bluuebunny/crossref_metadata_2025 huggingface dataset:
Engaging people with dementia in designing playful and creative practices: Co-design or co-creation?
Authors: Tsekleves Emmanuel , Bingley Amanda F , Luján Escalante Maria A , Gradinar Adrian
Published: August 2018

Stimulating active, social interactions for people with dementia is an important and timely challenge that merits continuing attention in design research. The idea of using participatory co-design to engage people with dementia is attracting increased interest. In this paper, we draw on our qualitative study that used a playful, participatory arts approach to explore the ways co-design could be implemented in a group of 12 people with dementia and their carers, and developed practical recommendations, in the form of a set of playing cards, for other researchers and caregivers to work in similar ways. The emphasis is on the value of play and playfulness, providing a ‘magic circle’ (Huizinga, 1955) that fosters the required conditions for a co-creative, co-design space. This aims to encourage social interaction between people with dementia, to stimulate imagination and creativity; and engage even the most the reticent, less confident members. Our observations, however, suggest that the exact notion and nature of co-design within the context of working with people with dementia is unclear. We critically explore whether such participatory creative practices that engage people with dementia can be considered as purely co-design. In conclusion, we argue that such interaction is better described as co-creation and that this definition can still embrace considerable contribution and involvement by people with dementia in a co-design process.
Continuous-wave line laser thermography for monitoring of rotating wind turbine blades
Authors: Hwang Soonkyu , An Yun-Kyu , Sohn Hoon
Published: August 2018

This article presents a continuous-wave line laser thermography system for monitoring of rotating wind turbine blades. The proposed continuous-wave line laser thermography system non-destructively inspects rotating blades by generating thermal waves on the target blades using a continuous-wave line laser beam and simultaneously recording the corresponding thermal wave propagation using an infrared camera. The continuous-wave line laser thermography system is positioned at a fixed point, and the blades are automatically scanned using the continuous-wave line laser thermography system as the blades rotate under normal operational conditions. A coordinate transform algorithm named “time–space-integrated coordination transform” is developed for precise damage evaluation in rotating blades. Time–space-integrated coordination transform transforms spatially and temporally varying thermal images taken by the infrared camera to only temporally varying thermal images viewed from the perspective of the fixed blade positions. The effectiveness of the proposed continuous-wave line laser thermography system is experimentally validated by detecting hidden delamination on lab-scale rotating blades. In the experiments, artificial delaminations with diameters of 15 and 30 mm are successfully visualized with no false alarms while the blades are rotating at 10 r/min.
Fatigue crack detection in pipes with multiple mode nonlinear guided waves
Authors: Guan Ruiqi , Lu Ye , Wang Kai , Su Zhongqing
Published: August 2018

This study elaborates fundamental differences in fatigue crack detection using nonlinear guided waves between plate and pipe structures and provides an effective approach for analysing nonlinearity in pipe structures. For this purpose, guided wave propagation and interaction with microcrack in a pipe structure, which introduced a contact acoustic nonlinearity, was analysed through a finite element analysis in which the material nonlinearity was also included. To validate the simulation results, experimental testing was performed using piezoelectric transducers to generate guided waves in a specimen with a fatigue crack. Both methods revealed that the second harmonic wave generated by the breathing behaviour of the microcrack in a pipe had multiple wave modes, unlike the plate scenario using nonlinear guided waves. Therefore, a proper index which considered all the generated wave modes due to the microcrack was developed to quantify the nonlinearity, facilitating the identification of microscale damage and further assessment of the severity of the damage in pipe structures.
An American Professor in Armenia: Reflections on Special Education, Speech-Language Pathology, and University Teaching
Authors: Miller Kevin J.
Published: August 2018

The author recounts his experience as a Fulbright U.S. Scholar in the Department of Special Education at Armenian State Pedagogical University in Yerevan during the fall of 2016. He describes the Fulbright U.S. Scholar Program, especially as it pertains to Armenia, and explores the current state of special education in Armenia, specifically inclusion and its impact on students, families, and faculty. The author describes courses he taught for students majoring in speech–language pathology or the education of students who are deaf or hard-of-hearing as well as guest lectures given in Yerevan and elsewhere in Armenia. In addition, he describes a research project he initiated at an elementary school in Yerevan. He concludes with insights gained from this experience.
Time-Dependent Finite Element Analysis of In Vivo Electrochemotherapy Treatment
Authors: Pintar Matevž , Langus Janez , Edhemović Ibrahim , Brecelj Erik , Kranjc Matej , Sersa Gregor , Šuštar Tomaž , Rodič Tomaž , Miklavčič Damijan , Kotnik Tadej , Kos Bor
Published: August 2018

Electrochemotherapy and irreversible electroporation are gaining importance in clinical practice for the treatment of solid tumors. For successful treatment, it is extremely important that the coverage and exposure time of the treated tumor to the electric field are within the specified range. In order to ensure successful coverage of the entire target volume with sufficiently strong electric fields, numerical treatment planning has been proposed and its use has also been demonstrated in practice. Most of numerical models in treatment planning are based on charge conservation equation and are not able to provide time course of electric current, electrical conductivity, or electric field distribution changes established in the tissue during pulse delivery. Recently, a model based on inverse analysis of experimental data that delivers time course of tissue electroporation has been introduced. The aim of this study was to apply the previously reported time-dependent numerical model to a complex in vivo example of electroporation with different tissue types and with a long-term follow-up. The model, consisting of a tumor placed in the liver with 2 needle electrodes inserted in the center of the tumor and 4 around the tumor, was validated by comparison of measured and calculated time course of applied electric current. Results of simulations clearly indicated that proposed numerical model can successfully capture transient effects, such as evolution of electric current during each pulse, and effects of pulse frequency due to electroporation effects in the tissue. Additionally, the model can provide evolution of electric field amplitude and electrical conductivity in the tumor with consecutive pulse sequences.
Mitochondrial DNA Mutations Induced by Carbon Ions Radiation: A Preliminary Study
Authors: Chen Yong , Gao Haining , Ye Wenling
Published: August 2018

Heavy-ion irradiation-induced nuclear DNA damage and mutations have been studied comprehensively. However, there is no information about the deleterious effect of heavy-ion irradiation on mitochondrial DNA (mtDNA). In this study, 2 typical mtDNA mutations were examined, including 4977 deletions and D310 point mutations. The 4977 deletions were quantified by real-time polymerase chain reaction, and D310 point mutations were analyzed by direct sequencing and a specific enzyme digestion genotyping method. Results showed that carbon ions radiation can induce temporal fluctuation of mtDNA 4977 deletions in 72 hours after irradiation, while survived clones were free from this deletion. Carbon ions induced more D310 mutations than X-rays, and the single-cell heteroplasmy was eliminated. This is the first study investigating mtDNA mutations induced by carbon ions irradiation in vitro. These findings would provide fundamental information for further investigation of radiation-induced mitochondrial biogenesis.
Health and Wellness Coaching Improves Weight and Nutrition Behaviors
Authors: Kennel Julie
Published: August 2018

Most Americans have an eating pattern inconsistent with the Dietary Guidelines, putting them at risk for obesity and chronic disease. Health and wellness coaching (HWC) for lifestyle behavior change is emerging as a potentially effective tool to prevent and treat chronic disease. A systematic literature review identified 11 randomized controlled trials studying the use of HWC for improving nutrition-related biomarkers and eating behaviors. These trials demonstrate efficacy of HWC across diverse populations and treatment modalities. Almost all (82%) of the trials showed an improvement in at least one outcome. The most commonly studied outcomes were weight, blood pressure, and fruit, vegetable, and fat intake. There are several gaps in the research. The assessment of nutrition-related behaviors can be expanded to include assessment of diet quality and eating patterns associated with chronic disease prevention. Research is needed to evaluate HWC for nutrition-related biomarkers and behaviors in understudied populations with known health disparities. In addition, the health coaching dosage for long-term maintenance of changed outcomes and behaviors is inconsistent or unknown. These gaps will be important to address to determine policies and best practices for future application of HWC.
Slope stability evaluation and monitoring of Tonglushan ancient copper mine relics
Authors: Tao Zhigang , Zhu Chun , Zheng Xiaohui , He Manchao
Published: August 2018

Due to natural environmental conditions and the effect of man, geological disasters (landslides, earthquakes, etc.) pose a serious threat to ancient relics distributed across China. In consideration of the current situation at the Tonglushan ancient copper mine relics, and on the basis of hydrology and geological engineering conditions of ancient relics, major factors affecting slope stability of ancient relics are analyzed. In light of major working condition types in the slopes of ancient relics, slope stability in relation to earthquakes and rainfall is analyzed using GeoStudio software with limit equilibrium methods. Results indicate that, with sustained rainfall, all slopes in the current reinforcement measure maintain a suitable stabilization status, but slope stability will sharply decline in response to an earthquake. Therefore, the influence of mining blasting activities on slope stability is analyzed. In view of the deformation characteristics of ancient copper mines, the sliding force remote monitoring and warning system based on the constant resistance and large deformation anchor bolt is adopted to continuously monitor the stability of the west slope of the relics. Monitoring results show that the application of “mechanical gun” instead of “explosive blasting” mining technique in the open-pit mine has effectively reduced the influence of mining disturbance on the stability of the western slope. As slope deformation of the relics can be effectively monitored and controlled, our findings provide a theoretical basis to analyze slope stability in other similar cultural relics.
Numerical tests on thermal cracking characteristics of rocks with different scales
Authors: Xiao Yang , Zhao Rui , Huang Qing-Xiang , Deng Jun , Lu Jun-Hui
Published: August 2018

Realistic failure process analysis, a thermal software simulation, was used to explore the scale effect of thermal cracking of rock under the thermal–mechanical coupling loading. The patterns and characteristics of thermal destruction were analyzed by simulating the thermal cracking of rocks with the same diameter different lengths, the same length but different diameters, and the same size ratio but different sizes (same length/diameter ratio but with different diameters). The acoustic emission and energy changes were also studied during thermal destruction. The results represented that the main forms of thermal cracking are tensile failure and shear failure. The smaller the scale is (length, diameter, and size), the more complex the pattern of thermal damage exhibited as failure patterns of inverted “S” or “V.” With the increasing scale, thermal damage models were simpler. The elastic modulus was determined by the diameter of specimens, and the peak stress was determined by the length of specimens. Overall, as the scale increased, the stress intensity decreased, but the number of acoustic emissions and acoustic emission energy and the corresponding accumulation increased.
An improved geometric error analysis method considering the variety of sensitivities over working space
Authors: Liu Xiaojian , Wang Yang , Qiu Lemiao , Wu Chenrui , Zhang Peng , Zhang Shuyou
Published: August 2018

Machine tool accuracy analysis has become increasingly important since accuracy as the major parameter of a machine is to a large extent determined by geometric accuracy design. In order to improve the comprehensiveness and veracity of geometric accuracy design, this article proposes an improved geometric error analysis method considering the variety of sensitivities over working space. A multi-rigid-body model which includes cutting tool’s wear-out error and workpiece’s clamping error is established to represent the position relationship of machine tool’s working components. The expression of geometric error is converted from matrix form to screw form through the screw mapping theory, so that rotational error can be expressed and calculated directly like the translational error. Considering motion errors along axes over the whole working space instead of at a fixed position, an improved sensitivity analysis algorithm is conducted to identify, among 38 components of errors increased the variety with tool wear and clamping errors, which of them have a significant impact on four different types of machine errors. Finally, the proposed method was implemented and validated on a horizontal boring machine, and the sensitivity analysis results over working space would offer vital evidence for the machine’s geometric accuracy design.
Investigation of Tissue Inhibitor of Metalloproteinases 1 in Plasma from Colorectal Cancer Patients and Blood Donors by Surface-Enhanced Laser Desorption/Ionization Time-of-Flight Mass Spectrometry
Authors: Caspersen M.B. , Sørensen N.M. , Schrohl A.S. , Iversen P. , Nielsen H.J. , Brünner N.
Published: August 2018

Early detection of colorectal cancer (CRC) improves patient survival. Plasma tissue inhibitor of metalloproteinases 1 (TIMP-1) measurements by enzyme-linked immunosorbent assay (ELISA) have been suggested as a new method for the early detection of CRC. To further investigate the nature of TIMP-1 in plasma, surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI TOF MS) was used. TIMP-1 measurements of plasma from 16 healthy donors and 14 CRC patients were performed using TIMP-1 monoclonal antibody in SELDI TOF MS and ELISA. SELDI TOF MS applying an antibody to TIMP-1 revealed that human plasma TIMP-1 has a mass of 25.1 kDa and exhibits several isoforms. Both methods showed increased plasma TIMP-1 values for cancer patients as compared to healthy individuals. The p values for the separation of the groups were 0.0019 for ELISA and <0.0001 for SELDI TOF MS. CRC did not fundamentally affect the appearance of TIMP-1 as evaluated by SELDI TOF MS.
HeritageBot platform for service in Cultural Heritage frames
Authors: Ceccarelli Marco , Cafolla Daniele , Russo Matteo , Carbone Giuseppe
Published: August 2018

A service robot for Cultural Heritage frames is proposed as a novel robotic platform with a modular design for both ground locomotion and flight capability. The peculiarities of the system are discussed by performance evaluation via simulation. A prototype has been built and tested both to prove the feasibility of the proposed design and to characterize its operation performance.
Pre-post effectiveness evaluation of Chronic Disease Self-Management Program (CDSMP) participation on health, well-being and health service utilization
Authors: Hevey David , Wilson O’Raghallaigh Jennifer , O’Doherty Veronica , Lonergan Katie ,   Marese Heffernan; Victoria Lunt; SineadMulhern; Damien Lowry; Niamh Larkin; Kathy McSharry; David Evans; Jackie Morris Roe; Mike Kelly; Peter Pardoe, Harry Ward; Sean Kinsella
Published: August 2018

Objectives

The Chronic Disease Self-Management Program (CDSMP) is a standardized self-management intervention for patients with various chronic diseases. CDSMP provides self-management skills to enhance patient health, well-being, and coping skills. The present study evaluates the effectiveness of CDSMP delivered in routine clinical services on health, health behaviors and healthcare utilization in patients with various chronic illnesses.

Methods

A pragmatic single group pre-post design evaluated the effectiveness of the CDSMP in an Irish cohort using self-report data collected by service providers in hospital, community health and patient organizations. Data on health, health behavior and healthcare utilization were collected at baseline ( n = 263), immediately post-program ( n = 102), and six months ( n = 81) after enrollment.

Results

CDSMP participants reported statistically significant increases in activity levels, self-efficacy, energy and quality of life, and a significant decrease in depression scores at six months follow-up. There was a significant decrease in self-reported visits to the GP and in total nights spent in hospital.

Discussion

This national pre–post study provides preliminary evidence for the potential effectiveness of CDSMP delivered during routine care in improving important health outcomes and reducing health care utilization among a heterogeneous sample of chronic disease patients.
Is the framing effect a framing affect?
Authors: Gosling Corentin J , Moutier Sylvain
Published: August 2018

Over the past 30 years, researchers have shown that human choices are highly sensitive to the ways in which alternatives are presented. For example, when individuals face a choice between a sure and a risky option, their willingness to take risks varies depending on whether the alternatives are framed in terms of gain or loss. The current major hypothesis that explains such a framing effect predicts that compared with an equivalent risky option, sure gains are emotionally attractive and sure losses are emotionally aversive. Using a behavioural paradigm, the main objective of the current study was to experimentally observe the extent to which the emotional attraction to sure gains and aversion to sure losses are at the core of framing susceptibility. First, our results showed that, as the literature suggests, the emotional attraction to sure gains and aversion to sure losses underpin the framing effect. Second, our results showed that methodological factors moderated the role of these emotional mechanisms in the framing effect. Implications and directions for future studies are discussed.
Automaticity and cognitive control: Effects of cognitive load on cue-controlled reward choice
Authors: Seabrooke Tina , Wills Andy J , Hogarth Lee , Mitchell Chris J
Published: August 2018

The extent to which human outcome–response (O-R) priming effects are automatic or under cognitive control is currently unclear. Two experiments tested the effect of cognitive load on O-R priming to shed further light on the debate. In Experiment 1, two instrumental responses earned beer and chocolate points in an instrumental training phase. Instrumental response choice was then tested in the presence of beer, chocolate, and neutral stimuli. On test, a Reversal instruction group was told that the stimuli signalled which response would not be rewarded. The transfer test was also conducted under either minimal (No Load) or considerable (Load) cognitive load. The Non-Reversal groups showed O-R priming effects, where the reward cues increased the instrumental responses that had previously produced those outcomes, relative to the neutral stimulus. This effect was observed even under cognitive load. The Reversal No Load group demonstrated a reversed effect, where response choice was biased towards the response that was most likely to be rewarded according to the instruction. Most importantly, response choice was at chance in the Reversal Load condition. In Experiment 2, cognitive load abolished the sensitivity to outcome devaluation that was otherwise seen when multiple outcomes and responses were cued on test. Collectively, the results demonstrate that complex O-R priming effects are sensitive to cognitive load, whereas the very simple, standard O-R priming effect is more robust.
Long-term monitoring to detect atrial fibrillation with the indwelling implantable cardiac monitors
Authors: Sanna Tommaso
Published: August 2018

An increasing number of detection tools are available and several detection strategies have been described to pursue the diagnosis of atrial fibrillation to prevent ischemic stroke. Monitoring tools include standard electrocardiography, snapshot single-lead recordings with professional or personal devices (e.g. smartphone-based), Holter monitor, external devices with long-term recording capabilities, and cardiac implantable electronic devices, including pacemakers, implantable cardioverter defibrillators and insertable cardiac monitors. Insertable cardiac monitors have shown high sensitivity and specificity for the detection of atrial fibrillation, allow up to three years of continuous monitoring, do not require cooperation of the patient, are well tolerated, have a short device-related time delay between detection of atrial fibrillation and notification to the physician, provide information on atrial fibrillation burden and are minimally invasive. On the other hand, insertable cardiac monitors require a considerable use of resources to process the recordings and have a significant initial cost. Studies conducted with insertable cardiac monitors on patients with prior stroke and on patients with risk factors for stroke but no prior cerebrovascular events or atrial fibrillation have consistently shown a measurable incidence of atrial fibrillation at follow-up. However, the effectiveness of oral anticoagulations in reducing the incidence of ischemic stroke in patients with atrial fibrillation lasting less than 24 h, though reasonable, is currently unproven. The future of atrial fibrillation detection tools and atrial fibrillation detection strategies will be influenced by ongoing studies exploring whether oral anticoagulations reduce the incidence of stroke in patients with atrial fibrillation burden lower than 24 h.
The 1-minute sit-to-stand test to detect exercise-induced oxygen desaturation in patients with interstitial lung disease
Authors: Briand Justine , Behal Hélène , Chenivesse Cécile , Wémeau-Stervinou Lidwine , Wallaert Benoit
Published: August 2018

Background:

Although the 6-min walk test (6MWT) is the gold standard for assessing exercise-induced impairment of gas exchange, it cannot easily be performed in a clinical office environment. The aim of this study was to compare the 1-min sit-to-stand test (1STST) with the 6MWT for the ability to assess exercise-induced oxygen desaturation in patients with interstitial lung diseases (ILDs).

Methods:

A total of 107 patients were enrolled and classified into three groups: sarcoidosis, fibrotic idiopathic interstitial pneumonia (f-IIP), and other forms of ILD. The 6MWT and 1STST were performed on the same day, and pulmonary function tests, pulse oxygen saturation (SpO2), and dyspnea and fatigue (modified Borg scale) were assessed. SpO2 desaturation was evaluated by intraclass correlation coefficient (ICC), Bland–Altman analysis, and kappa (κ) coefficient in the whole population and the patient subgroups.

Results:

The SpO2 nadir during the 1STST and 6MWT showed good consistency [mean ± standard deviation: 92.5% ± 5% and 90% ± 7%, respectively; ICC 0.77, 95% confidence interval (CI) 0.71–0.83] and correlated strongly ( r = 0.9, p < 0.0001). The frequency of patients with oxygen desaturation ⩾4% was also consistent for the two exercise tests ( κ = 0.68, 95% CI 0.54–0.82). The number of repetitions in the 1STST correlated with the 6MWT distance ( r = 0.5, p < 0.0001), but the dyspnea scores were higher during the 1STST than the 6MWT ( p < 0.0001). These findings did not differ for the three patient subgroups.

Conclusion:

The 1STST can measure exercise-induced desaturation in ILD patients and could be used as an alternative test to the 6MWT in office practice.
Long-term evaluation of NEDA-3 status in relapsing-remitting multiple sclerosis patients after switching from natalizumab to fingolimod
Authors: Diem Lara , Nedeltchev Krassen , Kahles Timo , Achtnichts Lutz , Findling Oliver
Published: August 2018

Background:

Natalizumab significantly reduces the disease activity in patients with relapsing-remitting multiple sclerosis but due to the risk of progressive multifocal leukoencephalopathy it is often discontinued. Fingolimod is seen as an alternative, but there are no long-term analyses of the efficacy of fingolimod in this setting using the no evidence of disease activity (NEDA)-3 criteria. We provide an assessment of patients who discontinued natalizumab and switched to fingolimod or other treatments by evaluating the proportion of patients who fulfil NEDA-3 criteria after prolonged follow-up periods.

Methods:

We conducted a retrospective observational study of multiple sclerosis patients, who were treated with continuous natalizumab or who had switched to fingolimod or other treatments after natalizumab discontinuation. We assessed NEDA-3 status, annual relapse rate and determined the odds ratio between disease course after treatment switch and other patient and treatment characteristics.

Results:

A total of 61 patients on continuous natalizumab treatment and 53 patients who switched from natalizumab to fingolimod or other treatments were accompanied for up to 5 years. While the proportion of natalizumab patients fulfilling NEDA-3 criteria remained stable at 90% during the entire follow-up period, the proportion of patients switching to fingolimod or other therapies dropped to 76.7% in the first year after discontinuation, and to 50% in the years thereafter. While the median Expanded Disability Status Scale remained stable and the percentage of relapsing patients did not change significantly, recurring magnetic resonance imaging activity was found in up to 42% of the patients after switching from natalizumab to other treatments. New disease activity was significantly correlated with extended treatment gap between natalizumab discontinuation and the start of a new therapy.

Discussion:

Patients remain clinically stable after discontinuing natalizumab and switching to other therapies. However, when considering NEDA-3 criteria, a considerable proportion of patients show disease reactivation. Careful monitoring and early evaluation of alternatives is necessary after switching from natalizumab to other treatments.
Can inflammation be resolved in Alzheimer’s disease?
Authors: Zhu Mingqin , Wang Xiuzhe , Sun Li , Schultzberg Marianne , Hjorth Erik
Published: August 2018

Alzheimer’s disease (AD) is a neurodegenerative disease characterized by progressive memory loss and dementia. Accumulating evidence suggests that inflammation is involved in the pathogenesis of AD. Epidemiological studies suggest that use of anti-inflammatory drugs is associated with a lower incidence of AD. However, clinical trials with anti-inflammatory drugs have not been successful. Recent studies have shown that inflammation is resolved by a process that is mediated by a group of lipid mediators, so called specialized pro-resolving lipid mediators (SPMs). Unlike anti-inflammatory strategies, which usually involve inhibition of the synthesis of inflammatory mediators, stimulating the resolution of inflammation is aimed at ending inflammation in a similar fashion as under normal physiological conditions. We have previously shown that pathways of resolution are impaired in AD. Moreover, we found that SPMs can improve neuronal survival and increase microglial phagocytosis of amyloid beta (Aβ) in in vitro studies, indicating that stimulating resolution of inflammation may be a potential therapeutic target in AD. In this review, we summarize recent findings regarding resolution of inflammation in AD. We also discuss possible strategies to stimulate the resolution of inflammation in AD, specifically focusing on signaling pathways, including SPMs, their receptors and enzymes involved in their formation.
Ethics for civil indoor drones: A qualitative analysis
Authors: de Miguel Molina María , Santamarina Campos Virginia , Carabal Montagud Mª Ángeles , de Miguel Molina Blanca
Published: August 2018

Drones face two main concerns: safety and security/privacy. Whilst safety has been broadly studied by literature, less research has been carried out into security/privacy. Moreover, current European regulations on drone flights apply to outdoor drones but not always to their indoor counterparts. However, several industrial sectors have started to use drones for indoor tasks such as surveillance, architecture, emergencies, and communication media. A qualitative study has been conducted in order to explore the concerns expressed by civil drone operators over the measures that manufacturers include in their products and information packages. Codes of conduct could also help these parties when there is no legal regulation that can be applied. We used content analysis as the method of analysis for three different sources: secondary data from a literature review and from public European documents, and primary data from focus groups. Results show that safety and security/privacy by design are seen as the best ethical measures, whilst codes of conduct could be used as complimentary information for professional users.
Muslim students’ experiences and perspectives on current teaching practices in Canadian schools
Authors: Amjad Afshan
Published: August 2018

This study investigated seven Muslim elementary school students’ classroom experiences in a large urban area in western Canada. Although existing studies have examined the experiences of Muslim high school, college and university students, no research focused specifically on Muslim elementary school children’s classroom experiences in Alberta prior to this study. The study used an interpretive inquiry approach in which interviews with children about their lived experiences of schooling served as a foundation for critical analysis of school culture. The study results provide important insights into the lives of Muslim immigrant children who are trying to adapt to their host country while maintaining their family and community religious beliefs and practices. According to the findings, there are clear signs of the presence of Islamophobia in Canadian schools.
Activity following reverse total shoulder arthroplasty: What should surgeons be advising?
Authors: MacInnes Scott J , Mackie Katherine E , Titchener Andrew , Gibbons Rebekah , Wang Allan W
Published: August 2018

Background

Reverse total shoulder arthroplasty (RTSA) is now the most frequently performed form of shoulder arthroplasty. There is currently no consensus on recommended levels of activity and sport following RTSA. The aim of this review is to outline the current evidence and provide a guide for surgeons on what to advise their patients regarding activity level following RTSA.

Methods

A systematic review of the literature was performed using the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was performed using the electronic databases PubMed and Medline. Included studies were of level 1 to 4 evidence in the English language evaluating complications and return to sport after RTSA.

Results

Eleven studies were selected and included a total of 621 patients (67% female) with a mean age of 73 years (range 22–92). All of the included patients participated in sports prior to RTSA. The rate of return to sport ranged from 60 to 86% and varied with the level of sport activity. Mean time to return to sport after surgery varied greatly between studies.

Conclusions

Return to sport is tolerated following RTSA; however, studies are short to medium term only and although the reported complication rate is low, the studies did not include radiographic evaluation. Longer term studies with subgroup analysis evaluating common recreational activities after RTSA are required, particularly in the younger population, in order to establish clear post-operative guidelines.
Cannulated Intramedullary Screw Fixation of Distal Fibular Fractures
Authors: Ebraheim Nabil A. , Vander Maten Josh William , Delaney Joshua R. , White Erik , Hanna Maged , Liu Jiayong
Published: August 2018

Background: Open reduction and internal fixation (ORIF) methods, primarily plates and screws, remain the standard of treatment for distal fibular fractures. This study evaluates the use of a cannulated intramedullary screw as a minimally invasive treatment method for distal fibular fractures, which has not been reported in the current literature. Methods: This retrospective study included 45 patients with distal fibular fractures treated with cannulated intramedullary screw fixation. All patients included in the cohort had a soft-tissue condition and/or comorbidity. The mean age was 54 years. The Weber classification system was used to assess the type of fracture. Average time to union, average time to weight bearing, and complications were monitored. Results: Reduction quality criteria were collected using previously published guidelines. Accordingly, reduction was determined to be good in 25 cases, fair in 15, and poor in 5. A low complication rate of 4% was reported. Average time to union was 10 weeks (range = 8-36 weeks), whereas average time to weight bearing was 14 weeks (range = 8-40 weeks). Conclusion: Cannulated intramedullary screw fixation can serve as a minimally invasive, safe, and satisfactory treatment for distal fibular fractures with resulting high union rates and low complication rates.

Levels of Evidence: Level IV: Retrospective, case series
Relationship between postoperative volume of macroadenomas and clinical outcome after endoscopic trans-sphenoidal resection
Authors: Onofrj Valeria , Vallejo Carina , Puac Paulo , Zamora Carlos , Castillo Mauricio
Published: August 2018

Purpose

Although symptoms are expected to improve after the resection of pituitary macroadenomas, tumor resection volume does not always correlate with the patient’s symptoms. Our objectives were to assess the pre and postoperative volumes of pituitary macroadenomas before, immediately after surgery and at follow-up, and to explore possible associations and correlations among these changes and symptoms.

Materials and methods

We retrospectively reviewed the clinical records and the preoperative and postoperative magnetic resonance imaging studies at 24 hours and at 3, 6 and 9 months follow-up of 146 patients who underwent surgery for pituitary macroadenomas. We measured tumor volumes before and after surgery and compared changes with symptom improvement.

Results

The mean preoperative tumor volume was 24.66 cm3 (standard deviation 65.18 cm3, 95% confidence interval (CI) 14–35.32). The most common symptoms were visual/cranial nerve abnormalities (65%) and headaches (56%). Immediately after surgery, symptoms persisted without significant changes in all patients. A progressive tumor volume decrease was noted during follow-up, and symptoms improved in 78% of patients. Despite no imaging evidence of chiasm or cavernous sinus compression, 32 patients showed no symptom improvement. Patients with symptoms for more than 1 year (mean duration of symptoms 26 months, SD 24.3, 95% CI 22.03–29.97 months) had a higher risk of the persistence of symptoms compared to patients with a mean duration of symptoms of less than 1 year (odds ratio 2.5, 95% CI 2.4–3, P < 0.005).

Conclusions

The duration of symptoms prior of surgery is a more important factor than tumor resection volume alone when considering the long-term outcome of symptoms. Furthermore, lack of symptom improvement in the immediate postoperative period does not necessarily represent an inadequate resection.
White-matter integrity in patients with systemic lupus erythematosus and memory deficits
Authors: Corrêa Diogo G , Zimmermann Nicolle , Borges Rafael S , Pereira Denis B , Doring Thomas M , Tukamoto Gustavo , Fonseca Rochele P , Gasparetto Emerson L
Published: August 2018

Purpose

Cognitive dysfunction is common in neuropsychiatric systemic lupus erythematosus (SLE). Memory is a commonly affected cognitive domain. Clinically, however, it is difficult to detect memory deficits. The objective of this study is to evaluate whether normal controls and SLE patients with and without memory deficit differ in terms of white-matter integrity.

Methods

Twenty SLE patients with memory deficit were compared to 47 SLE patients without memory deficit and 22 sex-, age-, and education-matched control individuals. Diffusion tensor imaging (DTI) was performed in a 1.5-Tesla scanner. For tract-based spatial statistics analysis, a white-matter skeleton was created. A permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were also projected onto the mean FA skeleton.

Results

Compared to controls, SLE patients with and without memory deficit had decreased FA in: bilateral anterior thalamic radiation, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus, corticospinal tract, genu, and body of the corpus callosum. SLE patients with and without memory deficit also presented increased MD and RD values compared to controls in these areas. Comparison between SLE patients with and without memory deficit did not present significant differences in DTI parameters.

Conclusion

DTI can detect extensive abnormalities in the normal-appearing white matter of SLE patients with and without memory deficit, compared to controls. However, there was no difference, in terms of white-matter integrity, between the groups of SLE patients.
Real-world incidence of patient-reported dyspnoea with ticagrelor
Authors: Prosser Adaire E. , Dawson Jessica L. , Koo KethLyn , O’Kane Karen M. , Ward Michael B. , Woodman Richard J. , Mangoni Arduino A. , Phillips Cameron J.
Published: August 2018

Dyspnoea, a common and multifactorial symptom in patients with acute coronary syndrome, has been associated with lower quality of life and hospital readmission. Prescriber preference for antiplatelet therapy, the standard of care in this patient group, is shifting to ticagrelor due to mortality benefits demonstrated in trials compared with clopidogrel. In these trials, dyspnoea was more commonly reported in patients prescribed ticagrelor but the aetiology is still debated.

An observational cohort study was conducted to quantify the rates and severity of dyspnoea reported in patients with acute coronary syndrome and newly prescribed ticagrelor compared with those prescribed clopidogrel. Dyspnoea was more commonly reported in patients prescribed ticagrelor at each follow up post-discharge ( p = 0.016). Rates were higher than previously reported in clinical trials. In some patients, dyspnoea necessitated drug therapy change and was associated with readmission to hospital ( p = 0.046). As ticagrelor is widely prescribed as a first-line antiplatelet agent for a range of patients with acute coronary syndrome, the incidence of dyspnoea in a generalized patient cohort may result in higher rates of drug discontinuation. This in turn could lead to higher rates of rehospitalisation and potential treatment failure than that reported from the controlled setting of a clinical trial.
Using social media in safety signal management: is it reliable?
Authors: Rees Sue , Mian Sadiqa , Grabowski Neal
Published: August 2018

Social media use is growing globally, with a reported 3 billion active users in 2017. This medium is used increasingly in a health setting by patients (and to a limited extent, healthcare professionals) to share experiences and ask advice on medical conditions as well as pharmaceutical products. In recent years, attention has turned to this huge, generally untapped, source of potential health information as a possible tool for pharmacovigilance, and in particular signal detection. In this article we explore some of the challenges of utilizing social media for safety signal detection and look at some of the pilot studies conducted to date in order to weigh the evidence for and against the utility of social media data in safety signal detection. After doing so we can conclude that the analysis of social media datasets has demonstrated a limited contribution to the signal detection and signal management process. The data available in social media can complement blind spots in traditional pharmacovigilance datasets and provide significant value for targeted investigations and studies such as those relating to abuse, misuse, use in pregnancy, and patient sentiments.
Automated generation of ‘good enough’ transcripts as a first step to transcription of audio-recorded data
Authors: Bokhove Christian , Downey Christopher
Published: August 2018

In the last decade, automated captioning services have appeared in mainstream technology use. Until now, the focus of these services have been on the technical aspects, supporting pupils with special educational needs and supporting teaching and learning of second language students. Only limited explorations have been attempted regarding its use for research purposes: transcription of audio recordings. This article presents a proof-of-concept exploration utilising three examples of automated transcription of audio recordings from different contexts; an interview, a public hearing and a classroom setting, and compares them against ‘manual’ transcription techniques in each case. It begins with an overview of literature on automated captioning and the use of voice recognition tools for the purposes of transcription. An account is provided of the specific processes and tools used for the generation of the automated captions followed by some basic processing of the captions to produce automated transcripts. Originality checking software was used to determine a percentage match between the automated transcript and a manual version as a basic measure of the potential usability of each of the automated transcripts. Some analysis of the more common and persistent mismatches observed between automated and manual transcripts is provided, revealing that the majority of mismatches would be easily identified and rectified in a review and edit of the automated transcript. Finally, some of the challenges and limitations of the approach are considered. These limitations notwithstanding, we conclude that this form of automated transcription provides ‘good enough’ transcription for first versions of transcripts. The time and cost advantages of this could be considerable, even for the production of summary or gisted transcripts.
Quality of life and functional outcome after single-radius and multi-radius total knee arthroplasty
Authors: Lee Merrill , Chen Jerry Yongqiang , Ying Hao , Nee Pang Hee , Tay Darren Keng Jin , Chin Pak Lin , Lu Chia Shi , Nung Lo Ngai , Jin Yeo Seng
Published: August 2018

Purpose:

The main objective of this study was to compare quality of life and functional outcome in patients who have undergone a single-radius (SR) or multi-radius (MR) total knee arthroplasty (TKA). The secondary objective was to observe changes in knee range of movement (ROM) and standardized knee scores (KSCs) in these patients. The hypothesis was that there would be no statistically significant difference between the two patient groups in quality of life and functional outcome.

Methods:

One hundred three SR TKAs were performed by a single surgeon between August 2008 and December 2012. A propensity score matching algorithm was used to select 103 MR TKAs performed during the same period. Preoperative and postoperative variables such as standardized knee and quality of life scores were captured prospectively and then analyzed via both the Student’s t-test and paired t-test to look for statistically significant differences between the SR and MR patient groups.

Results:

At 2 years postoperatively, there was no statistically significant difference between the SR and MR patient populations in knee extension, Oxford Knee Score, Knee Society Clinical Rating Scores, and the Physical Component Summary of the Short Form 36 Health Survey (SF-36). There was a statistically significant difference between the two patient groups in postoperative knee flexion in favor of the MR design ( p = 0.011).

Conclusion:

While an SR femoral implant design has several theoretical biomechanical advantages, postoperative standardized KSCs and quality of life scores in this single-surgeon series do not show a clear advantage of one design over the other.

Level of evidence:

III.
Groundwater Market in West Bengal, India: Does it Display Monopoly Power?
Authors: Acharyya Achiransu , Ghosh Madhusudan , Bhattacharya Rabindra N.
Published: August 2018

Based on village-level primary household survey in three districts of West Bengal, the present study tries to understand the groundwater market structure using the standard market theory. Comparing the internal rate of return of private investors on groundwater irrigation with past studies, it is found that although the degree of monopoly has gone down in the state over time, a certain element of monopoly still exists in the groundwater market. The estimates of price-to-marginal cost ratios and the Lerner index amply demonstrate the existence of high degree of monopoly in groundwater market. The study also shows that since banks give loans based on collateral, it is the large farmland owners who benefit from these bank loans for installation of electric submersibles for groundwater irrigation. Factors such as availability of rain and canal water, advance payment for water, distance of the land from the irrigation source, and maintenance and labour cost of water extraction mechanism also affect the price of water. As the groundwater extraction increases, it leads to lowering of the groundwater table leading to increasing cost for the water seller who in effect transfers the increasing cost to price leading to a rise in groundwater prices. This is a cause of concern not only for the small and marginal farmers but also for the sustainability of groundwater.

JEL Classifications: Q15, D42, Q21