bluuebunny/crossref_metadata_2025 huggingface dataset:
Fantasy as a Driving Force: Relations Between Fantasy and Motivation in Children
Authors: Hoff Eva V. , Ekman Alexandra , Kemdal Pho Anna
Published: October 2017

The relationship between children’s fantasy involvement and motivational style at school was investigated. Participants were 95 Swedish children in third to fifth grade (9–11 years). Fantasy involvement was measured with the Children’s Fantasy Inventory and motivation in the classroom was measured with the Goal Orientation Scales. Results revealed that being highly imaginative was related to higher mastery goal orientation. Among the two subscales with positive fantasy content, one—fanciful and happy fantasies—was connected to mastery goals. Among the two negative fantasy scales one—scary daydreams and attention lapses—was linked to avoidance goals. An implication of the results for teaching and learning situations is that fantasy involvement may function as a resource for motivating students.
Ambiguous collision outcomes and sliding with infinite friction in models of legged systems
Authors: Remy C David
Published: October 2017

This work explores the collision process at foot contact in models of legged robots. In particular, we highlight that for legged systems the widely used assumption of no sliding of the contact points can yield inconsistent outcomes. For certain contact configurations and system parameters, neither the assumption of lift-off of the trailing foot nor the assumption that it stays fixed on the ground yield valid solutions. The foot will slide, even if an infinite coefficient of friction is assumed. In a related effect, we present configurations in which the solution of the collision process is ambiguous. These behaviors are examined for the models of a minimalistic biped, a passive dynamic walker, and the five-link bipedal robot RAMone. The paper provides background for these non-intuitive behaviors and investigates the influence of system parameters onto the collision behavior of a passive dynamic walker. By studying bipedal models that range from minimalistic to physically accurate, this paper establishes a bridge between the theoretical study of unilateral contact in multibody dynamic simulations and the application of these simulation methods in the modeling of ground contact in actual legged systems.
Understanding and living with multiple sclerosis fatigue
Authors: Turpin Merrill , Kerr Georgina , Gullo Hannah , Bennett Sally , Asano Miho , Finlayson Marcia
Published: October 2017

Introduction

Fatigue substantially affects the lives of many people with multiple sclerosis. This study aimed to further our understanding of the experience of living with multiple sclerosis fatigue by exploring how people became aware of and understood their multiple sclerosis fatigue and how they accommodate it in their daily lives.

Method

The study used an existential approach to thematic analysis. Thirteen in-depth, semi-structured interviews with people who experienced multiple sclerosis fatigue were conducted and analysed.

Results

Participants developed an understanding of multiple sclerosis fatigue through gaining awareness of its effect on their lives, seeking information themselves and being informed by health professionals. Participants described how they began to understand the effect of fatigue in their lives and make decisions about how to accommodate it. They discussed the challenges associated with helping others to understand their multiple sclerosis fatigue.

Conclusion

Lay and expert explanations, the phenomenological notions of lived experience, self-identity and embodiment and stigma associated with invisible disability were useful concepts for understanding the results. Clinicians should consider these concepts when supporting people with multiple sclerosis fatigue to understand the effect of fatigue in their daily lives and use fatigue management strategies to make effective lifestyle changes to accommodate it.
Playing by the rules? New institutionalism, path dependency and informal settlements in Sub-Saharan Africa
Authors: Morrison Nicky
Published: October 2017

The scale of contemporary urbanization in Sub-Saharan Africa has culminated in the proliferation of informal settlements, with governments claiming a legitimate right to remove them. Drawing on new institutionalism as a conceptual framework and presenting the case of Old Fadama, an informal settlement within central Accra in Ghana, this paper sheds light on the way in which both formal and informal rules shape these legally unauthorized spaces. Using the analogy of a game, the author devises a novel typology to highlight the way in which different players maximize their personal advantage from maintaining the status quo. The paper concludes that as long as different interests are served by the existing socio-political arrangements then path dependency will endure, with government officials as the dominant playmaker in the locality ultimately controlling the rules and pace of the game.
Three playgrounds: Researching the multiple geographies of children’s outdoor play
Authors: Horton John , Kraftl Peter
Published: October 2017

This paper argues for more careful, combinative approaches to children’s outdoor play that can better apprehend the social-material, political and spatial constitution of children’s play with/in diverse urban communities. Much extant scholarship on play starts either from macro-scale generalisations about the ‘state’ of children’s play, or from micro-scale analyses of the performances, materialities and feelings that constitute play. Our approach in this paper is to both combine these approaches and, more significantly, to focus elsewhere. Drawing on a large-scale, multi-method study of children’s outdoor play in three London communities, we start our analyses with three ostensibly similar, and geographically-proximate playgrounds. Through detailed attention to children’s narratives about these playgrounds, we assert the value of a comparative approach that demonstrates how the three playgrounds articulated both overlapping and strikingly divergent social-political processes in each community. Children’s narratives ranged from humorous and affirmative accounts of relaxation, fun, friendship and wildfowl, to haunting urban myths that make manifest community anxieties about ‘strangers’, sexual violence and intravenous drug use, to troubling, stinging critiques of how playgrounds evinced longstanding concerns about social-political marginalisation. The paper opens out a number of important avenues for future scholarship on play, specifically, and for research in children’s geographies and childhood studies more generally. In particular, it emphasises the value of a comparative approach to outdoor play that pays detailed attention to the enduring role of myths and rumours in the co-constitution of playspaces with, in and as the social-political lives of communities.
Added Value of Preoperative Computed Tomography for Determining Cartilage Degeneration in Patients With Osteochondral Lesions of the Talar Dome
Authors: Nakasa Tomoyuki , Ikuta Yasunari , Yoshikawa Masahiro , Sawa Mikiya , Tsuyuguchi Yusuke , Adachi Nobuo
Published: October 2017

Background:

Osteochondral lesions of the talar dome (OLTs) involve the articular cartilage and subchondral bone. The subchondral bone plate (SBP) plays a crucial role in cartilage metabolism, and computed tomography (CT) can provide more precise information on subchondral bone. CT image prediction of the histological findings on OLT will be useful to determine the most appropriate therapeutic strategy.

Purpose:

To evaluate the unique features of the CT findings that relate to the condition of the articular cartilage in OLT.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Thirty ankles in 29 patients who had OLT with an osteochondral fragment were retrospectively reviewed. At surgery, the osteochondral fragment of 19 ankles could be preserved (preservation group) by fixation or drilling, and in the remaining 11 ankles, the osteochondral fragment was removed (excision group). Preoperative CT findings were compared between the 2 groups. Biopsies of the osteochondral fragment from 13 ankles were performed. The relationship between the CT and histological findings were evaluated.

Results:

The area of lesion in the preservation group was significantly larger than that in the excision group. The CT images of the lesion showed the rate of absorption of the SBP in the preservation group to be lower than that in the excision group. As for the lesion bed absorption, it was higher in the preservation group than in the excision group. All cases in the excision group showed bed sclerosis, compared with 42.1% in the preservation group. The specimens with disruption of the SBP exhibited cartilage degeneration and abundant chondrocyte cloning. OLT with absorption of the SBP on CT showed severe cartilage degeneration, while the remaining SBP on CT showed low-grade cartilage degeneration.

Conclusion:

This study shows the features of preoperative CT and histological findings in OLT with osteochondral fragments. The condition of the SBP affects the cartilage degeneration. CT findings provide important information for the determination of surgical treatment.
Development and Evaluation of a Game-Based Bayesian Intelligent Tutoring System for Teaching Programming
Authors: Hooshyar Danial , Binti Ahmad Rodina , Wang Minhong , Yousefi Moslem , Fathi Moein , Lim Heuiseok
Published: October 2017

Games with educational purposes usually follow a computer-assisted instruction concept that is predefined and rigid, offering no adaptability to each student. To overcome such problem, some ideas from Intelligent Tutoring Systems have been used in educational games such as teaching introductory programming. The objective of this study was to advance Online Game-based Bayesian Intelligent Tutoring System (OGITS) to enhance programming acquisition and online information searching skills, thus improving students’ ability in web-based problem solving through board games. The study sample comprised 79 college students in introductory level Computer Science classes. Qualitative and quantitative data were then gathered. Results of this study revealed generally favorable opinions about OGITS. As OGITS targets individual knowledge acquisition of computer programming and web-based problem-solving skills, it offers a suitable learning environment for students both as a stand-alone course and as a supplement to traditional classroom settings.
Parent Training Programs for School-Age Children With Autism: A Systematic Review
Authors: Black Marie E. , Therrien William J.
Published: October 2017

Parent training (PT) is widely used with families of children with autism spectrum disorder (ASD), and its benefits for young children and their parents have been documented. However, no reviews have examined the use of PT within interventions delivered to older children with ASD or investigated the added benefit of including a PT component in these interventions. Therefore, the purpose of this review is to explore the state of research regarding the inclusion of PT in interventions for school-age children with ASD and to determine the value added to these interventions by including a PT component. Fifteen PT studies examining 622 child participants with ASD were included. Participants, interventions, and the effects of the interventions are described. Overall, studies demonstrated moderately positive effects for interventions that included PT. Importantly, three studies isolating the added benefit of PT demonstrated an effect size (ES) of 0.33, 95% confidence interval (CI) [0.05, 0.61], indicating the value added to interventions by including parents. More research is needed to understand the development of effective PT, its components, and how to best design these programs to benefit school-age children with ASD.
Multisector Involvement Among Adolescents With Disabilities
Authors: Sullivan Amanda L. , Thayer Andrew J. , Sadeh Shanna S.
Published: October 2017

When youth experience psychosocial difficulties, multiple sectors of care may intervene. The present study examined the prevalence and sociodemographic predictors of multisector involvement related to psychosocial difficulties among adolescents with disabilities. Using a nationally representative sample of 9,230 students who participated in the National Longitudinal Transition Study–2, we estimated students’ rates of involvement in school, health, social service, and juvenile justice sectors and used logistic regression models to ascertain the relations to student characteristics. Students with disabilities were frequently involved with a variety of sectors of care, but schools remain the primary provider. Multisector involvement was commonplace, particularly for adolescents with emotional disturbance or autism. Disability and insurance type consistently predicted involvement of each sector, but other sociodemographic characteristics commonly related to disparities in involvement were not significant in most of our models. Communication and collaboration across systems can support the school-based problem solving and individualized planning for students with disabilities.
Human exposure to polyhexamethylene guanidine phosphate from humidifiers in residential settings: Cause of serious lung disease
Authors: Lee Ji Hyun , Yu Il Je
Published: October 2017

Exposure to the humidifier disinfectant, polyhexamethylene guanidine phosphate (PHMG), in mists generated from ultrasonic humidifiers was studied in a simulation chamber and apartment rooms. PHMG is suspected as a causative agent of lung disease in Korea residences. In the simulation-chamber study, the amount of disinfectant discharged from three different ultrasonic humidifiers was measured. Mists generated at 1, 2, and 4 times the recommended amount of disinfectant were sampled with an impinger, and the effect of relative humidity (RH) on airborne disinfectant concentration was studied by changing RH from 60%–70% to 90%–100%. In addition, particle size distribution (PSD) in mists was measured by scanning mobility particle sizer (SMPS), aerodynamic particle sizer (APS), and Mastersizer. In the apartment study, mists generated from ultrasonic humidifiers were sampled for 6 h in small and large rooms during fall ( n = 10) and winter ( n = 15). In the simulation study, the humidifiers discharged 205 ± 24.6 ml/h of mist at maximum capacity. Concentrations of airborne disinfectant increased with increasing concentration of disinfectant. RH affected airborne disinfectant concentration in the chamber, with increasing concentration with increasing RH. Below RH 70%, no airborne PHMG was detected. PHMG-containing mists generated from ultrasonic humidifier showed various sizes ranging from 149–157 nm to 690–740 nm to larger than 5.4 µm by SMPS, APS, and Mastersizer, respectively. Surface area mean diameter measured by Mastersizer ranged from 5.39 µm to 5.72 µm. In the apartment study conducted during the fall, the geometric mean (GM) and geometric standard deviation (GSD) and arithmetic mean (AM) and standard deviation (SD) of airborne PHMG concentration were 3.22 + 5.13 µg/m3 and 8.26 ± 12.18 µg/m3, respectively. In the winter, GM + GSD and AM ± SD of airborne PHMG concentration were 0.21 + 2.11 µg/m3 and 0.35 ± 0.62 µg/m3, respectively. RH and temperature in the apartment rooms for fall and winter were 22.5 ± 1.7°C, 74.5 ± 15.6% and 22.0 ± 2°C, 51.1 ± 12.9%, respectively. Different RHs in the fall and winter resulted in very different airborne concentrations of disinfectant in the apartment rooms. Exposure levels and PSD of mists generated from ultrasonic humidifiers in apartments are not sufficient to conclude that PHMG causes lung disease in Korean residences.
Metabolic Complications of Home Parenteral Nutrition
Authors: Davila Jamie , Konrad Denise
Published: October 2017

Home parenteral nutrition (HPN) has benefited countless patients since its initiation almost 5 decades ago. Over time, HPN has been found to be associated with various complications, including metabolic disorders. Metabolic complications can be grouped into short‐term (eg, fluid imbalance, electrolyte disturbances, glucose abnormalities) and long‐term (eg, hepatobiliary disorders, metabolic bone disease, iron deficiency anemia, manganese toxicity) categories. There are a number of treatment options for each complication. It is important to evaluate the entire clinical picture prior to initiating an intervention and use evidence‐based interventions when available. A dedicated multidisciplinary team is best suited to prevent and manage complications when they are identified.
Collagen sponge functionalized with chimeric anti-BMP-2 monoclonal antibody mediates repair of nonunion tibia defects in a nonhuman primate model: An exploratory study
Authors: Guo Lijia , Min Seiko , Su Yingying , Tang Jianxia , Du Juan , Goh Bee Tin , Saigo Leonardo , Wang Songlin , Ansari Sahar , Moshaverinia Alireza , Zadeh Homayoun H , Liu Yi
Published: October 2017

Recombinant human bone morphogenetic protein (BMP)-2 is an FDA-approved therapy for nonunion tibia fracture, though it has a number of biological and practical disadvantages. Our research group has developed a novel tissue engineering strategy termed antibody-mediated osseous regeneration. This entails application of anti-BMP-2 monoclonal antibodies (mAbs) to capture endogenous BMP’s to mediate in vivo bone formation. This has been documented in a number of animal models. The present exploratory study sought to investigate the application of antibody-mediated osseous regeneration for repair of nonunion tibia defect in a nonhuman primate model. A 20 mm segmental osteotomy was performed in tibia of 6 Macaca fascicularis and was implanted with absorbable collagen sponge that was functionalized with chimeric anti-BMP-2 or isotype matched control mAb. Cone beam computed tomography (CBCT), histologic and histomorphometric analyses were performed 12 weeks post-operatively. CBCT analyzed by quantitative 3D volumetric analysis revealed that sites implanted with absorbable collagen sponge functionalized with anti-BMP-2 mAb demonstrated numerically higher mineralized tissue (408 ± 127 mm3) compared with sites implanted with isotype matched control mAb (214 ± 81 mm3), though the difference was not statistically significant ( p = 0.09). Histologic and histomorphometric analysis showed de novo bone formation with greater ( p < 0.01) percentage of bone volume in sites implanted with anti-BMP-2 (41.3 ± 4.4%), compared with isotype matched control mAb (14.6 ± 5.6%). Results from the present exploratory study provide evidence for the potential of anti-BMP-2 mAb to mediate repair of a large segmental tibia defects in a nonhuman primate model. Therapeutic antibodies have generally been shown to have great safety and efficacy profile, though their application in tissue engineering has been limited in the past. Following further investigation, anti-BMP-2 mAbs immobilized on appropriate scaffold may have application in repair of large skeletal defects without the need for exogenous growth factors.
In vitro and in vivo evaluation of the duck's feet collagen sponge for hemostatic applications
Authors: Seo Ye Been , Lee Ok Joo , Sultan Md. Tipu , Lee Jung Min , Park Ye Ri , Yeon Yeung Kyu , Lee Ji Seung , Lee Young Jin , Kim Soon Hee , Park Chan Hum
Published: October 2017

Recently different hemostatic agents have been developed, but most of them are ineffective in severe bleeding and expensive or cause safety concerns. In this study, we fabricated duck's feet collagen-based porous sponges and investigated its use as a hemostatic agent. We determined the sponge's physical and biological characteristics and compared with Avitene via scanning electron microscope analysis, water-uptake abilities and porosity test, and cytotoxicity assay. The duck's feet collagen/silk sponge showed a larger interconnected porous structure compared to others sponges. The duck's feet collagen/silk sponge also exhibited significantly higher porosity than Avitene. Hemostatic properties of the sponges were evaluated by whole blood clotting and rat femoral artery hemorrhage experiment. The addition of silk to duck's feet collagen showed better blood clotting ability than Avitene in vitro. However, rat femoral artery hemorrhage test showed a similar hemostatic property between the duck's feet collagen-based sponges and Avitene. We suggest that duck's feet collagen-based sponge can be effectively used for hemostatic applications.
The effects of liquid crystal-based composite substrates on cell functional responses of human umbilical cord-derived mesenchymal stem cells by mechano-regulatory process
Authors: Wu Hao , Shang Yupan , Zhang Jiaqing , Cheang Lek Hang , Zeng Xiaoli , Tu Mei
Published: October 2017

Physical properties of extracellular matrix, including elasticity and microstructure, have been considered as important factors inducing stem cell differentiation. This study developed a novel type of liquid crystal-based matrix by combining the elastic property of polyurethane with viscoelastic liquid crystal to generate a soft elastic response resembling physical microenvironment of stem cell niche, and explored the mechano-driving cell behaviors. Addition of varying liquid crystal concentration (10 wt%, 30 wt% and 50 wt%) had great effects on surface morphology and elastic modulus of liquid crystal/ polyurethane composite substrates. Changes in microstructure and elastic modulus of the substrates could cause intense cell responses that influenced cell properties, including proliferation, adhesion, and osteogenic differentiation. Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) cultured on both liquid crystal-10/polyurethane and liquid crystal-30/polyurethane substrates exhibited higher viability, more actin filament, and larger spreading area while liquid crystal-50/polyurethane substrates seemed not to favor cell attachment and spreading. Alkaline phosphatase activity and calcium deposition were significantly improved with hUC-MSCs on both liquid crystal-10/ polyurethane and liquid crystal-30/ polyurethane substrates, and the maximal alkaline phosphatase activity was observed in liquid crystal-10/ polyurethane while the lowest in liquid crystal-50/ polyurethane. Osteopontin was upregulated to a high level in both liquid crystal-10/ polyurethane and liquid crystal-30/ polyurethane groups after 14 days culturing; the maximal expression of osteocalcin and related transcription factor 2 were found in liquid crystal-10/ polyurethane group on day 21. Our findings revealed that hUC-MSCs could intensely sense the bioactive patterns and soft-matter feature of liquid crystal domains and subsequently modulated cell behaviors, which may prove useful in the development of new class of biomaterials for applications in tissue engineering and regenerative medicine.
Surface modification of model hydrogel contact lenses with hyaluronic acid via thiol-ene “click” chemistry for enhancing surface characteristics
Authors: Korogiannaki Myrto , Zhang Jianfeng , Sheardown Heather
Published: October 2017

Discontinuation of contact lens wear as a result of ocular dryness and discomfort is extremely common; as many as 26% of contact lens wearers discontinue use within the first year. While patients are generally satisfied with conventional hydrogel lenses, improving on-eye comfort continues to remain a goal. Surface modification with a biomimetic, ocular friendly hydrophilic layer of a wetting agent is hypothesized to improve the interfacial interactions of the contact lens with the ocular surface. In this work, the synthesis and characterization of poly(2-hydroxyethyl methacrylate) surfaces grafted with a hydrophilic layer of hyaluronic acid are described. The immobilization reaction involved the covalent attachment of thiolated hyaluronic acid (20 kDa) on acrylated poly(2-hydroxyethyl methacrylate) via nucleophile-initiated Michael addition thiol-ene “click” chemistry. The surface chemistry of the modified surfaces was analyzed by Fourier transform infrared spectroscopy–attenuated total reflectance and X-ray photoelectron spectroscopy. The appearance of N (1s) and S (2p) peaks on the low resolution X-ray photoelectron spectroscopy spectra confirmed successful immobilization of hyaluronic acid. Grafting hyaluronic acid to the poly(2-hydroxyethyl methacrylate) surfaces decreased the contact angle, the dehydration rate, and the amount of nonspecific sorption of lysozyme and albumin in comparison to pristine hydrogel materials, suggesting the development of more wettable surfaces with improved water-retentive and antifouling properties, while maintaining optical transparency (>92%). In vitro testing also showed excellent viability of human corneal epithelial cells with the hyaluronic acid-grafted poly(2-hydroxyethyl methacrylate) surfaces. Hence, surface modification with hyaluronic acid via thiol-ene “click” chemistry could be useful in improving contact lens surface properties, potentially alleviating symptoms of contact lens related dryness and discomfort during wear.
Evaluation of N-phosphonium chitosan as a novel vaccine carrier for intramuscular immunization
Authors: Cai Jianzhou , Zhang Wu , Xu Jiake , Xue Wei , Liu Zonghua
Published: October 2017

Chitosan, as a potential vaccine delivery material, has obtained much attention for immunization prevention and therapy. However, its poor water solubility brings inconvenience for the practical applications. To address this issue, researchers have carried out many chemical modifications to prepare water-soluble chitosan derivatives for vaccine delivery. In this work, we prepared a chitosan derivative N-phosphonium chitosan with excellent water solubility and explored its potential as an intramuscular vaccine delivery system by using ovalbumin as a model antigen. Different vaccine formulations were intramuscularly injected into test mice. Through an immunohistochemistry assay, N-phosphonium chitosan-based antigen formulation could promote antigen arrival from injection site to the secondary lymph organ spleen. Further immunization results showed that 1 mg/ml N-phosphonium chitosan-based vaccine formulation could contribute to significantly higher level of antigen-specific immune responses, including higher antigen-specific IgG antibody titer, splenocyte proliferation, and cytokines secretion (interferon-γ, interleukin-10, and interleukin-4) by the splenocytes of the immunized mice. From the results, the water-soluble chitosan derivative N-phosphonium chitosan could be developed as a potential antigen carrier for immunization prevention and therapy.
The Theological Character of the Old Latin Version of Esther
Authors: Bellmann Simon
Published: October 2017

The Old Latin version of Esther is witness to a lost Greek Vorlage. It differs significantly from other ancient (Hebrew, Greek, and Aramaic) Esther stories as it includes, for instance, a prayer of the Jewish community as well as several additional cases of divine intervention; it also omits any mention of the ‘massacre episode’. Previous research on the Old Latin Esther has largely focused on text-historical questions. This article intends to broaden the discussion by examining the theological character of the text. A close comparison with the extant Hebrew and Greek Esther versions reveals that the Old Latin emphasizes the importance of the Jewish community and presents Mordecai as its prototypical leader in both religious and political matters. In addition, the Vetus Latina emphasizes the crucial role of divine action, induced by acts of religious observance and petitionary prayer.
The effects of advance ratio and blade number on the forward flight characteristics of cycloidal rotor
Authors: Yu Hu , Geng Qi Wang , Hai Lang Zhang , Xu Yang Fu , Hussain Farhat
Published: October 2017

Cycloidal rotor is a rotor whose blades pitch around the pitching axis and revolve around the rotor shaft that is parallel to blade. It can generate omni-directional thrust with high efficiency. In this paper, the numerical simulation models were validated by the wind tunnel experiments. Then physics of the cycloidal rotor in forward flight was studied. The effects of blade number and advance ratio were qualitatively discussed based on the numerical simulation results. Results of the analysis indicate that the rotor with more blades will result in smoother force curve, so that there will be lower vibration. However, the rotor with three or four blades will be the most efficient. The maximum forward flight efficiency is obtained from medium-to-high advance ratio. The efficiency is comparable with that of a screw propeller at the same Reynolds number. At low advance ratio, the peak lift on the blade can be observed when the blade is located at the lower left part of its trajectory. This is caused by positive blade pitch angle and relatively large inflow speed, which is similar to the downwash in the rotor cage under hovering status. From medium-to-high advance ratio, the thrust and lift primarily originated from the plunging motion of the blade. If the advance ratio is high enough, there will be negative horizontal force and positive torque, which means that the blade is taking energy from the inflow. Resultant force of the horizontal and vertical force does not vary too much with the advance ratio. But with the advance ratio approaching 1.0, the direction of the resultant force will point upwards and no horizontal force can be observed.
Antimalarial-induced cardiomyopathy: a systematic review of the literature
Authors: Tselios K , Deeb M , Gladman D D , Harvey P , Urowitz M B
Published: October 2017

Background

Antimalarials (AMs) are widely used in the treatment of connective tissue diseases. Their main side effect is retinal damage, while heart disease has been described in isolated cases. The aim of this study is to systematically review the existing literature on AM-induced cardiomyopathy (AMIC).

Methods

The PubMed database was searched for heart biopsy-confirmed AMIC cases. Information on demographics, clinical presentation, concomitant AM-related toxicity, cardiological investigations, treatment and outcome were collected. Descriptive statistics were used.

Results

Forty-seven cases (42 females) were identified with a mean age at diagnosis 56.4 ± 12.6 and mean AM treatment duration 12.7 ± 8.2 years. Systemic lupus erythematosus ( n = 19) and rheumatoid arthritis ( n = 18) were the most common primary diseases. Clinical presentation was that of congestive heart failure in 77%, while eight patients presented with syncope (17%). Complete atrioventricular block was reported in 17 patients; 24 received a permanent pacemaker (51%). Impaired systolic function was detected in 52.8%, bi-ventricular hypertrophy in 51.4% and restrictive filling pattern of the left ventricle in 18 patients. Cardiac magnetic resonance showed late gadolinium enhancement in seven cases, with a non-vascular pattern in the interventricular septum. Cardiomyocyte vacuolation was reported in all cases; intravacuolar lamellar and curvilinear bodies were observed in 46 (98%) and 42 (89.4%) respectively. Mortality rate was 45% (18/40).

Conclusion

AMIC is a rare, probably under-recognized, complication of prolonged AM treatment. It presents as a hypertrophic, restrictive cardiomyopathy with or without conduction abnormalities. Early recognition and drug withdrawal are critical with a survival rate of almost 55%.
Monitoring and Control in Language Production
Authors: Nozari Nazbanou , Novick Jared
Published: October 2017

Language research has provided insight into how speakers translate a thought into a sequence of sounds that ultimately becomes words, phrases, and sentences. Despite the complex stages involved in this process, relatively little is known about how we avoid and handle production and comprehension errors that would otherwise impede communication. We review current research on the mechanisms underlying monitoring and control of the language system, especially production, with particular emphasis on whether such monitoring is issued by domain-general or domain-specific procedures.
Grounding Verbal Working Memory: The Case of Serial Order
Authors: Abrahamse Elger L. , van Dijck Jean-Philippe , Fias Wim
Published: October 2017

The maintenance of serial order in verbal working memory (WM) is a major unsolved puzzle in cognitive science. Here we review a series of studies showing that serial order in verbal WM closely interacts with spatial processing. Accordingly, we outline the “mental whiteboard hypothesis,” which postulates that serial order in verbal WM is grounded in the spatial attention system. Specifically, serial context in verbal WM is provided by binding the memoranda to coordinates within an internal, spatially defined system within which (internal) spatial attention is at play to the purpose of searching for and retrieving information. Challenges and opportunities to be considered in future studies are discussed.
Gard and Yates v. GOSH, the Guardian and the United Kingdom: Reflections on the legal process and the legal principles
Authors: Bridgeman Jo
Published: October 2017

In this commentary, I examine the litigation over the medical treatment of Charlie Gard from the High Court in April 2017 to the European Court of Human Rights and back to the High Court in July 2017. As is usual in cases of conflict between parents and clinicians over a child’s medical treatment, referred to court for determination, at the heart of the dispute were sincerely and strongly held differences of opinion as to what was best for Charlie. The process of trying to convince Charlie’s parents of the futility of their hope was prolonged by the legal process as the case proceeded through the appeal stages with the view of the treating clinicians agreed by the judge prevailing each time. In the July hearing, after the appeal process had been exhausted, Francis J made great efforts to resolve the dispute and mediate the conflict, while retaining judicial authority, but by this time the relationship between the parents and hospital was irretrievably broken. The protracted legal process was traumatic for Charlie’s parents, stressful for Charlie’s clinicians and nurses and required the judiciary to authorize his continued ventilation when it had been concluded that this was contrary to Charlie’s best interests. I argue that this case demonstrates clearer than any before that a comprehensive review is required of the principles and processes applicable to disputes over children’s medical treatment.
Newborn cystic fibrosis screening in southeastern Mexico: Birth prevalence and novel CFTR gene variants
Authors: Ibarra-González Isabel , Campos-Garcia Felix-Julián , Herrera-Pérez Luz del Alba , Martínez-Cruz Patricia , Moreno-Graciano Claudia-Margarita , Contreras-Capetillo Silvina-Noemí , León-Burgos Verónica , Maldonado-Solis Felipe-Angel , Alcántara-Ortigoza Miguel Angel , González del Angel Ariadna , Vela-Amieva Marcela
Published: October 2017

Objective

To use the results of the first five years of a cystic fibrosis newborn screening program to estimate the cystic fibrosis birth prevalence and spectrum of cystic fibrosis transmembrane conductance regulator ( CFTR) gene variants in Yucatan, Mexico.

Methods

Screening was performed from 2010 to 2015, using two-tier immunoreactive trypsinogen testing, followed by a sweat test. When sweat test values were >30 mmol/L, the CFTR gene was analyzed.

Results

Of 96,071 newborns screened, a second sample was requested in 119 cases. A sweat test was performed in 30 newborns, and 9 possible cases were detected (seven confirmed cystic fibrosis and two inconclusive). The most frequently detected CFTR pathogenic variant (5/14 cystic fibrosis alleles, 35.7%) was p.(Phe508del); novel p.(Ala559Pro) and p.(Thr1299Hisfs*29) pathogenic variants were found.

Conclusions

Cystic fibrosis birth prevalence in southeastern Mexico is 1:13,724 newborns. Immunoreactive trypsinogen blood concentration is influenced by gestational age and by the time of sampling. The spectrum of CFTR gene variants in Yucatan is heterogeneous.
A genetic algorithm–based design approach for smart base isolation systems
Authors: Mohebbi Mohtasham , Dadkhah Hamed , Rasouli Dabbagh Hamed
Published: October 2017

This article presents a new approach for designing effective smart base isolation systems composed of a low-damping linear base isolation and a semi-active magneto-rheological damper. The method is based on transforming the design procedure of the hybrid base isolation system into a constrained optimization problem. The magneto-rheological damper command voltages have been determined using H2/linear quadratic Gaussian and clipped-optimal control algorithms. Through a sensitivity analysis to identify the effective design parameters, base isolation and control algorithm parameters have been taken as design variables and optimally determined using genetic algorithm. To restrict increases in floor accelerations, the objective function of the optimization problem has been defined as minimizing the maximum base drift while putting specific constraint on the acceleration response. For illustration, the proposed method has been applied to design a semi-active hybrid isolation system for a four-story shear building under earthquake excitation. The results of numerical simulations show the effectiveness, simplicity, and capability of the proposed method. Furthermore, it has been shown that using the proposed method, the acceleration of the isolated structure can also be incorporated into design process and practically controlled with a slight sacrifice of control effectiveness in reducing the base drift.
Model and experimental research of a hybrid self-contained electro-hydrostatic actuator using piezoelectric stack
Authors: Guo Yazi , Zhu Yuchuan , Li Yuyang , Fei Shangshu , Zhu Bin , Zhang Xinbin , Wang Xiaolu
Published: October 2017

Smart material–based electro-hydrostatic actuators are a potential alternative to traditional hydraulic actuators. Piezoelectric materials are a type of smart materials that can deliver large blocked forces. In this article, a piezoelectric stack–based electro-hydrostatic actuator is first introduced by presenting the schematic diagrams of its structure and work principle. Next, according to the research of the piezoelectric stack–based electro-hydrostatic actuator working principle, a mathematical model that can describe the dynamic characteristics of piezoelectric stack–based electro-hydrostatic actuator was established. The output displacement model of the piezoelectric stack–based actuator was established based on the improved asymmetric Bouc–Wen model. The simulation model was built in MATLAB/Simulink. Finally, experiments under different working conditions were conducted, as well as the corresponding simulations. The experimental results demonstrate that the prototype no-load output flow reaches its maximum at 275 Hz and the output flow peak is close to 1.6 L/min. Moreover, the load capacity is more than 20 kg and the maximum load is more than 50 kg according to the trend forecast. The simulation results exhibit good agreement with the experimental results, which means that the piezoelectric stack–based electro-hydrostatic actuator model is feasible.
Use of Guidelines for Reducing Stroke Risk in Patients With Nonvalvular Atrial Fibrillation: A Review From a Latin American Perspective
Authors: Cantú-Brito Carlos , Silva Gisele Sampaio , Ameriso Sebastián F.
Published: October 2017

Atrial fibrillation (AF) is a prominent risk factor for stroke and a leading cause of death and disability throughout Latin America. Contemporary evidence-based guidelines for the management of AF and stroke incorporate the use of practical and relatively simple scoring methods to estimate both stroke and bleeding risk, in order to assist in matching patients with appropriate interventions. This review examines consistencies and differences among guidelines for reducing stroke risk in patients with AF, assessing the role of user-friendly scoring methods to determine appropriate patients for anticoagulation and other treatment options. Current options include warfarin and direct oral anticoagulants such as dabigatran, rivaroxaban, apixaban, and edoxaban. These agents have been found to be superior or noninferior to standard vitamin K antagonist anticoagulation in large randomized trials. Potential benefits of these agents mainly include lower ischemic stroke rates, reduced intracranial bleeding, no need for regular monitoring, and fewer drug–drug and drug–food interactions. Expert opinions regarding clinical situations for which data are presently lacking, such as emergency bleeding and stroke in anticoagulated patients, are also provided. Enhanced attention and adherence to evidence-based guidelines are essential components for a strategy to reduce stroke morbidity and mortality across Latin America.
Acute Hypotension After MitraClip Implantation due to Acute Left Ventricular Failure
Authors: Dalia Adam A. , Essandoh Michael
Published: October 2017

The MitraClip is a percutaneously implanted device approved for the treatment of symptomatic organic mitral regurgitation in poor surgical candidates. Despite its proven efficacy and safety for mitral regurgitation treatment, the MitraClip may unmask the true afterload of the left ventricle by removing the low-pressure left atrial system and may cause acute left ventricular systolic failure (afterload mismatch). Rapid diagnosis and treatment of afterload mismatch is crucial to ensure optimal patient outcomes. The authors present a case of acute hemodynamic deterioration after MitraClip implantation in a patient with chronic severe left ventricular systolic dysfunction. Transesophageal echocardiography was pivotal for the rapid recognition of acute left ventricular failure and aided in the intraoperative decision-making process and therapy.
Clinical presentations, treatments and risk factors for mortality in cats with tick paralysis caused by Ixodes holocyclus: 2077 cases (2008–2016)
Authors: Leister Ellie , Morton John , Atwell Rick , Webster Rob
Published: October 2017

Objectives

The objective of this study was to describe seasonality, demographics, presentations, treatments, complications and outcomes for cats with Ixodes holocyclus causing tick paralysis, and to identify risk factors for mortality.

Methods

This was a retrospective single cohort study with 2077 cases occurring between 2008 and 2016, and presenting to one of four emergency clinics in south-eastern Queensland, Australia. Case mortality at 5 days post-presentation could be determined for 1742 cases, and potential risk factors for mortality were assessed using random-effects logistic regression.

Results

Cases occurred all year round, but there was a marked seasonal pattern with more cases presenting in spring than any other season. Overall, 54/1742 cases (3%) died by 5 days after presentation. Five day mortality incidence for cases that received polyclonal canine tick antitoxin serum (TAS) and recommended treatment was 28/1410 (2%) vs 4/52 (8%) for cases that did not receive TAS ( P <0.001). Mechanical ventilation was recommended for 131/2077 cases (6%). Where mechanical ventilation was recommended but not implemented, mortality incidence was 15/17 (88%), whereas 4/22 cases (18%) that received mechanical ventilation died by day 5. From multivariable analyses, initial gait score (overall P = 0.047) and body temperature on presentation (overall P <0.001) were independently associated with mortality; cases with higher gait scores and those with body temperatures <35°C were at greater risk of death. Cases that had an adverse reaction to TAS were also more likely to die ( P = 0.002). Additional ticks were detected at coat clipping for 80/872 (9%) the cases that were clipped, and coat clipping was associated with a reduced risk of mortality ( P = 0.020). Risk of mortality did not differ significantly by time of year, clinic location, breed, sex, neuter status, age, weight, coat length or number of ticks found.

Conclusions and relevance

The overall mortality risk for cats treated for tick paralysis caused by I holocyclus is low. Risk factors for mortality include advanced gait and respiratory scores, and hypothermia at presentation. Coat clipping and TAS reduce the risk of mortality, whereas the occurrence of a TAS reaction increases the risk. Mechanical ventilation reduces mortality risk in cats with respiratory failure due to tick paralysis.
Serum symmetric dimethylarginine and creatinine in Birman cats compared with cats of other breeds
Authors: Paltrinieri Saverio , Giraldi Marco , Prolo Amanda , Scarpa Paola , Piseddu Eleonora , Beccati Massimo , Graziani Benedetta , Bo Stefano
Published: October 2017

Objectives

The aim of this study was to assess whether, in contrast to serum creatinine, which is higher in Birman cats than in other breeds, the serum concentration of symmetric dimethylarginine (SDMA) is comparable in clinically healthy Birmans and in the general feline population. This could allow, in this breed, to better evaluate chronic kidney disease (CKD).

Methods

Serum creatinine and SDMA were measured in clinically healthy Birmans (n = 50) and in cats of other breeds (n = 46), and the results were statistically compared. A breed-specific reference interval (RI) was established for Birmans and compared with the RI for the general feline population (0.0–14.0 µg/dl).

Results

Creatinine (1.58 ± 0.36 mg/dl) and SDMA (12.2 ± 2.8 µg/dl) were higher ( P <0.001) in Birmans than in cats of other breeds (1.19 ± 0.17 mg/dl; 10.3 ± 2.5 µg/dl). In 20/50 Birman cats (40.0%) serum creatinine was higher than both the non-breed-specific RI of our laboratory and the threshold recommended to classify cats as IRIS stage 2 (1.6 mg/dl). The concentration of SDMA was higher than the pre-existing RI in 10/50 Birmans (20.0%) and in four cats of other breeds (8.7%). Among Birmans, the proportion of cats with SDMA >14 µg/dl was lower ( P <0.017) than the proportion of cats with creatinine >1.60 mg/dl. However, the deviation from the upper limit of the RI was lower than the analytical variability of the method in 7/10 Birmans and in 4/4 cats of other breeds. The breed-specific RI (3.5–18.7 µg/dl) overlapped with the pre-existing one.

Conclusions and relevance

SDMA may be a better marker of CKD in Birman cats than creatinine when non-breed-specific RIs are utilised. The coupled analysis of creatinine and SDMA could help prevent errors in diagnosing and staging CKD in Birman cats.