bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional Variation in Transient Ischemic Attack and Minor Stroke in Alberta Emergency Departments
Authors: Leong Michelle , Stang Jillian M. , McGuire Natasha , Lang Eddy , Coutts Shelagh B. , Patocka Catherine
Published: May 2020

Background and Purpose—

Multiple studies have shown the 90-day risk of stroke following an emergency department (ED) diagnosis of transient ischemic attack (TIA) or minor stroke is significant, with the greatest risk of recurrence being within the first 24 to 48 hours following initial symptom onset. This study explored regional differences in ED disposition, neuroimaging, and subsequent 90-day stroke risk of patients diagnosed with TIA or minor stroke in Alberta.

Methods—

We used administrative databases to identify ED visits, neuroimaging, and 90-day return visits for TIA or minor stroke in Alberta from April 2011 to March 2016 among adults ≥20 years of age and stratified them based on regions of presentation (Edmonton, Calgary, or nonmajor urban).

Results—

During the 5-year study period, 22 421 patients had index ED visits for TIA or minor stroke. All 3 regions had a similar number of ED visits for TIA/minor stroke; however, on index ED visit, Calgary had a higher proportion of computed tomographic angiography imaging (48.8%;
P
<0.0001) compared with Edmonton (6.7%) and nonmajor urban region (5.7%) and higher proportion of discharged patients (83%;
P
<0.0001) compared with Edmonton (77.7%) and nonmajor urban region (73.5%). The risk of admission for stroke within 90 days of discharge after index ED visit for TIA/minor stroke in Calgary (3.4%) was lower than Edmonton (4.5%) and the nonmajor urban region (4.6%;
P
=0.002).

Conclusions—

This study demonstrates regional variation in computed tomographic angiography for neurovascular imaging of patients presenting to the ED for TIA/minor stroke and a possible association with frequency of index visit admission and 90-day readmission for the same problem.
Teaching Impact on Telestroke Nurse Recognition of Large Vessel Occlusion Computerized Tomography Perfusion Patterns
Authors: Williams Laura , Helms Maria , Snider Emily K. , Chang Brenda , Singh Sam , Asimos Andrew W.
Published: May 2020

Background and Purpose—

A distinguishing feature of our Stroke Network is telestroke nurses who remotely facilitate evaluations. To enable expeditious transfer of large vessel occlusion (LVO) acute ischemic stroke patients presenting to nonthrombectomy centers, the telestroke nurses must immediately identify color thresholded computerized tomography perfusion (CTP) patterns consistent with internal carotid artery (ICA), middle cerebral artery (MCA) segment 1(M1), and MCA segment 2 (M2) LVO acute ischemic stroke.

Methods—

We developed a 6-month series of tutorials and tests for 16 telestroke nurses, focusing on CTP pattern recognition consistent with ICA, M1, or M2 LVO acute ischemic stroke. We simultaneously conducted a prospective cohort study to evaluate the impact of this intervention.

Results—

Telestroke nurses demonstrated good accuracy in detecting ICA, M1, or M2 LVO during the first 3 months of teaching (83%–94% accurate). This significantly improved during the last 3 months (99%–100%), during which the likelihood of correctly identifying the presence of any one of these LVOs exceeded that of the first 3 months (
P
<0.001). There was a higher probability of correctly identifying any CTP pattern as consistent with either an ICA, M1, or M2 occlusion versus other types of occlusions or nonocclusions (odds ratio, 5.22 [95% CI, 3.2–8.5]). Over time, confidence for recognizing CTP patterns consistent with an ICA, M1, or M2 LVO did not differ significantly.

Conclusions—

A series of tutorials and tests significantly increased the likelihood of telestroke nurses correctly identifying CTP patterns consistent with ICA, M1, or M2 LVOs, with the benefit of these tutorials and test reviews peaking and plateauing at 4 months.
Deep Gray Matter Iron Deposition and Its Relationship to Clinical Features in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy Patients
Authors: Sun Chengyue , Wu Yue , Ling Chen , Xie Zhiying , Kong Qingle , Fang Xiaojing , An Jing , Sun Yunchuang , Zhang Wei , Yang Qi , Wang Zhaoxia , Zhang Zihao , Yuan Yun
Published: May 2020

Background and Purpose—

Distribution patterns of iron deposition in deep gray matter and their association with clinical characteristics in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) remain unclear. We aimed to evaluate iron deposition in deep gray matter in patients with CADASIL using 7.0-T susceptibility-weighted imaging and mapping and to explore its correlations with clinical characteristics.

Methods—

Thirty-nine patients with CADASIL, confirmed via genetic analysis or skin biopsy, were enrolled. We examined patients using the Mini-Mental State Examination, modified Rankin Scale, and brain 7.0-T magnetic resonance imaging and obtained magnetic resonance imaging lesion loads, small vessel disease scores, and susceptibility mapping. The following regions of interest were selected: caudate nucleus, putamen, globus pallidus, thalamus, substantia nigra, and red nucleus. The quantitative differences in the susceptibility of deep gray matter between the CADASIL and control groups and the correlations between deep gray matter susceptibility and clinical characteristics were identified.

Results—

Compared with the control group, the CADASIL group showed significantly increased susceptibility of caudate nucleus, putamen, thalamus, substantia nigra, and red nucleus. The susceptibility of deep gray matter in basal ganglia region, including caudate nucleus, putamen, and thalamus, significantly increased with age or disease duration and positively correlated with small vessel disease scores in patients with CADASIL. Moreover, the susceptibility of thalamus positively correlated with modified Rankin Scale scores after adjusting for age and disease duration and that of putamen negatively correlated with Mini-Mental State Examination scores in patients with CADASIL after adjusting for age.

Conclusions—

Our findings indicate an association between abnormal iron deposition in deep gray matter of patients with CADASIL and their clinical characteristics. Therefore, excess iron deposition in deep gray matter, as indicated by 7.0-T susceptibility-weighted imaging and mapping, might not only be a novel magnetic resonance imaging feature but also a potential biomarker for CADASIL severity.
Influence of Preexisting Cognitive Impairment on Clinical Severity of Ischemic Stroke
Authors: Béjot Yannick , Duloquin Gauthier , Crespy Valentin , Durier Jérôme , Garnier Lucie , Graber Mathilde , Giroud Maurice
Published: May 2020

Background and Purpose—

The ongoing ageing population is associated with an increasing number of patients with stroke who have preexisting cognitive impairment. This study aimed to evaluate clinical severity in patients with ischemic stroke according to prestroke cognitive status.

Methods—

Patients with ischemic stroke were prospectively identified among residents of Dijon, France using a population-based registry (2013–2017). Prestroke cognitive status (no impairment, mild cognitive impairment [MCI], or dementia) was recorded, and severity at stroke onset was measured using the National Institutes of Health Stroke Scale (NIHSS) score. Association between prestroke cognitive status and severity was evaluated using ordinal regression analysis models in which the NIHSS score was considered as a categorical variable.

Results—

Among the 1048 patients (mean age, 76.3±15.2 years; 54.0% women), a greater severity was observed in those with MCI (n=132; median NIHSS: 6; interquartile range, 2–15), and those with dementia (n=164; median NIHSS: 7; interquartile range, 3–16), than in patients without cognitive impairment (n=752; median NIHSS: 3; interquartile range, 1–9). MCI (odds ratio [OR], 1.70 [95% CI, 1.21–2.38];
P
=0.002) and dementia (OR, 2.24 [95% CI, 1.65–3.04];
P
<0.001) were both associated with a greater severity at onset. The association was still observed after adjustment for clinical variables and proximal arterial occlusion (OR, 1.52 [95% CI, 1.02–2.28];
P
=0.04 for MCI; OR, 2.16 [95% CI, 1.45–3.22];
P
<0.001 dementia). Further adjustment for prestroke handicap slightly reduced the magnitude of the association (OR, 1.49 [95% CI, 0.98–2.25];
P
=0.06 for MCI, and OR, 1.98 [95% CI, 1.26–3.12];
P
=0.02 for dementia). The greater severity in patients with prestroke cognitive impairment was not specifically driven by a more severe impairment of either motor or language function.

Conclusions—

Patients with preexisting cognitive impairment suffered more severe ischemic stroke. This result could reflect a lower brain tolerance of acute ischemia. Further studies are needed to explore the underlying mechanisms that could be targeted from therapeutic perspectives focusing on neuroprotection.
2B, 2C, or 3
Authors: LeCouffe Natalie E. , Kappelhof Manon , Treurniet Kilian M. , Lingsma Hester F. , Zhang Guang , van den Wijngaard Ido R. , van Es Adriaan C.G.M. , Emmer Bart J. , Majoie Charles B.L.M. , Roos Yvo B.W.E.M. , Coutinho Jonathan M. ,   on behalf of the MR CLEAN Registry Investigators*
Published: May 2020

Background and Purpose—

A score of ≥2B on the modified Thrombolysis in Cerebral Infarction scale is generally regarded as successful reperfusion after endovascular treatment for ischemic stroke. The extended Thrombolysis in Cerebral Infarction (eTICI) includes a 2C grade, which indicates near-perfect reperfusion. We investigated how well the respective eTICI scores of 2B, 2C, and 3 correlate with clinical outcome after endovascular treatment.

Methods—

We used data from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands Registry, a prospective, nationwide registry of endovascular treatment in the Netherlands. We included patients with a proximal intracranial occlusion of the anterior circulation for whom final antero-posterior and lateral digital subtraction angiography imaging was available. Our primary outcome was the distribution on the modified Rankin Scale at 90 days per eTICI grade. We performed (ordinal) logistic regression analyses, using eTICI 2B as reference group, and adjusted for potential confounders.

Results—

In total, 2807/3637 (77%) patients met the inclusion criteria. Of these, 17% achieved reperfusion grade eTICI 0 to 1, 14% eTICI 2A, 25% eTICI 2B, 12% eTICI 2C, and 32% eTICI 3. Groups differed in terms of age (
P
<0.001) and occlusion location (
P
<0.01). Procedure times decreased with increasing reperfusion grades. We found a positive association between reperfusion grade and functional outcome, which continued to increase after eTICI 2B (adjusted common odds ratio, 1.22 [95% CI, 0.96–1.57] for eTICI 2C versus 2B; adjusted common odds ratio, 1.33 [95% CI, 1.09–1.62] for eTICI 3 versus 2B).

Conclusions—

Our results indicate a continuous relationship between reperfusion grade and functional outcome, with eTICI 3 leading to the best outcomes. Although this implies that interventionists should aim for the highest possible reperfusion grade, further research on the optimal strategy is necessary.
Low-Frequency Vibrations Enhance Thrombolytic Therapy and Improve Stroke Outcomes
Authors: Dhanesha Nirav , Schnell Thomas , Rahmatalla Salam , DeShaw Jonathan , Thedens Daniel , Parker Bradley M. , Zimmerman M. Bridget , Pieper Andrew A. , Chauhan Anil K. , Leira Enrique C.
Published: May 2020

Background and Purpose—

We aim to determine the potential impact on stroke thrombolysis of drip-and-ship helicopter flights and specifically of their low-frequency vibrations (LFVs).

Methods—

Mice with a middle cerebral artery autologous thromboembolic occlusion were randomized to receive rtPA (recombinant tissue-type plasminogen activator; or saline) 90 minutes later in 3 different settings: (1) a motion platform simulator that reproduced the LFV signature of the helicopter, (2) a standardized actual helicopter flight, and (3) a ground control.

Results—

Mice assigned to the LFV simulation while receiving tPA had smaller infarctions (31.6 versus 54.9 mm
3
;
P
=0.007) and increased favorable neurological outcomes (86% versus 28%;
P
=0.0001) when compared with ground controls. Surprisingly, mice receiving tPA in the helicopter did not exhibit smaller infarctions (47.8 versus 54.9 mm
3
;
P
=0.58) nor improved neurological outcomes (37% versus 28%;
P
=0.71). This could be due to a causative effect of the 20- to 30-Hz band, which was inadvertently attenuated during actual flights. Mice using saline showed no differences between the LFV simulator and controls with respect to infarct size (80.9 versus 95.3;
P
=0.81) or neurological outcomes (25% versus 11%;
P
=0.24), ruling out an effect of LFV alone. There were no differences in blood-brain barrier permeability between LFV simulator or helicopter, compared with controls (2.45–3.02 versus 4.82 mm
3
;
P
=0.14).

Conclusions—

Vibration in the low-frequency range (0.5–120 Hz) is synergistic with rtPA, significantly improving the effectiveness of thrombolysis without impairing blood-brain barrier permeability. Our findings reveal LFV as a novel, safe, and simple-to-deliver intervention that could improve the outcomes of patients.

Visual Overview—

An online
visual overview
is available for this article.
Prehospital Triage of Acute Stroke Patients During the COVID-19 Pandemic
Authors: Goyal Mayank , Ospel Johanna M. , Southerland Andrew M. , Wira Charles , Amin-Hanjani Sepideh , Fraser Justin F. , Panagos Peter ,   on behalf of the AHA/ASA Stroke Council Science Subcommittees: Emergency Neurovascular Care (ENCC), the Telestroke and the Neurovascular Intervention Committees
Published: May 2020

The coronavirus disease 2019 (COVID-19) pandemic has broad implications on stroke patient triage. Emergency medical services providers have to ensure timely transfer of patients while minimizing the risk of infectious exposure for themselves, their co-workers, and other patients. This statement paper provides a conceptual framework for acute stroke patient triage and transfer during the COVID-19 pandemic and similar healthcare emergencies in the future.
Theta-burst TMS to the posterior superior temporal sulcus decreases resting-state fMRI connectivity across the face processing network
Authors: Handwerker Daniel A. , Ianni Geena , Gutierrez Benjamin , Roopchansingh Vinai , Gonzalez-Castillo Javier , Chen Gang , Bandettini Peter A. , Ungerleider Leslie G. , Pitcher David
Published: May 2020

Humans process faces by using a network of face-selective regions distributed across the brain. Neuropsychological patient studies demonstrate that focal damage to nodes in this network can impair face recognition, but such patients are rare. We approximated the effects of damage to the face network in neurologically normal human participants by using theta burst transcranial magnetic stimulation (TBS). Multi-echo functional magnetic resonance imaging (fMRI) resting-state data were collected pre- and post-TBS delivery over the face-selective right superior temporal sulcus (rpSTS), or a control site in the right motor cortex. Results showed that TBS delivered over the rpSTS reduced resting-state connectivity across the extended face processing network. This connectivity reduction was observed not only between the rpSTS and other face-selective areas, but also between nonstimulated face-selective areas across the ventral, medial, and lateral brain surfaces (e.g., between the right amygdala and bilateral fusiform face areas and occipital face areas). TBS delivered over the motor cortex did not produce significant changes in resting-state connectivity across the face processing network. These results demonstrate that, even without task-induced fMRI signal changes, disrupting a single node in a brain network can decrease the functional connectivity between nodes in that network that have not been directly stimulated.
On the Path to Becoming
Authors: Sarabi Niloo E.
Published: May 2020

In this article, I undertake a critical analysis of Marzieh Meshkini’s 2000 directorial debut, The Day I Became a Woman, which won multiple awards at the Toronto and Venice Film Festivals, and I investigate the manner in which Meshkini’s visual aesthetics enable her to enrich vital debates about the veil, gender socialization and social mobility as well as female pleasure and jouissance in contemporary Iranian society and abroad. Through a close reading of the figurative film language and innovative cinematography in Meshkini’s film, including its novel play with different temporalities and its artistic approach to mise-en-scène and framing of various shots, I examine the extent to which Meshkini succeeds in conveying her compelling social message in terms of Iranian women’s experiences, more than two decades after the Islamic revolution.
Edge Detection Reveals Abrupt and Extreme Climate Events
Authors: Bathiany Sebastian , Hidding Johan , Scheffer Marten
Published: May 2020

The most discernible and devastating impacts of climate change are caused by events with temporary extreme conditions (“extreme events”) or abrupt shifts to a new persistent climate state (“tipping points”). The rapidly growing amount of data from models and observations poses the challenge to reliably detect where, when, why, and how these events occur. This situation calls for data-mining approaches that can detect and diagnose events in an automatic and reproducible way. Here, we apply a new strategy to this task by generalizing the classical machine-vision problem of detecting edges in 2D images to many dimensions (including time). Our edge detector identifies abrupt or extreme climate events in spatiotemporal data, quantifies their abruptness (or extremeness), and provides diagnostics that help one to understand the causes of these shifts. We also publish a comprehensive toolset of code that is documented and free to use. We document the performance of the new edge detector by analyzing several datasets of observations and models. In particular, we apply it to all monthly 2D variables of the RCP8.5 scenario of the Coupled Model Intercomparison Project (CMIP5). More than half of all simulations show abrupt shifts of more than 4 standard deviations on a time scale of 10 years. These shifts are mostly related to the loss of sea ice and permafrost in the Arctic. Our results demonstrate that the edge detector is particularly useful to scan large datasets in an efficient way, for example multimodel or perturbed-physics ensembles. It can thus help to reveal hidden “climate surprises” and to assess the uncertainties of dangerous climate events.
An Overview of the Extratropical Storm Tracks in CMIP6 Historical Simulations
Authors: Priestley Matthew D. K. , Ackerley Duncan , Catto Jennifer L. , Hodges Kevin I. , McDonald Ruth E. , Lee Robert W.
Published: May 2020

The representation of the winter and summer extratropical storm tracks in both hemispheres is evaluated in detail for the available models in phase 6 of the Coupled Model intercomparison Project (CMIP6). The state of the storm tracks from 1979 to 2014 is compared to that in ERA5 using a Lagrangian objective cyclone tracking algorithm. It is found that the main biases present in the previous generation of models (CMIP5) still persist, albeit to a lesser extent. The equatorward bias around the SH is much reduced and there appears to be some improvement in mean biases with the higher-resolution models, such as the zonal tilt of the North Atlantic storm track. Low-resolution models have a tendency to underestimate the frequency of high-intensity cyclones with all models simulating a peak intensity that is too low for cyclones in the SH. Explosively developing cyclones are underestimated across all ocean basins and in both hemispheres. In particular the models struggle to capture the rapid deepening required for these cyclones. For all measures, the CMIP6 models exhibit an overall improvement compared to the previous generation of CMIP5 models. In the NH most improvements can be attributed to increased horizontal resolution, whereas in the SH the impact of resolution is less apparent and any improvements are likely a result of improved model physics.
Assessment of Precipitating Marine Stratocumulus Clouds in the E3SMv1 Atmosphere Model: A Case Study from the ARM MAGIC Field Campaign
Authors: Zheng X. , Klein S. A. , Ghate V. P. , Santos S. , McGibbon J. , Caldwell P. , Bogenschutz P. , Lin W. , Cadeddu M. P.
Published: May 2020

This paper presents a process-oriented evaluation of precipitating stratocumulus and its transition to cumulus in version 1 of the Energy Exascale Earth System Model (E3SMv1) using comprehensive case-study observations from a field campaign of the Atmospheric Radiation Measurement program (ARM). The E3SMv1 single-column model (SCM) of the marine boundary layer and its low clouds and precipitation are compared to observations including subcloud drizzle retrievals from a combination of Doppler radar and lidar backscatter measurements. The SCM is also compared to a large-eddy simulation (LES) of the same case. The combination of advanced remote sensing observations and LES is a powerful framework to evaluate the physical parameterizations of large-scale models. Given the observed large-scale environment, the E3SMv1 SCM realistically represents the evolution of clouds and boundary layer structure during the stratocumulus-to-cumulus transition. The model well simulates the liquid water path and its diurnal cycle in the stratocumulus period as well as the two-layer vertical thermodynamic structure and lower cloud fraction in the transition period. E3SMv1’s success in simulating the cloud in the stratocumulus period permitted examination of its precipitation processes. Here problems were identified with E3SMv1 producing an unrealistically small subcloud precipitation fraction, an unrealistic double peak in the vertical profiles of precipitation mass, and drizzle that evaporates too close to the surface. Further model diagnostics determined that these unrealistic characteristics resulted from an overly long microphysics time step and an unrealistic parameterization of the precipitation fraction. These results imply that careful consideration of these issues is needed in order to better simulate precipitation processes in marine stratocumulus.
Using a WRF-ADCIRC Ensemble and Track Clustering to Investigate Storm Surge Hazards and Inundation Scenarios Associated with Hurricane Irma
Authors: Kowaleski Alex M. , Morss Rebecca E. , Ahijevych David , Fossell Kathryn R.
Published: May 2020

This article investigates combining a WRF-ADCIRC ensemble with track clustering to evaluate how uncertainties in tropical cyclone–induced storm tide (surge + tide) predictions vary in space and time and to explore whether this method can help elucidate inundation hazard scenarios. The method is demonstrated for simulations of Hurricane Irma (2017) initialized at 1200 UTC 5 September, approximately 5 days before Irma’s Florida landfalls, and 1200 UTC 8 September. Mixture models are used to partition the WRF ensemble tracks from 5 and 8 September into six and five clusters, respectively. Inundation is evaluated in two affected regions: southwest (south and west Florida) and northeast (northeast Florida through South Carolina). For the 5 September simulations, inundation in the southwest region varies significantly across the ensemble, indicating low forecast confidence. However, clustering highlights the areas of inundation risk in south and west Florida associated with different storm tracks. In the northeast region, every cluster has high inundation probabilities along a similar coastal stretch, indicating high confidence at a ~5-day lead time that this area will experience inundation. For the 8 September simulations, track and inundation in both regions vary less across the ensemble, but clustering remains useful for distinguishing among flooding scenarios. These results demonstrate the potential of dynamical TC–surge ensembles to illuminate important aspects of storm surge risk, including highlighting regions of high forecast confidence where preparations can reliably be initiated early. The analysis also shows how clustering can augment probabilistic hazard forecasts by elucidating inundation scenarios and variability across a surge ensemble.
Assessment of Cloud Retrieval for IASI 1D-Var Cloudy-Sky Assimilation and Improvement with an ANN Approach
Authors: Lee Ahreum , Sohn Byung-Ju , Pavelin Ed , Kim Yoonjae , Kang Hyun-Suk , Saunders Roger , Noh Young-Chan
Published: May 2020

The Unified Model (UM) data assimilation system incorporates a 1D-Var analysis of cloud variables for assimilating hyperspectral infrared radiances. For the Infrared Atmospheric Sounding Interferometer (IASI) radiance assimilation, a first guess of cloud top pressure (CTP) and cloud fraction (CF) is estimated using the minimum residual (MR) method, which simultaneously obtains CTP and CF by minimizing radiance difference between observation and model simulation. In this study, we examined how those MR-based cloud retrievals behave, using “optimum” CTP and CF that yield the best 1D-Var analysis results. It is noted that the MR method tends to overestimate cloud top height while underestimating cloud fraction, compared to the optimum results, necessitating an improved cloud retrieval. An artificial neural network (ANN) approach was taken to estimate CTP as close as possible to the optimum value, based on the hypothesis that CTP and CF closer to the optimum values will bring in better 1D-Var results. The ANN-based cloud retrievals indicated that CTP and CF biases shown in the MR method are much reduced, giving better 1D-Var analysis results. Furthermore, the computational time can be substantially reduced by the ANN method, compared to the MR method. The evaluation of the ANN method in a global weather forecasting system demonstrated that it helps to use more temperature channels in the assimilation, although its impact on UM forecasts was found to be near neutral. It is suggested that the neutral impact may be improved when error covariances for the cloudy sky are employed in the UM assimilation system.
Dexmedetomidine for Treatment of Delayed Peak Symptoms of Cannabis Withdrawal Syndrome: A Case Report
Authors: MacCamy Katie , Hu Daniel
Published: May 2020

Background: Cannabis withdrawal syndrome (CWS) is characterized by irritability, sleep disorders, and physical discomfort that typically peaks within 7 days of cessation. Case: A patient with a 30-year history of heavy cannabis developed prolonged symptoms of CWS that peaked at greater than 40 days after cessation, who was successfully managed with dexmedetomidine. Discussion: This case report documents an unusual case of significantly delayed CWS peak in symptoms, as well as the novel use of dexmedetomidine for inpatient management of CWS.
An Evolutionarily Conserved Helix Mediates Ameloblastin-Cell Interaction
Authors: Su J. , Bapat R.A. , Visakan G. , Moradian-Oldak J.
Published: May 2020

Ameloblastin (Ambn) has the potential to regulate cell-matrix adhesion through familiar cell-binding domains, but the proposed sequence motifs are not highly conserved across species. Here, we report that Ambn binds to ameloblast-like cell membranes through a highly evolutionary conserved amphipathic helix-forming (AH) motif encoded by exon 5. We applied high-resolution confocal microscopy to show colocalization of Ambn with ameloblast membrane surfaces in developing mouse incisors. Using a series of Ambn-derived peptides and Ambn variants, we showed that Ambn binds to cell membranes through a motif within the sequence encoded by exon 5. Using peptides derived from the N- or C-termini of this sequence, as well as Ambn variants that lacked or had a disrupted AH motif, we demonstrated that the AH motif located at the N-terminus of the sequence is involved in cell-Ambn adhesion. Sequence analysis revealed that this highly conserved AH motif is absent from other enamel matrix proteins, including amelogenin, enamelin, and amelotin. Collectively, these data suggest that Ambn binds to the cell surface membrane via a helix-forming motif and provide insight into the molecular mechanism and function of Ambn in enamel cell-matrix interaction.
Anomalous Psychedelic Experiences: At the Neurochemical Juncture of the Humanistic and Parapsychological
Authors: Luke David
Published: May 2020

This article explores the nature of psychedelically induced anomalous experiences for what they reveal regarding the nature of “expanded consciousness” and its implications for humanistic and transpersonal psychology, parapsychology, and the psychology and underlying neuroscience of such experiences. Taking a multidisciplinary approach, this essay reviews the nature of 10 transpersonal or parapsychological experiences that commonly occur spontaneously and in relation to the use of psychedelic substances, namely synesthesia, extradimensional percepts, out-of-body experiences, near-death experiences, entity encounters, alien abduction, sleep paralysis, interspecies communication, possession, and psi (telepathy, precognition, and clairvoyance and psychokinesis).
How much is the fish? When foreign policy meets fishing interests in the EU’s Arctic endeavour
Authors: Raspotnik Andreas , Østhagen Andreas
Published: May 2020

This article explores the interaction between European Union (EU) foreign policy and the external dimension of fisheries policy in a specific case: a dispute over snow crab fisheries around the Norwegian Arctic Archipelago of Svalbard. We do two things: first, we examine a specific case that concerns both EU foreign policy and fisheries policy in order to understand the workings of the EU regarding these two policy domains. Second, we connect the dots between the EU’s external fisheries policy and the EU as a foreign policy actor in general, examining how intra-institutional dynamics matter when studying policy and its related developments in Brussels. This analysis of the snow-crab dispute between the EU and Norway illustrates how a relatively minor issue in fisheries policies is also relevant to the study of the foreign policy of the EU, and more generally for the links between foreign policy and fisheries as a nexus that is increasingly relevant in international politics.
Handshaking towards zero-concept analysis and technical measures of LEED zero-energy building in connection with technical standard of nearly zero-energy building in China
Authors: Kang Yiting , Wu Jianlin , Liu Ruijie , He Linghao , Yu Zhen , Yang Yashuai
Published: May 2020

To achieve zero-energy building target, both China and the US have planned pathway by formulating guidelines and standards. China has published National China technical standard for nearly zero energy building (CTS-NZEB), which defines detailed principles of zero-energy building. The US LEED zero energy evaluation system has been released based on LEED rating system. Defined target and scope have been introduced in this evaluation system; however, there are no technical and detailed approaches in the rating system. To support future projects achieving the LEED Zero Energy certification in China, accessible applications have been analyzed in perspectives of technology and economy in this article. The comparison and analysis results show that the strategies and technical index of CTS-NZEB can be adopted comprehensively in LEED Zero Energy rating system for Chinese buildings except for renewable energy resources because air source or ground source heat pump system, which are extensively used in China but not acceptable in LEED Zero Energy rating system. High-performance strategies, including low U-value envelope, exterior shading devices, high air tightness envelope, high-efficiency heating, ventilation, and air-conditioning system, and low thermal bridge impact, can be applied to pursue LEED Zero Energy rating system. The incremental costs of NZEBs in China are also supported by government through market and financial policies. This would make significant impacts on Chinese buildings to achieve the LEED Zero Energy target.
Perspectives on Literacy by Four Adolescents, Their Teachers, and Family Members
Authors: Rosenblum L. Penny , Herzberg Tina S.
Published: May 2020

Introduction:

To better understand the process students with visual impairments experience in learning and using braille as a literacy medium, the researchers conducted interviews. The role of technology in the literacy experiences of the students was also examined.

Methods:

Individual interviews were conducted with four triads (a student, a teacher, and a family member). Five themes were identified across the interviews.

Results:

There were similarities and differences in how braille was introduced and taught to each student. None of the four students had a braille reading speed of more than 30 words per minute, and each struggled to use braille and technology to keep up with academic classes. Students and family members reported an emotional effect in regard to the loss of vision and the need to transition from print to braille.

Discussion:

Although instructional approaches differed, the teachers used strategies and materials based on their students’ interests and abilities. Family members were supportive of their children learning braille and using technology. The students recognized that their braille reading was slow and that there was much to learn in order to succeed academically both now and in the future.

Implications for practitioners:

Today’s students with visual impairments need multiple methods to complete literacy tasks. Practitioners must design programs that allow students to gain necessary skills with braille and technology so that they can meaningfully integrate braille and technology as tools in their literacy toolbox.
The Influence of Demographic, Relational, and Risk Asymmetries on the Frequency of Intimate Partner Violence in Young Adulthood
Authors: Cooper Lindsey M. , Longmore Monica A. , Manning Wendy D. , Giordano Peggy C.
Published: May 2020

Social characteristics are prominent factors in mate selection, but they are also important for the quality and functioning of intimate relationships. Researchers have shown that the intimate relationships that are considered the most successful often have high levels of partner similarity. Yet this prior work is limited, as it largely focuses on demographic differences (or asymmetries) between intimate partners. In addition to demographic asymmetries, we explored how differences in relational and risk behaviors were associated with intimate partner violence (IPV). Examining data from the Toledo Adolescent Relationships Study ( n = 828), we found that young adults in relationships with demographic, relational, and risk asymmetries reported greater frequency of violence. Furthermore, we found that asymmetries in risk behavior had the strongest association with IPV. These findings highlighted the importance of considering different types of asymmetries and provided new insight into the functioning of young adult relationships.
One and Done: Examining the Relationship Between Years of College Basketball Experience and Career Statistics in the National Basketball Association
Authors: Zestcott Colin A. , Dickens Jessie , Bracamonte Noah , Stone Jeff , Harrison C. Keith
Published: May 2020

Since 2006, the so-called one and done rule prevents American high school players from joining the National Basketball Association (NBA) without at least 1 year of college basketball experience. While there is debate about the pros and cons of the one and done rule, few studies have fully examined how minimal (or no) college experience relates to performance in the NBA. The current study used publicly available offensive and defensive statistics for all players in the NBA from 1995 to 2016, to examine the relationship between years of college experience and career success in the NBA. Results showed that players with less college experience had better offensive, defensive, and advanced metric (player efficiency rating [PER] and value over replacement player [VORP]) statistics than players with more college experience. However, players with less college experience also made more mistakes in game play, such as turnovers and fouls. The results suggest that college players may not need to attend college to succeed in the NBA.
Extracorporeal membrane oxygenation and V/Q ratios: an ex vivo analysis of CO2 clearance within the Maquet Quadrox-iD oxygenator
Authors: Zakhary Bishoy , Sheldrake Jayne , Pellegrino Vincent
Published: May 2020

While hypercapnia is typically well treated with modern membrane oxygenators, there are cases where respiratory acidosis persists despite maximal extracorporeal membrane oxygenation support. To better understand the physiology of gas exchange within the membrane oxygenator, CO2 clearance within an adult Maquet Quadrox-iD oxygenator was evaluated at varying blood CO2 tensions and V/Q ratios in an ex vivo extracorporeal membrane oxygenation circuit. A closed blood-primed circuit incorporating two Maquet Quadrox-iD oxygenators in series was attached to a Maquet PLS Rotaflow pump. A varying blend of CO2 and air was connected to the first oxygenator to provide different levels of pre-oxygenator blood CO2 levels (PvCO2) to the second oxygenator. Varying sweep gas flows of 100% O2 were connected to the second oxygenator to provide different V/Q ratios. Exhaust CO2 was directly measured, and then VCO2 and oxygenator dead space fraction (VD/VT) were calculated. VCO2 increased with increasing gas flow rates with plateauing at V/Q ratios greater than 4.0. Exhaust CO2 increased with PvCO2 in a linear fashion with the slope of the line decreasing at high V/Q ratios. Oxygenator dead space fraction varied with V/Q ratio—at lower ratios, dead space fraction was 0.3-0.4 and rose to 0.8-0.9 at ratios greater than 4.0. Within the Maquet Quadrox-iD oxygenator, CO2 clearance is limited at high V/Q ratios and correlated with elevated oxygenator dead space fraction. These findings have important implications for patients requiring high levels of extracorporeal membrane oxygenation support.
Perception of prolonged extracorporeal membrane oxygenation in Europe: an EuroELSO survey
Authors: Lepper Philipp M , Barrett Nicholas A , Swol Justyna , Lorusso Roberto , Di Nardo Matteo , Belliato Mirko , Bělohlávek Jan , Broman Lars Mikael
Published: May 2020

The substantial increase in the number of patients receiving extracorporeal membrane oxygenation over the last decade has led to an evolution of indications and an expansion into wider patient groups. One of the unanticipated benefits of the increase in extracorporeal membrane oxygenation has been a change in the understanding of the natural history of many respiratory diseases. Development in technology and materials, reduced extracorporeal membrane oxygenation–specific complications, and improvement of critical care, in general, have facilitated longer extracorporeal membrane oxygenation runs, and the definition of prolonged extracorporeal membrane oxygenation was recently expanded to continuous support for more than 28 days. This survey aimed to describe European ECMO centers’ perception and arbitrary definition of prolonged extracorporeal membrane oxygenation, patient management, and futility. Of 94 center responses, 37% regarded 14-21 days, 30% 21-28 days, and 28% >28 days as prolonged treatment. Bridge to recovery (64%) or to transplantation (20%) was the most common causes. Awake, and ambulation while on extracorporeal membrane oxygenation was reported from 34% of the centers. In case of perceived futility, decision to withdraw was taken in 65% of the centers in agreement between profession and family and in 30% by profession only. One-fourth of the centers did not discontinue support. Large differences prevail among European ECMO centers concerning local perception and patient management in prolonged extracorporeal membrane oxygenation.
The clinical efficacy of kinesio taping in shoulder disorders: a systematic review and meta analysis
Authors: Celik Derya , Karaborklu Argut Sezen , Coban Ozge , Eren Ilker
Published: May 2020

Objective:

To evaluate the effects of kinesio taping on shoulder disorders, as a single treatment modality or as conjunction to other treatments.

Data sources:

MEDLINE, PEDro (Physiotherapy Evidence Database), The Cochrane Library, Web of Science, Embase and OpenGrey databases were searched for trials published before 5 February 2020.

Methods:

This study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline statement. Randomized controlled trials published in English or Turkish were included. The methodological quality of the studies was assessed with the Physiotherapy Evidence Database scale. For analysis of continuous data, mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used. The I2 statistics was used to measure the heterogeneity.

Results:

Fourteen studies were included with 680 participants. Kinesio taping did not produce better results on pain compared to sham (MD by –0.77 (95% CI = –1.77, 0.22), P = 0.13), exercises (MD by –0.51 (95% CI = –1.41, 0.39), P = 0.27), or passive treatments (MD by –0.29 (95% CI = –0.77, 0.19), P = 0.24). Similarly, kinesio taping did not found superior to sham kinesio taping (SMD by –0.01 (95% CI = –0.31, 0.29), P = 0.94), exercises (SMD by 0.41 (95% CI = –0.25, 1.07), P = 0.22), or passive treatments on function (SMD by –0.02 (95% CI = –0.19, 0.15), P = 0.82). There was no significant SMD on range of motion (ROM) by –0.07 (95% CI = –0.47, 0.33, P = 0.74) compared to sham kinesio taping and –0.06 (95% CI = –0.20, 0.09, P = 0.46) compared to passive treatment. Overall, effect size was found small to moderate.

Conclusion:

Despite reported positive effects in some studies, there is no firm evidence of any benefit of kinesio taping on shoulder disorders.
Comparing the effects of multi-session anodal trans-cranial direct current stimulation of primary motor and dorsolateral prefrontal cortices on fatigue and quality of life in patients with multiple sclerosis: a double-blind, randomized, sham-controlled trial
Authors: Mortezanejad Marzieh , Ehsani Fatemeh , Masoudian Nooshin , Zoghi Maryam , Jaberzadeh Shapour
Published: May 2020

Objective:

To compare the effects of anodal trans-cranial direct current stimulation (a-tDCS) over primary motor and dorsolateral prefrontal cortices on Fatigue Severity Scale and its lasting effect on fatigue reduction and improvement in quality of life in patients with multiple sclerosis.

Design:

A randomized, double-blinded, sham-controlled parallel clinical trial study.

Setting:

Neurological physiotherapy clinics.

Subjects:

Thirty-nine participants were randomly assigned to three groups: dorsolateral prefrontal cortex a-tDCS, primary motor a-tDCS (experimental groups) and sham a-tDCS. Finally, 36 participants completed the whole study ( n = 12 in each group).

Interventions:

Participants in the experimental groups received six-session a-tDCS (1.5 mA, 20 minutes) during two weeks (three sessions per week). The sham group received six sessions of 20-minute sham stimulation.

Main measures:

The Fatigue Severity Scale and quality of life were assessed before, immediately and four weeks after the intervention.

Results:

Findings indicated a significant reduction in the Fatigue Severity Scale and a significant increase in the quality of life in both experimental groups, immediately after the intervention ( P < 0.001), while Fatigue Severity Scale and quality of life changes were not significant in the sham a-tDCS group ( P > 0.05). In addition, improvement of the variables remained four weeks after the intervention in dorsolateral prefrontal cortex a-tDCS (mean differences (95% confidence interval): 0.03 (−0.63 to 0.68) as compared to primary motor (−0.62 (−0.11 to −1.14) and sham a-tDCS groups (−0.47 (−1.37 to 0.43)).

Conclusion:

Both primary motor and dorsolateral prefrontal cortex a-tDCS as compared to sham intervention can immediately improve fatigue and quality of life. However, the effects last up to four weeks only by the dorsolateral prefrontal cortex a-tDCS.
Ignorance loops: How non-knowledge about bee-toxic agrochemicals is iteratively produced
Authors: Durant Jennie L
Published: May 2020

In this article, I examine the knowledge politics around pesticides in the United States and the role it plays in honey bee declines. Since 2006, US beekeepers have lost an average of one-third of their colonies each year. Though a number of factors influence bee health, beekeepers, researchers and policymakers cite pesticides as a primary contributor. In the US, pesticide registration is overseen by the US Environmental Protection Agency (EPA), with the required tests conducted by chemical companies applying for registration. Until 2016, the EPA only required chemical companies to measure acute toxicity for non-target species, which means that many pesticides with sublethal toxicities are not labeled bee-toxic, and farmers can apply them without penalty while bees are on their farms or orchards. In addition, California state and county regulators will typically only investigate a bee kill caused by a labeled bee-toxic pesticide, and so emergent data on non-labeled, sublethal pesticides goes uncollected. These gaps in data collection frustrate beekeepers and disincentivize them from reporting colony losses to regulatory agencies – thus reinforcing ignorance about which chemicals are toxic to bees. I term the iterative cycle of non-knowledge co-constituted by regulatory shortfalls and stakeholder regulatory disengagement an ‘ignorance loop’. I conclude with a discussion of what this dynamic can tell us about the politics of knowledge production and pesticide governance and the consequences of ‘ignorance loops’ for stakeholders and the environment.
A dynamic model of global value network governance
Authors: Galanis Giorgos , Kumar Ashok
Published: May 2020

This paper presents a novel understanding of the changing governance structures in global supply chains. Motivated by the global garment sector, we develop a geographical political economy dynamic model that reflects the interaction between bargaining power and distribution of value among buyer and producer firms. We find that the interplay between these two forces, in combination with the spatial specificities of global production and consolidation, can drive governance structures towards a more symbiotic position.
Cluster headache in Asian populations: Similarities, disparities, and a narrative review of the mechanisms of the chronic subtype
Authors: Peng Kuan-Po , Takizawa Tsubasa , Lee Mi Ji
Published: May 2020

Objective

Headache disorders like migraine show geographic and ethnic differences between Asian and European/North American countries. In cluster headache, these differences are rarely mentioned and discussed. This article aimed to review the characteristics of cluster headache in Asian countries and compare the clinical features to those in European and North American populations.

Methods

We conducted a narrative literature review on the demographics, clinical presentations, and treatments of cluster headache in Asian countries.

Results

Patients with cluster headache in Asian populations showed a stronger male predominance compared to European and North American populations. Chronic cluster headache was rare in Asian countries. The clinical presentation of restlessness was not as common in Asian as it was in European and North American countries, and Asian patients with aura were extremely rare. Patients in Asian countries may have a lower circadian rhythmicity of cluster headache and a lower headache load, as demonstrated by lower attack frequencies per day, bout frequencies, and bout durations.

Conclusions

Regional differences in the presentation of cluster headache exist. Greater awareness for cluster headache should be raised in Asian regions, and further studies are warranted to elucidate the mechanisms behind observed differences.