bluuebunny/crossref_metadata_2025 huggingface dataset:
A Scoring Error in the Mini-Mental State Test
Authors: Schulzer Michael , Calne Donald B. , Snow Barry , Mak Edwin
Published: April 2017

A scoring error is identified in the Mini-Mental and the Modified Mini-Mental State test. The major effect of this error is to produce a gap in the total score distribution of the test, resulting in a potential spurious underestimation of the score. Two possible remedies are suggested to resolve this problem.
Gender and Support for Mental Health Research
Authors: Page Stewart
Published: April 2017

Grants awarded by the Ontario Mental Health Foundation (OMHF) between 1986 and 1991 were analyzed for their relevance to male and female mental health topics following earlier research by Stark-Adamec in 1981. OMHF fellowships and scholarships, 1986 to 1991, National Health Research and Development Program funding, 1989 to 1990 and 1990 to 1991 funding by the Medical Research Council were also examined. Essentially, funding focused on neither gender; issues concerning gender and mental health were seldom involved in research funded by these agencies.
Quelques inconvénients de la psychiatrie de secteur: un plaidoyer contre la sectorisation
Authors: Borgeat François
Published: April 2017

The author presents a critical and polemic essay bearing on the organization of psychiatric services based on catchment areas. Several negative consequences are discussed: the loss of initial goals related to community psychiatry, the adoption of a major first-line role for psychiatrists and the identification of psychiatrists to the treatment of chronic and severe psychiatric disorders. Catchment area psychiatrists and psychiatric teams frequently function in a unique manner within the medical profession, and their spreading throughout the community leads to the development of closed subcultures often characterized by resistance to change and a lack of academic motivation. Catchment area psychiatry is also described as generating crisis after crisis and as detrimental to the positive evolution of former mental hospitals.
A Case of Paranoid Disorder Associated with Hyperthyroidism
Authors: Steinberg Paul Ian
Published: April 2017

This paper describes a patient presenting with paranoid symptoms who eventually was diagnosed as having Graves' disease. In this patient, paranoid disorder appeared to occur concurrently with hyperthyroidism in a clear state of consciousness. This case underscores the need to maintain a high index of suspicion of possible medical conditions in psychiatric patients. This is especially the case in the presence of unexplained symptoms and when there is a difficulty communicating with the patient. The importance of carrying out a careful physical examination on admission to a psychiatric unit is emphasized. Another indication for further medical investigation in a patient with psychiatric symptoms is the absence of a psychological explanation for a worsening of the psychiatric symptoms.
II: A Personal Perspective
Authors: Hechtman Lily
Published: April 2017

This paper provides an overview of key future directions that child psychiatry may follow. It then focuses on the potential value of longitudinal studies in general and on those involving attention deficit hyperactive disorder in particular, with the aim of delineating how such studies may enable us to proceed toward some of the future directions outlined.
Symptômes Positifs Et Négatifs De La Schizophrénie: Une Mise à jour
Authors: Roy Marc-André , Devriendt Xavier
Published: April 2017

The purpose of this article is to summarize the results of studies examining the validity of the positive and negative sub-types of schizophrenia as proposed by Crow. The authors summarized Crow's model's predictions in the form of 12 research questions and examined whether its predictions were confirmed. The following predictions are generally confirmed by the data collected: (i) it is possible to measure negative symptoms with accuracy; (ii) the negative symptoms predict a deterioration; (Hi) the negative symptoms are generally correlated with overall cognitive deficits; (iv) each dimension appears to have distinct neurobiological substrata. However, several elements of the Crow model are not supported by the data collected. Among the necessary modifications, the most important are as follows: (i) it appears more productive to conceive of the negative symptoms as distinct dimensions, rather than distinct diseases; (ii) at least three dimensions exist for describing the symptoms of schizophrenia; (Hi) the negative symptoms are not necessarily intrinsic to the schizophrenic process, and they may be due to other causes; (iv) the negative symptoms are not necessarily irreversible, and can be improved under ataractics; (v) the positive symptoms, in particular those relating to disorganization, can also be correlated with cognitive deficits.
Implication Des Noyaux Gris Centraux Dans Le Trouble Obsessionnel-Compulsif: Une Revue
Authors: Vincent Annick , Baruch Philippe , Pourcher Emmanuelle , Vincent Pierre
Published: April 2017

This article reviews the main clinical indicators linking the basal nuclei to obsessive compulsive disorder (OCD). Various pathologies associated with lesions of the basal nuclei are examined, followed by a review of neuropharmacological, brain imaging and psychosurgical studies. Once the role of the neostriatum in ritualistic behaviours has been clarified, the symptoms of OCD are interpreted based on the hypothesis of a lesion of the striato-orbito-frontal loop.
Geriatric Psychiatry Consultation in the Community
Authors: Stolee Paul , Le Clair J. Kenneth , Kessler Linda
Published: April 2017

While increasing emphasis is being placed on geriatric psychiatry consultation and outreach services, there is considerable variation in terms of the composition and direction of these programs. Programs vary in terms of their objectives, location, target population, use of health professions and other resources and their method of consultation. The purposes of this paper are to review the characteristics of existing programs, to review the needs of the targets of consultation and to consider theoretical and methodological approaches which have been found to be useful in mental health/psychiatric consultation, in continuing medical education, and in program evaluation. On the basis of this review, future directions for effective approaches to consultative outreach in geriatric psychiatry will then be proposed.
Liens Entre Les Symptômes et Le Fonctionnement Social Chez Des Personnes Souffrant de Schizophrénie ou de Trouble Affectif Majeur
Authors: Laroche Irène , Hodgins Sheilagh , Toupin Jean
Published: April 2017

With a view to examining the appropriateness of relying solely on pharmacotherapy rather than on a program of multimodal therapy, the goal of this study is to test the hypothesis that there is little relationship between psychotic and affective symptoms on the one hand, and life skills and social functioning on the other. Eighty-four male subjects presenting a diagnosis of schizophrenia, mania or severe depression were therefore recruited in hospitals in the Montrealregion. The relationships previously identified were studied, while factors likely to affect them, such as the chronicity of the disorder, the level of intellectual functioning, and the presence of additional symptoms, were controlled as necessary. The results suggest poorer social functioning among the schizophrenics having a high level of negative symptoms. In addition, the relationship between negative symptoms and IQ suggests that the intellectual functioning of these individuals can potentially affect the acquisition of skills required for adequate social functioning. Among subjects with a major affective disorder, the results reveal poor social functioning even during quasi-asymptomatic periods. These results suggest that patients suffering from schizophrenia or a major affective disorder require interventions aimed at increasing their level of psychosocial functioning.
Evidence-Based Psychiatry
Authors: Elliot M. Goldner , Bilsker Dan
Published: April 2017

Objective

To apply the evidence-based medicine paradigm to the domain of psychiatric practice and to bring out the consequences for psychiatry of this approach in order to foster the emergence of an evidence-based psychiatry.

Method

The basic assumptions of traditional and evidence-based paradigms, as delineated by the Evidence-Based Working Group, are used to structure an exploration of the evidence-based approach to psychiatry. Theoretical and practical issues are considered and an example of evidence-based decision making is given.

Results

An evidence-based approach to psychiatry is described as one that emphasizes the importance of systematic observation and the use of rules of evidence in hypothesis testing. It is suggested that psychiatrists using this approach will be in a position to provide superior patient care.

Discussion

The application of scientific method to psychiatric problems is discussed as the essence of an evidence-based approach. The common error of “scientism” is described. The authors identify advantages and limitations of an evidence-based approach to psychiatric practice and advocate a decision-making process that balances individualized clinical acumen (phronesis) and information derived from empirical study of groups of patients (techne).
Prevalence of Dissociative Symptoms and Disorders in an Adult Psychiatric Inpatient Population in Canada
Authors: Sheila A. Horen , Pierre P. Leichner , Stuart Lawson J.
Published: April 2017

Objective

This study attempted to estimate the prevalence of dissociative symptoms and disorders in a Canadian adult psychiatric inpatient population and also attempted to determine the extent to which dissociative disorders were recognized by the attending clinical staff.

Method

All appropriate and consenting adult psychiatric inpatients at the Kingston Psychiatric Hospital in Kingston, Ontario, were given the Dissociative Experiences Scale. Patients scoring 25 or greater were interviewed with the Dissociative Disorders Interview Schedule and the Structured Clinical Interview for DSM-IV Dissociative Disorders. Admission or discharge diagnoses data were used to determine whether or not dissociative disorders were being recognized.

Results

A total of 48 patients completed the Dissociative Experiences Scale and 14 (29%) scored 25 or greater. The prevalence of dissociative disorders in this hospital population was estimated to be 17%. Dissociative identity disorder was found in six percent, dissociative amnesia in eight percent and dissociative disorder not otherwise specified in two percent of the population. These disorders tended to be under-recognized.

Conclusion

Research on more extensive populations is required to establish the true prevalence of dissociative symptoms and disorders in psychiatric inpatients.
The Correlates of Cortical Sulci Atrophy and Central Atrophy in a Cohort of Schizophrenia and Manic Subjects in Nigeria
Authors: Adeyinka Abiodun O. , Ohaeri Jude U. , Osuntokun Benjamin O.
Published: April 2017

The prevalence of brain cortical sulci atrophy and central (subcortical) atrophy among Nigerian psychiatric patients is highlighted and compared with findings from developed countries. The relationship between these indices of brain atrophy and clinical parameters is also examined. Visual ratings of cortical sulci atrophy and central (subcortical) atrophy, assessed on the computed tomography (CT) image console, were compared among 50 patients with schizophrenia, 14 patients with mania and 41 healthy control subjects. The patients with schizophrenia and the patients with mania had a significantly higher prevalence of brain atrophy than normal subjects. Among the patients with schizophrenia, indices of brain atrophy were not significantly associated with disease outcome, and the presence of negative symptoms. In view of the findings from a parallel study of the same patients that psychiatric patient groups showed other evidence of CT abnormalities, the findings of this study indicate that the so-called functional psychiatric states in developing countries — as in developed countries — are probably associated with some diffuse neuropathological process.
Extended Survival of Patients on Long-Term Lithium Treatment
Authors: Ahrens Bernd , Grof Paul , Möller Henri-J. , Müller-Oerlinghausen Bruno, , Wolf Thomas
Published: April 2017

Objective

Findings from a recent international multi-centre trial are compatible with the idea that long-term lithium treatment extends the survival of patients suffering from affective disorders to match the general population. A similar reduction of mortality was found in Canadian patients, although important questions remained to be answered about cardiovascular and suicide mortality, and patient selection.

Method

Based on data collected in a study (I) from lithium clinics in Canada, Denmark, Germany and Austria, an analysis was carried out of suicide and cardiovascular mortality in patients who received prophylactic lithium treatment.

Results

In patients given lithium for two years or longer (n = 641), both suicide and cardiovascular mortality were the same as, or only slightly higher than, in the general population; in patients given lithium for less than two years (n = 186), both mortalities remained high. The reduced mortality is not likely to be the result of selection because the patients who were treated briefly and those treated for a longer time did not differ in important mortality variables.

Conclusions

In addition to its ability to prevent recurrences, prophylactic lithium treatment appears capable of reducing both the excess suicide risk and excess cardiovascular mortality of affective illness.
The Neurology of Alcoholic Denial: Implications for Assessment and Treatment
Authors: James D. Duffy
Published: April 2017

Alcohol has neurotoxic effects that frequently result in significant sensorimotor and cognitive deficits. These cognitive deficits may have profound implications for the behaviour and treatment of patients who abuse alcohol. In particular, the deficits in executive cognition that are typical of alcoholic dementia result in difficulties with planning, insight and impulse control. These deficits are frequently misinterpreted as alcoholic denial and are therefore assumed to have a psychodynamic basis. This paper reviews the neurological substrates for insight and self-monitoring and discusses a possible pathophysiology for a subgroup of alcoholic patients who exhibit alcoholic denial. Implications of this model for the evaluation and treatment of alcoholic patients are discussed.
Current Research Findings on Childhood Autism
Authors: Sigman Marian , Arbelle Shoshana , Dissanayake Cheryl
Published: April 2017

Objective

To review the main areas of current research findings regarding the core deficits in autism and the implications of these findings for the practicing clinician.

Method

Behavioural, cognitive, emotional and neurophysiological aspects are covered with an emphasis on the importance of methodology.

Results

The implication of these findings for the treatment of autism is discussed.

Conclusion

Autism can teach us how we learn about emotions and the possibility of sensitive periods of development.
Management of Suspected Neuroleptic Malignant Syndrome
Authors: Velamoor Vr , Swamy Gn , Parmar Late-Rs , Williamson P , Caroff Sn
Published: April 2017

Objective

Neuroleptic Malignant Syndrome (NMS) is a rare but potentially lethal form of drug-induced hyperthermia. The objective of this paper is to provide data regarding early and suspected cases as well as offer guidelines for managing this condition. Knowledge of suspected cases will lead to early recognition and prompt management of this condition in the future.

Method

To address the gap in knowledge, we present 2 case reports of patients with early NMS-like symptoms. The case reports are followed by a brief review of the literature on differential diagnoses, risk factors, early signs and treatment data.

Conclusions

The most rational approach to treating NMS entails a hierarchy of interventions determined by the severity and progression of symptoms.
Cigarette Smoking during Pregnancy
Authors: Stewart Donna E , Streiner David L
Published: April 2017

Objectives

To determine: 1. the prevalence of regular smoking in the latter half of pregnancy in a sample of Canadian prenatal patients; 2. the psycho-social and demographic characteristics that differentiate smoking from nonsmoking patients; 3. the characteristics that differentiate prenatal patients who smoke more than 10 cigarettes per day from those who smoke 1 to 10 cigarettes per day; and 4. the psychiatric morbidities or psychological attitudes associated with smoking in pregnancy.

Methods

Consecutive consenting women 20 or more weeks pregnant were given, at a prenatal clinic, the General Health Questionnaire (GHQ), the Fetal Health Locus of Control (FHLC), and a study questionnaire to complete.

Results

Five-hundred and forty-five women completed the questionnaires. Eighty-nine (16.3%) women reported regular daily cigarette smoking in the second half of pregnancy, while 43 (7.9%) smoked more than 10 cigarettes per day. Women who smoked were more likely than nonsmokers to be under 21, born in Canada, have only elementary education, be unemployed and unmarried, eat unhealthy diets, drink alcohol, use nonprescription and illicit drugs, have unplanned pregnancies, histories of emotional and physical problems, and have suffered physical abuse before and during pregnancy. Smokers were more likely than nonsmokers to meet case status on the GHQ and on the FHLC to believe “chance” and less likely to believe that “internal control” or “powerful others” affected the health of their fetuses. “Social disorganization”, “health risks”, and “poor health” factors accounted for 83.1% of the total variance.

Conclusions

Women who smoke in pregnancy have a higher rate than nonsmokers of other health risk behaviours, social disadvantage, and emotional disturbance. Psychiatrists can play an important role in identifying and treating emotional and psychiatric morbidity in women of reproductive age to facilitate a reduction in smoking rates in this high-risk population.
An Overview of Treatment in Paranoia / Delusional Disorder
Authors: Munro Alistair , Mok Hiram
Published: April 2017

Objective

To examine delusional disorder (formerly paranoia) which has re-emerged as an important diagnosis in psychiatry and familiarize present-generation psychiatrists with this disorder and its treatment. To benefit other researchers, a bibliography is appended.

Method

Approximately 1,000 articles on paranoia/delusional disorder were analyzed in detail. These articles date from 1961 with the greater majority dating from 1980 onward. Case descriptions were often vague and only cases identifiable by DSM-IV diagnostic criteria were accepted. Eventually 257 cases were accumulated, but it was only possible to report on treatment aspects of 209 of these, due to lack of detail.

Results

Because the data are so disparate, and the literature is confusing in therapeutics aspects, only the broadest conclusions can be drawn. However, it does appear that when adequately treated, delusional disorder is an illness with a reasonably good prognosis. Cases respond equally well to treatment, whatever the specific delusional content, and pimozide currently appears to be the neuroleptic which produces the best results.

Conclusions

There is an urgent need to raise standards in the study of delusional disorder and its treatment.
Suggestions for Implementing Community Psychiatry Training in Existing Residency Programs
Authors: Johnston Mary , Binder Tammy , Freeland Alison , Gillis Katherine
Published: April 2017

Objective

To demonstrate how an experience of partnership evolved when a group of psychiatry residents moved beyond the traditional hospital setting and began to question their current training.

Method

We describe our experience in the context of the current literature and suggest ways of implementing community psychiatry training in existing residency programs.

Results

Principles of community psychiatry — partnership, respect and shared responsibility — are good standards in psychiatric care.

Conclusions

Community psychiatry training may be possible in existing resident rotations, although teaching in the community setting may also be of value. Research and clinical work in “community psychiatry” need to be valued. Problems may be enriching if they are resolved collaboratively.
Economics of Schizophrenia
Authors: Williams Richard , Dickson Ruth A
Published: April 2017

Objective:

To discuss the costs associated with mental illnesses that constitute a significant percentage of the total direct health care costs, currently estimated at $1605 per person per year (9% of the gross national product). The cost of all mental illness in the US has been estimated at US$103.7 billion (1985 dollars), of which schizophrenia alone accounts for US$22.7 billion.

Method:

A number of studies that have attempted to evaluate the cost of therapies in schizophrenia are examined.

Results:

While schizophrenia affects only 1% of the population, it accounts for 2.5% of total health care expenditures in the US. For first-admission patients suffering from schizophrenia, it would appear to cost less to provide the most clinically-effective treatments than to provide a good level of milieu care with special treatment.

Conclusion:

Community-based care can be less costly than conventional hospital-based programs and can improve patient quality of life. Inhospital programs that reduce length of stay with the use of medication clinics or day hospital care may achieve significant cost savings. A special challenge is the subgroup of patients suffering from schizophrenia that is neuroleptic-resistant. New drugs, such as the atypical neuroleptics, clozapine and risperidone, may prove to be highly cost-effective in treating schizophrenia by preventing relapse and reducing hospital lengths of stay.
Clinical and Financial Outcomes Evaluation of Multimodal Pharmacist Warfarin Management of a Statewide Urban and Rural Population
Authors: Lee James C. , Horner Kathleen E. , Krummel Michelle L. , McDanel Deanna L.
Published: April 2017

Purpose:

To evaluate the efficacy, safety, and indirect financial outcomes of pharmacist face-to-face warfarin management with telephone-based distance management utilizing local laboratories or patient self-testing (PST).

Methods:

A retrospective analysis of a clinic population of 336 patients on established warfarin therapy distributed statewide in rural and urban settings over a 6-month period was conducted. Participants were stratified into face-to-face management, telephone-based management utilizing local laboratory testing, and telephone-based management utilizing PST.

Results:

The primary outcome of international normalized ratio (INR) time in therapeutic range (TTR) for face-to-face management was significantly greater than distance management utilizing local laboratory testing (69.0% vs 60.5%, P = .0032). No difference was observed between face-to-face management and PST (69.0% vs 68.0%, P = .25). No significant difference in bleeding or thromboses was observed. Although increased clinician time was utilized during face-to-face encounters compared to telephone encounters (8.7-minute face-to-face, 5.5-minute local laboratory, and 5.4-minute PST), face-to-face encounters tended to be billable at lower levels, whereas telephone-based encounters were billable at higher levels.

Conclusion:

A multimodal approach to pharmacist warfarin management of a patient population distributed statewide in rural and urban locations is effective despite TTR differences associated with INR testing used in distance management. PST may improve warfarin treatment outcomes and adherence in distance management, particularly when the use of alternative oral anticoagulants is inappropriate. Although time and billing differences between face-to-face and distance management exist, clinical and safety outcomes remain acceptable despite encounter complexity and support reimbursement of pharmacist anticoagulation management in all settings.
Aerodynamic design optimization for low Reynolds tandem airfoil
Authors: Chen Fangzheng , Yu Jianqiao , Mei Yuesong
Published: April 2017

A series of aerodynamic design optimization studies are performed to investigate the performance of two-dimensional tandem airfoil at low Reynolds number of 220,000. A total of 23 design variables, including decalage, gap, stagger, and airfoil profile variables are considered. Hierarchical evolutionary algorithm together with dynamic metamodel optimization is used to achieve the maximum lift-to-drag ratio for tandem airfoil. The studies investigate the impact of various design variables on optimized tandem airfoil. The results show that tandem airfoil in lower Reynolds flow has better aerodynamic performance at high angle of attack. And the lift-to-drag ratio can be further increased by 11.9% when airfoil profile variables are introduced. Morphing tandem airfoil can overcome low lift-to-drag ratio at lower lift coefficient, and is attractive for unmanned aircraft.
Appraisement of geographic information systems as tool supporting energy management in the cities
Authors: Pietras-Szewczyk Małgorzata
Published: April 2017

Polish international obligations, in particular the European Union and European Commission directives, pose a real challenge for Poland to radically reduce emissions of atmospheric pollutions and significantly increase the usage of energy coming from renewable sources in the overall energy balance of the country. These goals seem to be difficult to achieve, nevertheless the development and implementation of innovative concepts is always a step forward. Nowadays the renewable energy sources seem to be the panacea for the problems of pollutions and energy saving. Many inventors and scientists work on concept of smart grid technology. The basic concept of this technology is producing energy directly in the cities. It seems to be a good idea but often in urban areas there is no place for new installations or cost of land is the barrier. Therefore to produce and manage energy directly in the cities, we have to take into account many aspects such as cost of land, location, available renewable energy sources, number of inhabitants, electrical network, terrain obstacles, and local plans. Here is the good place to use geographic information system technology which can help us to analyze all these issues and combine spatial, satellite, and statistical data to create one coherent concept of managing various sources of energy in the cities. The aim of this study is to consider opportunities of using geographic information systems in supporting process of energy management in the cities. It was taken into account many important elements: solar conditions, impact of cloudiness on value of solar radiation, spatial data, buildings and electrical network, obstacles, and number of inhabitants. It is all for identify the advantages and disadvantages of geographic information system in the analysis of solar energy potential in the city.
Changes in blood and urinary cadmium levels and bone mineral density according to osteoporosis medication in individuals with an increased cadmium body burden
Authors: Eom S-Y , Yim D-H , Hong S-M , Kim Y-D , Kim H , Choi B-S , Park J-D , Park C-H , Kim G-B , Yu S-D
Published: April 2017

The aim of this study was to assess changes in bone mineral density (BMD) and cadmium (Cd) levels in blood and urine in individuals living in a Cd-contaminated area according to the type of osteoporosis medication over a three-year period. This follow-up study included 204 residents living in the vicinity of a closed copper refinery, who had been found to have elevated urinary or blood Cd levels. Cd levels in the blood and urine, as well as BMD, were measured every 6 months. After the first BMD measurement, individuals were prescribed antiresorptives such as alendronate or vitamin D and calcium, according to their BMD. Subjects were classified according to the type of medicine provided over the previous 6 months. General linear models controlling for other factors were used to evaluate the effects of each type of medication on the participants’ Cd levels and BMD. Spinal BMD showed a significant increase in the antiresorptive group compared to the nontreatment group. Significant decreases in blood Cd levels were found in the vitamin D and calcium group, in comparison to the nontreatment group, as well as a marginally significant decrease in the antiresorptive group. The vitamin D and calcium group showed a significantly greater decrease in urinary Cd levels than the nontreatment group. In contrast, antiresorptive medication was found to have a negative effect on urinary Cd excretion. These results suggest that vitamin D and calcium treatment for osteoporosis lowers blood Cd levels more effectively and improves urinary Cd excretion.
Sex Education in Children and Adolescents With Disabilities in Yogyakarta, Indonesia From a Teachers’ Gender Perspective
Authors: Tsuda Satoko , Hartini Sri , Hapsari Elsi Dwi , Takada Satoshi
Published: April 2017

Children and adolescents with disabilities (CAD) frequently engage in inappropriate sexual behaviors. In Indonesia, the need for sex education for CAD remains unclear. This study investigated teacher attitudes toward providing sex education in special schools to clarify the gender differences among teachers providing sex education. Questionnaires were sent to 180 teachers. The response rate was 72.2%. Eighty-three percent of responders were Muslim. Our findings revealed that teachers in special schools considered sex education to be important. However, the number of sex education contents was limited, and female teachers were more positive about teaching sex education than male teachers. Equally, female teachers taught a greater number of sex education contents than did male teachers. These findings were consistent with reports from developed countries although cultural and religious background differed from those of Indonesia. Sex education for CAD was accepted by teachers in Indonesia; however, materials and tools for education should be developed further.
Wireless energy harvesting using time reversal technique: An experimental study with numerical verification
Authors: Ji Qing , Parvasi Seyed Mohammad , Ho Siu Chun Michael , Franchek Matthew , Song Gangbing
Published: April 2017

Fully embedded devices and portable devices located in inaccessible areas may be constrained in terms of service lifespan due to limitations in battery capacity. Furthermore, conventional electromagnetic-based wireless charging may be difficult due to environmental interference. Thus, in this article, we present a method that can remotely charge such devices through piezo-generated stress waves that propagate along the structure hosting the device to be charged. However, in order to fully utilize such a conduit for transmitting energy, the dispersive and scattering nature of solid materials should be overcome. As a way to overcome this obstacle, the method innovatively applies the time reversal technique for use in energy harvesting. Through the time reversal technique, the energy transmitted by external actuators, instead of dispersing unhelpfully around the device, can be focused tightly at the energy harvesting component of the device. The method was successfully demonstrated on a copper pipe using four piezoelectric transducers. It was further found that time-reversed signals from multiple actuators can linearly superimpose to increase the amount of energy focused on the energy harvester, thus potentially solving problems related to distance and the signal attenuating properties of the material in the hosting structure. The method was also modeled and simulated using the finite element method through the commercial FE-package Abaqus. Results from both experiment and simulation matched well, thus demonstrating the viability of the wireless energy harvesting method.
Emerging Infectious Disease Content in Newspaper Editorials: Public Health Concern or Leadership Issue?
Authors: You Myoungsoon , Joo Jungmin , Park Esuri , Noh Ghee-Young , Ju Youngkee
Published: April 2017

We conducted a content analysis of newspaper editorials on the Middle East respiratory syndrome outbreak in Korea. Subject matter, social and personal efficacy information, and affective tone were evaluated using a mixed-methods approach. An analysis of 241 publications with the acronym “MERS” revealed that public health was the most salient, followed by leadership/governance, coping, medical system, and economic consequences. Societal efficacy information was more frequent than personal efficacy information, and a negative tone was predominant. However, leadership became the most frequent in the later stages. Personal efficacy information decreased over time and across content with a negative tone.
Cerebral rituximab uptake in multiple sclerosis: A 89Zr-immunoPET pilot study
Authors: Hagens Marloes HJ , Killestein Joep , Yaqub Maqsood M , van Dongen Guus AMS , Lammertsma Adriaan A , Barkhof Frederik , van Berckel Bart NM
Published: April 2017

Previous studies have demonstrated that the chimeric monoclonal antibody rituximab significantly reduces clinical and radiological disease activity in relapsing-remitting multiple sclerosis as early as 4 weeks after the first administration. The exact mechanisms leading to this rapid effect have not yet been clarified. The aim of this positron emission tomography study was to assess central nervous system penetration as a possible explanation, using zirconium-89-labelled rituximab. No evidence was found for cerebral penetration of [89Zr]rituximab.
Brain atrophy 15 years after CIS: Baseline and follow-up clinico-radiological correlations
Authors: Vidal-Jordana Angela , Sastre-Garriga Jaume , Pareto Deborah , Tur Carmen , Arrambide Georgina , Otero-Romero Susana , Huerga Elena , Mitjana Raquel , Auger Cristina , Tintoré Mar , Rovira Alex , Montalban Xavier
Published: April 2017

Background:

Brain atrophy in multiple sclerosis (MS) patients is present since the very early stages of the disease and it has been related to long-term disability.

Objective:

To estimate brain volume (BV) at 15 years after a clinically isolated syndrome (CIS) and to evaluate its relationship with disease outcomes.

Methods:

From a prospective cohort including patients presenting with a CIS, 54 patients with a brain magnetic resonance imaging (MRI) performed 15 years after CIS were included. Brain parenchymal fraction (BPF), grey matter fraction (GMF) and white matter fraction (WMF) at 15-year follow-up were obtained. Regression analyses were conducted to predict BV loss and reaching an Expanded Disability Status Scale (EDSS) of 3.0 in that 15-year period.

Results:

In multivariable analyses, lower values of BPF and WMF were significantly associated with being male, presenting 3–4 Barkhof criteria at baseline, presenting a second relapse, and with a decision to start treatment. In the multivariable logistic regression analysis, only lower GMF was associated with a greater risk of reaching EDSS 3.0 (odds ratio (OR) = 0.24, p = 0.028).

Conclusion:

Lower BPF and WMF 15 years after CIS are associated with previous markers of inflammatory disease. Lower GMF 15 years after a CIS is associated with an increased risk of reaching an EDSS of 3.0.
Against network thinking: A critique of pathological sovereignty
Authors: Coward Martin
Published: April 2017

This article advances a critique of network thinking and the pathological sovereignty that it gives rise to. The network is ubiquitous as a metaphor for understanding the social, economic and political dynamics of the contemporary era. Implicitly drawing on an analogy with communications infrastructures such as the telegraph or internet, the network metaphor represents global politics in terms of nodes related to one another through conduit-like links. I begin by demonstrating the widespread nature of network thinking and outline the way in which conventional metaphors structure both thinking and action. I then recreate an episodic history of network thinking in order to demonstrate the key entailments of the network metaphor. I argue that there are four entailments of network thinking: the prioritisation of connectivity; the identification of novel actors; de-territorialisation; and a lack of concern for contiguity and context. The article then outlines the corresponding political and ethical consequences that follow from these entailments, specifically: fantasies of precision; new threat imaginaries; unboundedness; and a failure to attend to culture and community. I contend that network thinking gives rise to a pathological sovereignty whose dual faces can be seen in drone strikes and invasive surveillance. Finally, I argue that thinking beyond the network requires us to foreground the importance of contiguity and context in understanding global politics. This article contributes both a novel theoretical framework for challenging the hegemony of network thinking and an ethical call for greater recognition of the harm caused by pathological sovereignty.
Willingness to Invest in Children: Psychological Kinship Estimates and Emotional Closeness
Authors: Antfolk Jan , Karlsson Linda C. , Söderlund Johanna , Szala Anna
Published: April 2017

In general, adults invest more in related children compared to unrelated children. To test whether this pattern reflects variations in psychological kinship estimates (i.e., putative relatedness weighted by certainty in relatedness), willingness to invest in children belonging to different categories (direct offspring, nieces/nephews, stepchildren, and friends’ children) was measured in a population-based sample of 1,012 adults. Respondents reported more willingness to invest in their own biological children, than in other related children (nieces and nephews), or in stepchildren and friends’ children. Compared to putative relatedness, respondents’ psychological kinship estimates better predicted the willingness to invest. This association was partially mediated by emotional closeness. Additionally, the age of a child and the number of children in the care of the respondent were negatively associated with willingness to invest. The association between psychological kinship estimates and willingness to invest supports evolutionary predictions. Investment in stepchildren was, however, higher than expected.
Characterization of Volitional Electromyographic Signals in the Lower Extremity After Motor Complete Spinal Cord Injury
Authors: Heald Elizabeth , Hart Ronald , Kilgore Kevin , Peckham P. Hunter
Published: April 2017

Background. Previous studies have demonstrated the presence of intact axons across a spinal cord lesion, even in those clinically diagnosed with complete spinal cord injury (SCI). These axons may allow volitional motor signals to be transmitted through the injury, even in the absence of visible muscle contraction. Objective. To demonstrate the presence of volitional electromyographic (EMG) activity below the lesion in motor complete SCI and to characterize this activity to determine its value for potential use as a neuroprosthetic command source. Methods. Twenty-four subjects with complete (AIS A or B), chronic, cervical SCI were tested for the presence of volitional below-injury EMG activity. Surface electrodes recorded from 8 to 12 locations of each lower limb, while participants were asked to attempt specific movements of the lower extremity in response to visual and audio cues. EMG trials were ranked through visual inspection, and were scored using an amplitude threshold algorithm to identify channels of interest with volitional motor unit activity. Results. Significant below-injury muscle activity was identified through visual inspection in 16 of 24 participants, and visual inspection rankings were well correlated to the algorithm scoring. Conclusions. The surface EMG protocol utilized here is relatively simple and noninvasive, ideal for a clinical screening tool. The majority of subjects tested were able to produce a volitional EMG signal below their injury level, and the algorithm developed allows automatic identification of signals of interest. The presence of this volitional activity in the lower extremity could provide an innovative new command signal source for implanted neuroprostheses or other assistive technology.
Manual aspiration thrombectomy with a Penumbra catheter for acute anterior cerebral artery occlusion
Authors: Chung Gyung Ho , Kwak Hyo Sung , Park Jung Soo , Lee Jong Myong
Published: April 2017

Purpose

The purpose of this article is to assess the efficacy and safety of manual aspiration thrombectomy (MAT) using a Penumbra catheter in patients with anterior cerebral artery (ACA) occlusions.

Materials and methods

From January 2012 to March 2016, 16 patients underwent MAT with Penumbra catheters using a proximal and distal supporting technique to treat ACA occlusions. We evaluated immediate angiographic results and clinical outcomes by reviewing patient electrical medical records.

Results

Of these patients, 11 had a complete obstruction of the distal internal carotid artery (ICA) and five had ACA and middle cerebral artery (MCA) occlusions. All patients achieved successful recanalization of the distal ICA or MCA (Thrombolysis in Cerebral Infarction (TICI) grade ≥2b). Overall the recanalization rate for ACA occlusions (TICI grade≥2b) was 93.7% (15/16). The median procedure time was 45 minutes (range: 35–65 minutes). No patients were observed to have a procedure-related subarachnoid hemorrhage. Four patients (25.0%) died during hospitalization because of massive symptomatic hemorrhage, brain edema, or herniation. At discharge, the median NIHSS score for surviving patients was 6 (range: 1–17). Five patients had favorable clinical outcomes (modified Rankin scale ≤2).

Conclusion

MAT appears to be safe and successfully achieves recanalization in patients with ACA occlusions.
Strengths and Limitations of New Approaches for Graphical Presentation of Blood Glucose Monitoring System Accuracy Data
Authors: Pleus Stefan , Flacke Frank , Sieber Jochen , Haug Cornelia , Freckmann Guido
Published: April 2017

Graphical presentation of blood glucose monitoring systems’ (BGMSs) accuracy typically includes difference plots (DPs). Recently, 3 new approaches were presented: radar plots (RPs), rectangle target plots (RTPs), and surveillance error grids (SEGs). BGMS data were modeled based on 3 scenarios that can be encountered in real life to highlight strengths and limitations of these approaches. Detailed assessment of BGMS data may be easier in plots with individual data points (DPs, RPs, SEGs), whereas RTPs may facilitate display of large amounts of data or comparison of BGMS. SEGs have the advantage of assessing clinical risk. The selection of a specific type depends mostly on the kind of information sought (eg, accuracy in specific concentration intervals, lot-to-lot variability, clinical risk) as there is no “absolute best” approach.
Oral cancer in South East Asia
Authors: Cheong Sok Ching , Vatanasapt Patravoot , Yi-Hsin Yang , Zain Rosnah B , Kerr Alexander Ross , Johnson Newell W
Published: April 2017

Objectives:

To document the burden of oral cancer in South East Asia (SEA) and to examine the gaps in acquiring accurate data within these countries.

Methods:

Epidemiological data on oral cancer from countries in SEA were obtained and reviewed from public population-based databases. Descriptions on the incidence and mortality of oral cancer were based on data obtained from GLOBOCAN 2012, and prediction of the number of cases and deaths due to oral cancer were also taken from the same database. The availability of and accessibility to population-based cancer registry were also documented.

Results:

Five of the eleven countries in SEA have national cancer registries, but the reporting periods varied from 2002 to 2014 across these countries. Whilst incidence and mortality data were obtainable for all SEA countries from GLOBOCAN 2012, data quality varied substantially across the countries. Estimated incidences of oral cancer ranged from 1.6 to 8.6/100,000 per annum with similar rates in males and females for most countries. The incidence was the highest in Myanmar and Brunei for males and females, respectively. Mortality due to oral cancer was reported to be 0.4 to 5.3/100,000, with the highest mortality in Myanmar and Timor-Leste among males and females, respectively. Based on the predicted number of cases and deaths for 2020, oral cancer incidence and mortality is expected to increase and the trends are similar between males and females, which is not surprising as with population growth, the disease burden will rise further.

Conclusion:

This study demonstrates a severe lack of accurate epidemiological data on oral cancer and underscores the urgent need to develop expertise within this region that can address this issue. While there is a clear need for improved primary prevention, for increased skilled workforce and for improved diagnostic and treatment facilities, an essential first step is to establish robust cancer registries so that progress or lack thereof can be monitored accurately, and appropriate action planned.
Concussion Management Plan Compliance: A Study of NCAA Power 5 Conference Schools
Authors: Buckley Thomas A. , Baugh Christine M. , Meehan William P. , DiFabio Melissa S.
Published: April 2017

Background:

In response to concerns over concussions and repeated head impacts that occur during sports, the National Collegiate Athletic Association (NCAA) mandated that all member institutions enact a concussion management plan (CMP). Although institutional and health care provider self-reports have been investigated, compliance with NCAA protocol recommendations has not been examined.

Purpose:

To examine the CMPs from the 65 institutions within the NCAA Power 5 conferences for compliance with the NCAA 2015 concussion guidelines.

Study Design:

Descriptive epidemiology study.

Methods:

Each institution’s publicly available CMP was obtained in 2015, reviewed, and coded for compliance with each of the required 47 components. Overall compliance rate, item-level, category-level, and institution-level compliance was assessed. Independent predictors of compliance, including each institution’s athletic training staff size, academic performance, and athletic performance, were examined with quasi-binomial regression.

Results:

CMPs varied substantially in length and level of detail. The overall compliance rate for all components across all institutions was 94.3% (2880/3055). Twelve components achieved 100% (65/65) compliance, and the lowest levels of compliance were clustered in “return to learn.” There were 22 institutions that achieved a 100% compliance rate; the lowest institutional compliance was 59.6%. There were no significant associations between the independent predictors and institutional compliance.

Conclusion:

Overall compliance with NCAA concussion management requirements was high, but there remains room for improvement. The lowest level of compliance was clustered in the return-to-learn section. There were limited details provided in the reducing head trauma component. Items with lower compliance (reducing head trauma, return to learn) tended to be outside the core competencies of the medical staff, indicating an area for improvement. Encouragingly, many institutions and specific components demonstrated full compliance.