of arterial spin labelling helps to identify perfusion alterations and the extension of the ischaemic injury.
Does the addition of a supportive chatbot promote user engagement with a smoking cessation app? An experimental study
Authors: Perski Olga , Crane David , Beard Emma , Brown Jamie
Published: October 2019

Objective

The objective of this study was to assess whether a version of the Smoke Free app with a supportive chatbot powered by artificial intelligence (versus a version without the chatbot) led to increased engagement and short-term quit success.

Methods

Daily or non-daily smokers aged ≥18 years who purchased the ‘pro’ version of the app and set a quit date were randomly assigned (unequal allocation) to receive the app with or without the chatbot. The outcomes were engagement (i.e. total number of logins over the study period) and self-reported abstinence at a one-month follow-up. Unadjusted and adjusted negative binomial and logistic regression models were fitted to estimate incidence rate ratios (IRRs) and odds ratios (ORs) for the associations of interest.

Results

A total of 57,214 smokers were included (intervention: 9.3% (5339); control: 90.7% (51,875). The app with the chatbot compared with the standard version led to a 101% increase in engagement (IRRadj = 2.01, 95% confidence interval (CI) = 1.92–2.11, p < .001). The one-month follow-up rate was 10.6% (intervention: 19.9% (1,061/5,339); control: 9.7% (5,050/51,875). Smokers allocated to the intervention had greater odds of quit success (missing equals smoking: 844/5,339 vs. 3,704/51,875, ORadj = 2.38, 95% CI = 2.19–2.58, p < .001; follow-up only: 844/1,061 vs. 3,704/5,050, ORadj = 1.36, 95% CI = 1.16–1.61, p < .001).

Conclusion

The addition of a supportive chatbot to a popular smoking cessation app more than doubled user engagement. In view of very low follow-up rates, there is low quality evidence that the addition also increased self-reported smoking cessation.
Applying a Delphi process towards assessing the status and conceptualization of intercultural communication studies in china
Authors: Gefei Suo , Kulich Steve
Published: October 2019

Aiming at pooling the opinions of internationally and nationally known intercultural experts on the status and conceptualization of intercultural communication studies in China, this research project adopted a Delphi process. Exploratory questionnaires were sent to an identified set of experts (N = 45) via email for the first stage, responses (N = 34) compiled, evaluated, and questions edited; a more focused questionnaire redistributed to experts for the second stage (N = 20); and a summary of findings was checked and confirmed for the third stage (N = 15). Themes and theoretical issues were formulated through each stage, compiled, and where possible integrated. This research process has generated the following findings: (1) leading topics related to intercultural communication are identified; (2) major research methodologies adopted in each related field are examined; (3) highly cited authors and theories most applied in intercultural communication studies are ranked; (4) emerging trends in the field are listed; and (5) assessments and recommendations for the ongoing development, significance, and relevance of intercultural communication studies in the Chinese context are highlighted. Strengths and weaknesses of the results and this study are then noted toward future development of the field.
Lessons of the dragon: Bruce Lee and perfectionism between East and West
Authors: Barrowman Kyle
Published: October 2019

This article endeavors to understand the work of Bruce Lee, particularly his appearance on the US television series Longstreet (1971–1972), with reference to the philosophical concept of perfectionism. Although in extant scholarship Lee has often been presented as an anti-Confucian figure, this article reexamines Lee’s Confucian connections vis-à-vis perfectionism. By virtue of an investigation into the centrality of the concepts of character, volition, and self-actualization in Confucianism, in conjunction with an analysis of their prominence in Western (specifically, Aristotelian and Emersonian) philosophy, this article situates Lee between Eastern and Western perfectionist traditions. This article then examines Lee’s work on Longstreet in an effort to elucidate the perfectionist ethos that fueled Lee’s philosophy of Jeet Kune Do and, by extension, his media pedagogy regarding teaching and learning martial arts. Ultimately, this article argues that Lee represents a quintessential perfectionist pedagogue and that the most important lessons to be learned from Lee involve such perfectionist hallmarks as building character, cultivating virtue, and self-actualizing.
Accelerated Move for AI Education in China
Authors: Yang Xiaozhe
Published: October 2019

Purpose:

This article summarizes recent developments in the use of artificial intelligence (AI) in Chinese education, paying particular attention to the different applications of AI at a number of different levels. The article reviews key government policies and guidelines and suggests a course for future development.

Design/Approach/Methods:

The article analyzes key government policies relevant to the implementation of AI in Chinese education. Additionally, the article leverages the author’s experience as a key member of national information technology curriculum development, which involved participation in the drafting of various curriculum standards and policy documents and discussions with numerous administrative officials, teachers, and researchers.

Findings:

This article argues that the use of AI in Chinese education varies at different levels. AI implementation is at its early stage in elementary education; more prevalent in higher education, and even more common in the field of civic education. As a result, in multiple dimensions, Chinese students are becoming better trained to face an age of AI and working together to create an informatized education environment.

Originality/Value:

This article describes how China is searching for the point where top-down system design meets bottom-up applications to chart its own course for the use of AI in education.
The Future of Learning and the Future of Assessment
Authors: Elmore Richard F.
Published: October 2019

Purpose:

The aim of this article is to point out that assessment should serve as useful information about the development of learners’ capabilities, but not define, measure, evaluate, and confer “merit.”

Design/Approach/Methods:

By arguing the current assessments are institutionalized which have deeply embedded social, cultural, and political purposes and ignoring learning at the individual or collective level, this article redefines learning, schooling, and assessment. Learning should be embodied, highly individualized, highly contextual, and lifelong, so schooling and assessment should support such learning form rather than perform attainment, custody, and control. Neurological basis of learning in human beings supports the new definition.

Findings:

Assessment should provide valuable information to guide, give feedback, and support the dynamic feature of learning. Future assessment is a tool to reflect how learners judge their learning, how they develop as a learning organism, and how they have the ability to develop agency and control over learning.

Originality/Value:

This article gives learning, schooling, and assessment new definitions combining the current situation and neurological evidence. It would be a thorough and novel guideline for the designing of future assessment.
The Influence of Stigma and Views on Mental Health Treatment Effectiveness on Service Use by Age and Ethnicity: Evidence From the CDC BRFSS 2007, 2009, and 2012
Authors: Min Jong Won
Published: October 2019

The purpose of this study is to conduct a cross-cultural comparison of perceived public stigma of mental health and views on mental health treatment effectiveness and their effects on service use among the U.S. adult population of White, Black, and Hispanic ethnic backgrounds. The pooled data came from the 2007, 2009, and 2012 Centers of Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) survey, which included unweighted sample sizes of 149,344 Whites, 11,156 Blacks, and 11,072 Hispanic adults aged 55 years old or older. For both 55 to 64 and 65+ age groups, White respondents were most likely to hold greater perceived public stigma. Middle-aged Hispanic adults also showed high levels of perceived public stigma, though not as high as White counterparts. Hispanic adults of both age groups had the least favorable views on the effectiveness of mental health treatment. Among Whites and Hispanics who were not psychologically distressed, unfavorable views on treatment effectiveness significantly reduced the likelihood of seeking mental health services. Given age and ethnic differences in perceived public stigma and views on mental health treatment effectiveness, future efforts aimed at combating stigma should be tailored around various factors for effective intervention strategies.
Cervical, Thoracic, and Spinopelvic Compensation After Proximal Junctional Kyphosis (PJK): Does Location of PJK Matter?
Authors: Kim Han Jo , York Philip J. , Elysee Jonathan C. , Shaffrey Christopher , Burton Douglas C. , Ames Christopher P. , Mundis Gregory M. , Hostin Richard , Bess Shay , Klineberg Eric , Smith Justin S. , Passias Peter , Schwab Frank , Lafage Renaud ,   the International Spine Study Group(ISSG)
Published: October 2019

Study Design:

Retrospective case series.

Objective:

Compensatory changes above a proximal junctional kyphosis (PJK) have not been defined. Understanding these mechanisms may help determine optimal level selection when performing revision for PJK. This study investigates how varying PJK location changes proximal spinal alignment.

Methods:

Patients were grouped by upper instrumented vertebrae (UIV): lower thoracic (LT; T8-L1) or upper thoracic (UT; T1-7). Alignment parameters were compared. Correlation analysis was performed between PJK magnitude and global/cervical alignment.

Results:

A total of 369 patients were included; mean age of 63 years, body mass index 28, and 81% female, LT (n = 193) versus UT (n = 176). The rate of radiographic PJK was 49%, higher in the LT group (55% vs 42%, P = .01). The UT group displayed significant differences in all cervical radiographic parameters ( P < .05) between PJK versus non-PJK patients, while the LT group displayed significant differences in T1S and C2-T3 sagittal vertical axis (SVA) (CTS). In comparing UT versus LT patients, UT had more posterior global alignment (smaller TPA [T1 pelvic angle], SVA, and larger PT [pelvic tilt]) and larger anterior cervical alignment (greater cSVA [cervical SVA], T1S-CL [T1 slope–cervical lordosis] mismatch, CTS) compared to LT. Correlation analysis of PJK magnitude and location demonstrated a correlation with increases in CL, T1S, and CTS in the UT group. In the LT group, PT increased with PJK angle ( r = 0.17) and no significant correlations were noted to SVA, cSVA, or T1S-CL.

Conclusions:

PJK location influences compensation mechanisms of the cervical and thoracic spine. LT PJK results in increased PT and CL with decreased CTS. UT PJK increases CL to counter increases in T1S with continued T1S-CL mismatch and elevated cSVA.
Rates and Patterns of Lower Extremity Sports Injuries in All Gender-Comparable US High School Sports
Authors: Brant Julia Aogaichi , Johnson Bernadette , Brou Lina , Comstock R. Dawn , Vu Tien
Published: October 2019

Background:

High school athletes with lower extremity sports injuries (LESIs) frequently present to the emergency department in the United States. Previous epidemiological studies have presented rates and mechanisms of LESIs in these athletes. No studies, however, have looked at LESIs in gender-comparable sports in an attempt to evaluate what differences exist between LESIs in boys and girls.

Purpose:

To describe the epidemiology of LESIs among US high school athletes using a large national database of athletes in sports that could be considered gender comparable, given the rules of play and protective equipment.

Study Design:

Descriptive epidemiology study.

Methods:

Descriptive data from 2005 to 2016 were collected using the internet-based High School Reporting Information Online (High School RIO), a national high school sports injury surveillance system, for athletes participating in 8 gender-comparable sports (soccer, volleyball, basketball, baseball/softball, swimming and diving, track and field, cross-country, and tennis). Rates and patterns of injury were evaluated, with injury rates calculated as ratio of injuries per 10,000 athlete-exposures. Rate ratios (RRs) were calculated to compare the LESI rates in girls and boys.

Results:

In both genders, LESI rates (per 10,000 athlete-exposures) were highest in soccer (girls, 15.87; boys, 11.68) followed by basketball (girls, 11.51; boys, 9.35), and were lowest in swimming and diving (girls, 0.70; boys, 0.39). Although injury rates were significantly higher in girls compared with boys in all sports, only in tennis was the RR greater than 2 (RR, 2.03; 95% CI, 1.17-3.54). Girls had a greater proportion of severe LESIs and injuries that received radiographic evaluation, such as magnetic resonance imaging, compared with boys for all sports except volleyball. Consistency in the mechanism of injury was demonstrated between genders within each sport.

Conclusion:

This study demonstrated that LESIs are common among high school athletes and disproportionately affect girls more than boys, especially when looking at severe injuries and resource utilization. Further studies are needed to elucidate the cause of these findings. We hope that the awareness of gender-based differences in LESIs will lead to improvements in targeted efforts to decrease injury rates and injury severity.
An Empirical Investigation of India’s Outward Foreign Direct Investment: A Macro Perspective
Authors: Kakoti Dikshita
Published: October 2019

Since 1990, globalization of Indian economy led to a speedy growth of foreign direct investment (FDI) inflows and simultaneously outward foreign direct investment (OFDI) also shows an increasing trend. However, India’s OFDI has attracted a little attention from the researchers and they have considered the OFDI in terms of commitments or approved equities. The motivation of this article is to investigate the India’s macro factors influencing actual OFDI flows from India by empirically recognizing four factors, namely gross domestic product, inward FDI, real effective exchange rate, and real interest rate over the period 1980–2016. The study has used Augmented Dicky-Fuller (ADF) and Phillips–Perron (PP) Unit root tests for checking the stationarity of the variable of the model. Later on, autoregressive distributive lag (ARDL) model and error correction mechanism is used for testing the long-run as well as short-run dynamics of the model. The result shows that all the selected variables have positive and significant influence on India’s outward investment flows.