bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel motion cueing algorithm integrated multi-sensory system–Vestibular and proprioceptive system
Authors: Duc-An Pham , Duc-Toan Nguyen
Published: December 2019

Motion cueing algorithms are used to produce a motion which feels as realistic as possible while remaining in the limited workspace of driving simulators. Several optimal motion cueing algorithms were developed to improve both the exploitation of the workspace of a driving simulator and the realistic of the simulated motion. In the dynamics model of the optimal motion cueing algorithms, several kinds of motion-sensory systems are integrated to optimize the simulated motion sensation. However, most previous works have just focused on the visual and vestibular system. The mathematical model of the proprioceptive system, that also senses the non-visual motion, has rarely been concerned. In this paper, a novel optimal motion cueing algorithm, which integrates model of the proprioceptive system, is developed to reduce the false cues from muscle spindle of head/neck system sensing lateral tilted angle. The optimal motion cueing algorithm has a significant effect on the pilot's perception when the tilted angle is rather large. An example of the simulation of a roller coaster running along a planar S-curve trajectory with only lateral acceleration is investigated with current motion cueing algorithms and optimal motion cueing algorithm. Several objective criteria were introduced to evaluate the simulated perception of all investigated motion cueing algorithms. The results demonstrate that optimal motion cueing algorithm is better than current motion cueing algorithms in most criteria and also sub-criteria.
Estimating Private School Premium for Primary School Children in Ethiopia: Evidence from Individual-level Panel Data
Authors: Eigbiremolen Godstime Osekhebhen
Published: December 2019

This article presents the first value-added model of private school effect in Ethiopia, using the unique Young Lives longitudinal data. I found a substantial and statistically significant private school premium (about 0.5 standard deviation) in Maths, but not in Peabody Picture Vocabulary Test (PPVT). Private school premium works for both low and high ability children. The results are robust to sorting on unobserved ability, grouping on lag structures and transfer between private and public schools. Combined with available contextual data, empirical evidence suggests that the effectiveness of private primary schools may be due to more learning time and teacher’s attention enjoyed by students. I also attempted to contribute methodologically to the literature by directly testing the structural assumption underpinning value-added models.
The use of partial fuel stratification to enable stable ultra-lean deflagration-based Spark-Ignition engine operation with controlled end-gas autoignition of gasoline and E85
Authors: Hu Zongjie , Zhang Junjie , Sjöberg Magnus , Zeng Wei
Published: December 2019

Lean operation of Spark-Ignition engines can provide higher thermal efficiency compared to standard stoichiometric operation. However, for a homogeneous lean mixture, the associated reduction of flame speeds becomes an important issue from the perspective of robust ignition and fast flame spread throughout the charge. This study is focused on the use of a lean partial fuel stratification strategy that can stabilize the deflagration, while sufficiently fast combustion is ensured via the use of end-gas autoignition. The engine has a spray-guided Direct-Injection Spark-Ignition combustion system and was fueled with either a high-octane certification gasoline or E85. Partial fuel stratification was achieved using several fuel injections during the intake stroke in combination with a small pilot-injection concurrent with the Spark-Ignition. The results reveal that partial fuel stratification enables very stable combustion, offering higher thermal efficiency for parts of the load range in comparison to well-mixed lean and stoichiometric combustion. The heat release and flame imaging demonstrate that the combustion often has three distinct stages. The combustion of the pilot-injected fuel, ignited by the normal spark, acts as a “super igniter,” ensuring a very repeatable initiation of combustion, and flame incandescence reveals locally rich conditions. The second stage is mainly composed of blue flame propagation in a well-mixed lean mixture. The third stage is the compression autoignition of a well-mixed and typically very lean end-gas. The end-gas autoignition is critical for achieving high combustion efficiency, high thermal efficiency, and stable combustion. Partial fuel stratification enables very effective combustion-phasing control, which is critical for controlling the occurrence and intensity of end-gas autoignition. Comparing the gasoline and E85 fuels, it is noted that achieving end-gas autoignition for the higher octane E85 requires a more aggressive compression of the end-gas via the use of a more advanced combustion phasing or higher intake-air temperature.
Influence of layering pattern of modified kenaf fiber on thermomechanical properties of epoxy composites
Authors: Mohammed AR , Atiqah MS Nurul , Gopakumar Deepu A , Fazita MR , Rizal Samsul , Hermawan D , Thomas Sabu , Khalil HPS Abdul
Published: December 2019

Natural fiber-reinforced composites gained considerable interest in the scientific community due to their eco-friendly nature, cost-effective, and excellent mechanical properties. Here, we reported a chemical modification of kenaf fiber using propionic anhydride to enhance the compatibility with the epoxy matrix. The incorporation of the modified woven and nonwoven kenaf fibers into the epoxy matrix resulted in the improvement of the thermal and mechanical properties of the composite. The thermal stability of the epoxy composites was enhanced from 403°C to 677°C by incorporating modified woven kenaf fibers into the epoxy matrix. The modified and unmodified woven kenaf fiber-reinforced epoxy composites had a tensile strength of 64.11 and 58.82 MPa, respectively. The modified woven composites had highest flexural strength, which was 89.4 MPa, whereas, for unmodified composites, it was 86.8 MPa. The modified woven fiber-reinforced epoxy composites showed the highest value of flexural modulus, which was 6.0 GPa compared to unmodified woven composites (5.51 GPa). The impact strength of the epoxy composites was enhanced to 9.43 kJ m−2 by the incarnation of modified woven kenaf fibers into epoxy matrix. This study will be an effective platform to design the chemical modification strategy on natural fibers for enhancing the compatibility toward the hydrophobic polymer matrices.
Safeguarding against failure in intellectual character education: The case of the eristic agent
Authors: Kotsonis Alkis
Published: December 2019

The vast majority of contemporary scholars working in intellectual character education endeavor to identify those elements that render an educational program reliably successful at fostering the growth of intellectual excellences in students. In this article, I adopt an opposite perspective: I examine potential reasons as to why virtue-based approaches to education might fail to enable students to acquire intellectual virtues. Given the scarcity of accounts of educational failure in contemporary intellectual character education, I search for such accounts in the philosophical roots of the concept of intellectual virtues. In this article, I focus on Plato’s discussion of the eristic agent, namely, an individual who has developed epistemically valuable cognitive abilities but, due to insufficient moral character education, results in misusing them to pursue non-epistemic and quite often also non-moral ends. I argue that Plato’s account of the eristic practice has much to offer to intellectual character education today. It strongly indicates that intellectual virtues cannot be fostered in isolation from moral virtues and that the development of the students’ (1) epistemic emotions and (2) moral virtues should take place prior to the fostering of intellectual excellences in them.
The Necessity of Intersectionality as a Framework to Explore Queer and Trans Student Retention
Authors: Duran Antonio , Pope Raechele L. , Jones Susan R.
Published: December 2019

Limited research on queer and transgender college student retention has led to a lack of understanding of the institutional structures that support these collegians. Moreover, what scholarship does exist oftentimes uses power-neutral lenses to explain the factors that lead to the retention of queer and transgender students. Using intersectionality as an analytic framework to illustrate the necessity of framing issues of retention with attention to overlapping systems of power and oppression provides a challenge to the existing literature. This article provides examples of higher education practices and policies from the perspectives of structural, representational, and political intersectionality. Implications for research and practice are offered.
Preventing Birth Defects by Changing Maternal Antiepileptic Drug Therapy: We’ve Come a Long Way, Baby
Authors: Noe Katherine
Published: December 2019

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Assessing medication adherence using Stata
Authors: Linden Ariel
Published: December 2019

In this article, I introduce the medadhere command, which computes medication adherence rates for two commonly used measures in research and practice: the medication possession ratio and the proportion of days covered. medadhere computes adherence rates for a single medication or multiple medications, and its options provide great flexibility to support the specific needs of the user.
Extensions to the label commands
Authors: Klein Daniel
Published: December 2019

Data management tasks include manipulating variables, variable labels, and value labels. While Stata has versatile commands and functions to address the first task, managing variable and value labels is not as convenient. In this article, I introduce a new command, elabel, that enhances the capabilities of Stata’s label commands. I discuss these enhancements using various examples. I also demonstrate how to add new commands to elabel.
Simar and Wilson two-stage efficiency analysis for Stata
Authors: Badunenko Oleg , Tauchmann Harald
Published: December 2019

When one analyzes the determinants of production efficiency, regressing efficiency scores estimated by data envelopment analysis on explanatory variables has much intuitive appeal. Simar and Wilson (2007, Journal of Econometrics 136: 31–64) show that this conventional two-stage estimation procedure suffers from severe flaws that render its results, and particularly statistical inference based on them, questionable. They additionally propose a statistically grounded bootstrap-based two-stage estimator that eliminates the above-mentioned weaknesses of its conventional predecessors and comes in two variants. In this article, we introduce the new command simarwilson, which implements either variant of the suggested estimator in Stata. The command allows for various options and extends the original procedure in some respects. For instance, it allows for analyzing both outputand input-oriented efficiency. To demonstrate the capabilities of simarwilson, we use data from the Penn World Tables and the Global Competitiveness Report by the World Economic Forum to perform a cross-country empirical study about the importance of quality of governance in a country for its efficiency of output production.
The Haunting Aesthetics of Tacoma
Authors: Jones Ashley P.
Published: December 2019

Video games are well suited to exploring questions of philosophical intent through their construction and design. Exploring the layered and complex forms of video game design and aesthetics is a growing area of gaming studies that is pointing toward these larger and important questions, even changing the way gaming studies is being approached by scholars. This article examines the relationship between video games’ design and aesthetics and Derrida’s conceptual framework of hauntology. Using Mannon and Temkin’s definition of glitch aesthetics, I conduct a close visual analysis of Tacoma as a case study in how Derrida’s hauntology is present within video games. Tacoma’s aesthetic choices bring to light how video games play with Western understandings of presence, life, and death.
Dorsal Wrist Spanning Plate Fixation for Treatment of Radiocarpal Fracture-Dislocations
Authors: Wahl Elizabeth P. , Lauder Alexander S. , Pidgeon Tyler S. , Guerrero Evan M. , Ruch David S. , Richard Marc J.
Published: December 2019

Background: Radiocarpal dislocations are rare injuries that result from high-energy forces across the wrist with the hallmark finding of radiocarpal ligament disruption. Published treatment methods are comprehensive with moderate-to-good outcomes. The purpose of this study was to review the treatment of radiocarpal dislocations with a dorsal wrist spanning plate. Methods: A retrospective review was conducted analyzing the radiographic and clinical outcomes of patients treated for a radiocarpal dislocation using a dorsal wrist spanning plate over a 10-year period. Outcomes assessed included radiographic joint incongruity and arthrosis, wrist range of motion, grip strength, Visual Analogue Scale (VAS) score, surgical complications, and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Results: Thirteen patients were treated with a dorsal wrist spanning plate for radiocarpal dislocation with a mean follow-up of 615 days from the time of initial surgery. Six patients (46%) had associated distal radioulnar joint instability. The mean wrist range of motion at the final follow-up was: flexion 39°, extension 44°, pronation 79°, and supination 84°. One patient (8%) developed ulnar translation of the carpus, and 11 patients (85%) developed radiographic posttraumatic wrist arthrosis. Mean VAS and DASH scores were 4 and 18, respectively. Conclusions: Acute treatment with a dorsal wrist spanning plate in this series resulted in comparable outcomes to what have been previously reported in the literature. The dorsal wrist spanning plate offers the surgeon a reliable method of stabilization, with minimal additional surgical trauma to the wrist, while avoiding the potential for infections that develop with other treatment methods.
Capitalist nationalism and Zionist state-building, 1920s-1950s: Chocolate and diamonds in Mandate Palestine and Israel
Authors: De Vries David
Published: December 2019

The nationalism of business is a crucial issue in the history of British-ruled Palestine (1917-1947) and post-1948 Israel. The importation of Jewish private capital into Palestine was a key factor in shaping the economic development of the Zionist settler project, and in creating an advantage over the Arab community. The Zionism of the Jewish firms was an essential aspect of the political consensus in the Jewish polity and its state-building aspirations. Moreover, the participation of companies in World War II, the war of 1948, and in the establishment of Israel was an essential resource that was mobilized for the Zionist economic expansion and triggered the absorption of Holocaust survivors and Jewish immigrants from Arab and North African countries. These national expressions of private firms harbour a complexity. They illustrate political and cultural beliefs, and an active affiliation to a national movement. At the same time, they are instrumental in the sense that firms benefitted materially and culturally from this association. Furthermore—and particularly relevant to states that have emerged from a colonial past—these practices do not evolve only from the businesses themselves but also from the impact of statist structures on the nationalism of firms. These aspects are discussed through the prism of chocolate manufacturing and the diamond-cutting industry.
Prior stroke and transient ischemic attack as risk factors for subsequent stroke in atrial fibrillation patients: A report from the GARFIELD-AF registry
Authors: Hacke Werner , Bassand Jean-Pierre , Virdone Saverio , Camm A John , Fitzmaurice David A , Fox Keith AA , Goldhaber Samuel Z , Goto Shinya , Haas Sylvia , Kayani Gloria , Mantovani Lorenzo G , Misselwitz Frank , Pieper Karen S , Turpie Alexander GG , van Eickels Martin , Verheugt Freek WA , Kakkar Ajay K ,   for the GARFIELD-AF Investigators
Published: December 2019

Background

It is not always possible to verify whether a patient complaining of symptoms consistent with transient ischemic attack has had an actual cerebrovascular event.

Research question

To characterize the risk of cardiovascular events associated with a history of stroke/transient ischemic attack in patients with atrial fibrillation.

Study design and methods

This study investigated the clinical characteristics and outcomes of patients with a history of stroke/transient ischemic attack among 52,014 patients enrolled prospectively in GARFIELD-AF registry. The diagnosis of stroke or transient ischemic attack was not protocol defined but based on physicians’ assessment. Patients’ one-year risk of death, stroke/systemic embolism, and major bleeding was assessed by multivariable Cox regression.

Results

At enrollment, 5617 (10.9%) patients were reported to have a history of stroke or transient ischemic attack. Patients with stroke or transient ischemic attack were older and had a greater burden of diabetes, moderate-to-severe kidney disease, and atherothrombosis and higher median CHA2DS2-VASc and HAS-BLED scores than those without history of stroke or transient ischemic attack. After adjustment, prior stroke/transient ischemic attack was associated with significantly higher risk for all-cause mortality (hazard ratio (HR), 1.26; 95% confidence interval (CI), 1.12–1.42), cardiovascular death (HR, 1.22; 95% CI, 1.01–1.48), non-cardiovascular death (HR, 1.39; 95% CI, 1.15–1.68), and stroke/systemic embolism (HR, 2.17; 95% CI, 1.80–2.63) than patients without history of stroke/transient ischemic attack. In patients with a prior stroke alone higher risk was observed for all-cause mortality (HR, 1.29; 95% CI, 1.11–1.50), non-cardiovascular death (HR, 1.39; 95% CI, 1.10–1.77), and stroke/systemic embolism (HR, 2.29; 95% CI, 1.83–2.86). No significantly elevated risk of adverse events was seen for patients with history of transient ischemic attack alone.

Interpretation

A history of prior stroke or transient ischemic attack is a strong independent risk factor for mortality and stroke/systemic embolism. This excess risk is mainly attributed to a history of stroke (with or without transient ischemic attack), whereas history of transient ischemic attack is a weaker predictor. Clinical trial registration: NCT01090362.
The Chemical Optimization of Cerebral Embolectomy trial: Study protocol
Authors: Renú Arturo , Blasco Jordi , Millán Mónica , Martí-Fàbregas Joan , Cardona Pere , Oleaga Laura , Macho Juan , Molina Carlos , Roquer Jaume , Amaro Sergio , Dávalos Antonio , Zarco Federico , Laredo Carlos , Tomasello Alejandro , Guimaraens Leopoldo , Barranco Roger , Castaño Carlos , Vivas Elío , Ramos Anna , López-Rueda Antonio , Urra Xabier , Muchada Marián , Cuadrado-Godía Elisa , Camps-Renom Pol , Román Luis S , Ríos José , Leira Enrique C , Jovin Tudor , Torres Ferran , Chamorro Ángel ,   for the CHOICE Investigators
Published: December 2019

Rationale

The potential value of rescue intraarterial thrombolysis in patients with large vessel occlusion stroke treated with mechanical thrombectomy has not been assessed in randomized trials.

Aim

The CHemical OptImization of Cerebral Embolectomy trial aims to establish whether rescue intraarterial thrombolysis is more effective than placebo in improving suboptimal reperfusion scores in patients with large vessel occlusion stroke treated with mechanical thrombectomy.

Sample size estimates

A sample size of 200 patients allocated 1:1 to intraarterial thrombolysis or intraarterial placebo will have >95% statistical power for achieving the primary outcome (5% in the control versus 60% in the treatment group) for a two-sided (5% alpha, and 5% lost to follow-up).

Methods and design

We conducted a multicenter, randomized, placebo-controlled, double blind, phase 2b trial. Eligible patients are 18 or older with symptomatic large vessel occlusion treated with mechanical thrombectomy resulting in a modified treatment in cerebral ischemia score 2b at end of the procedure. Patients will receive 20–30 min intraarterial infusion of recombinant tissue plasminogen activator or placebo (0.5 mg/ml, maximum dose limit 22.5 mg).

Study outcome(s)

The primary outcome is the proportion of patients with an improved modified treatment in cerebral ischemia score 10 min after the end of the study treatment. Secondary outcomes include the shift analysis of the modified Rankin Scale, the infarct expansion ratio, the proportion of excellent outcome (modified Rankin Scale 0–1), the proportion of infarct expansion, and the infarction volume. Mortality and symptomatic intracerebral bleeding will be assessed.

Discussion

The study will provide evidence whether rescue intraarterial thrombolysis improves brain reperfusion in patients with large vessel occlusion stroke and incomplete reperfusion (modified treatment in cerebral ischemia 2b) at the end of mechanical thrombectomy.
Validation of an automated ASPECTS method on non-contrast computed tomography scans of acute ischemic stroke patients
Authors: Kuang Hulin , Qiu Wu , Najm Mohamed , Dowlatshahi Dar , Mikulik Robert , Poppe Alex Y , Puig Josep , Castellanos Mar , Sohn Sung I , Ahn Seong H , Calleja Ana , Jin Albert , Asil Talip , Asdaghi Negar , Field Thalia S , Coutts Shelagh , Hill Michael D , Demchuk Andrew M , Goyal Mayank , Menon Bijoy K ,   for the INTERRSeCT Collaborators
Published: December 2019

Background

The Alberta Stroke Program Early CT Score (ASPECTS) is a systematic method of assessing the extent of early ischemic change on non-contrast computed tomography in patients with acute ischemic stroke. Our objective was to validate an automated ASPECTS scoring method we recently developed on a large data set.

Materials and methods

We retrospectively collected 602 acute ischemic stroke patients’ non-contrast computed tomography scans. Expert ASPECTS readings on non-contrast computed tomography were compared to automated ASPECTS. Statistical analyses on the total ASPECTS, region level ASPECTS, and dichotomized ASPECTS (≤4 vs. >4) score were conducted.

Results

In total, 602 scans were evaluated and 6020 (602 × 10) ASPECTS regions were scored. Median time from stroke onset to computed tomography was 114 min (interquartile range: 73–183 min). Total ASPECTS for the 602 patients generated by the automated method agreed well with expert readings (intraclass correlation coefficient): 0.65 (95% confidence interval (CI): 0.60–0.69). Region level analysis showed that the automated method yielded accuracy of 81.25%, sensitivity of 61.13% (95% CI: 58.4%–63.8%), specificity of 86.56% (95% CI: 85.6%–87.5%), and area under curve of 0.74 (95% CI: 0.73–0.75). For dichotomized ASPECTS (≤4 vs. >4), the automated method demonstrated sensitivity 97.21% (95% CI: 95.4%–98.4%), specificity 57.81% (95% CI: 44.8%–70.1%), accuracy 93.02%, and area under the curve of 0.78 (95% CI: 0.74–0.81). For each individual region (M1–6, lentiform, insula, and caudate), the automated method demonstrated acceptable performance.

Conclusion

The automated system we developed approached the stroke expert in performance when scoring ASPECTS on non-contrast computed tomography scans of acute ischemic stroke patients.
Normal-appearing white matter microstructural injury is associated with white matter hyperintensity burden in acute ischemic stroke
Authors: Etherton Mark R , Wu Ona , Giese Anne-Katrin , Rost Natalia S
Published: December 2019

Background

White matter hyperintensity of presumed vascular origin is a risk factor for poor stroke outcomes. In patients with acute ischemic stroke, however, the in vivo mechanisms of white matter microstructural injury are less clear.

Aims

To characterize the directional diffusivity components in normal-appearing white matter and white matter hyperintensity in acute ischemic stroke patients.

Methods

A retrospective analysis was performed on a cohort of patients with acute ischemic stroke and brain magnetic resonance imaging with diffusion tensor imaging sequences acquired within 48 h of admission. White matter hyperintensity volume was measured in a semi-automated manner. Median fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity values were calculated within normal-appearing white matter and white matter hyperintensity in the hemisphere contralateral to the acute infarct. Linear regression analysis was performed to evaluate predictors of white matter hyperintensity volume and normal-appearing white matter diffusivity metrics.

Results

In 319 patients, mean age was 64.9 ± 15.9 years. White matter hyperintensity volume was 6.33 cm3 (interquartile range 3.0–12.6 cm3). Axial and radial diffusivity were significantly increased in white matter hyperintensity compared to normal-appearing white matter. In multivariable linear regression, age (β = 0.20, P = 0.003) and normal-appearing white matter axial diffusivity (β = 37.9, P < 0.001) were independently associated with white matter hyperintensity volume. Subsequent analysis demonstrated that increasing age (β = 0.004, P < 0.001) and admission diastolic blood pressure (β = 0.001, P = 0.02) were independent predictors of normal-appearing white matter axial diffusivity in multivariable linear regression.

Conclusions

Normal-appearing white matter axial diffusivity increases with age and is an independent predictor of white matter hyperintensity volume in acute ischemic stroke.
An investigation of the synthesis of vilazodone
Authors: Hu Fan , Su Weike
Published: December 2019

A novel synthetic route toward vilazodone is described by using 4-cyanoaniline and 5-bromo-2-hydroxybenzaldehyde as starting materials, with an overall yield of 24% and 99% purity. First, the intermediate (3-(4-chlorobutyl)-1 H-indole-5-carbonitrile) is synthesized via diazotization of 4-cyanoaniline, followed by Fischer indole cyclization with 6-chlorohexanal. Subsequently, another intermediate, 5-(piperazin-1-yl)benzofuran-2-carboxamide, is generated via aromatic nucleophilic substitution of 5-bromobenzofuran-2-carboxamide with piperazine. Finally, vilazodone is obtained via nucleophilic substitution of the above two key intermediates by treatment with Et3N/K2CO3. In comparison to the original process, this route avoids the use of expensive and toxic reagents and resolves issues such as safety, environmental concerns, and high costs.
Serum CXCL12/SDF-1 level is positively related with lumbar intervertebral disc degeneration and clinical severity
Authors: Er Zhao-Juan , Yin Chun-Fang , Wang Wen-Jing , Chen Xue-Jun
Published: December 2019

This study aimed to examine whether stromal cell-derived factor-1 (SDF-1) or C-X-C chemokine ligand 12 (CXCL12) participates in the development of lumbar disc degeneration, as implicated earlier by the level of CXCL12 correlating with this disease. It enrolled 145 patients with symptomatic lumbar intervertebral disc degeneration (IDD) and 130 asymptomatic healthy controls with no indication of IDD. Radiological assessment of the IDD patients was targeted at the lumbar vertebra region, based on Pfirrmann grade. Degeneration of the multifidus and psoas major muscles was evaluated using Goutallier classification. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were obtained for assessing the severity of manifestation. The levels of serum CXCL12, IL-6 and TNF-α were determined by ROC curve analysis, resulting in their prognostic value for Pfirrmann grading. Higher levels of serum CXCL12 were found in patients with IDD than in asymptomatic individuals, and were positively related to the Pfirrmann grade as well as multifidus muscle degeneration. Furthermore, serum CXCL12 concentration showed a significant correlation with the VAS and ODI scores. In addition, elevated serum CXCL12 levels were related to serum levels of TNF-α and IL-6. The ROC curve analysis implicated that CXCL12 could function as a biomarker of the early-mediate phase of IDD development. In summary, the serum CXCL12/SDF-1 level is positively related with lumbar IDD and its clinical severity.
Latest advances in cerebrospinal fluid and blood biomarkers of Alzheimer’s disease
Authors: Milà-Alomà Marta , Suárez-Calvet Marc , Molinuevo José Luís
Published: December 2019

Alzheimer’s disease (AD) is the most common neurodegenerative disease and its diagnosis has classically been based on clinical symptoms. Recently, a biological rather than a syndromic definition of the disease has been proposed that is based on biomarkers that reflect neuropathological changes. In AD, there are two main biomarker categories, namely neuroimaging and fluid biomarkers [cerebrospinal fluid (CSF) and blood]. As a complex and multifactorial disease, AD biomarkers are important for an accurate diagnosis and to stage the disease, assess the prognosis, test target engagement, and measure the response to treatment. In addition, biomarkers provide us with information that, even if it does not have a current clinical use, helps us to understand the mechanisms of the disease. In addition to the pathological hallmarks of AD, which include amyloid-β and tau deposition, there are multiple concomitant pathological events that play a key role in the disease. These include, but are not limited to, neurodegeneration, inflammation, vascular dysregulation or synaptic dysfunction. In addition, AD patients often have an accumulation of other proteins including α-synuclein and TDP-43, which may have a pathogenic effect on AD. In combination, there is a need to have biomarkers that reflect different aspects of AD pathogenesis and this will be important in the future to establish what are the most suitable applications for each of these AD-related biomarkers. It is unclear whether sex, gender, or both have an effect on the causes of AD. There may be differences in fluid biomarkers due to sex but this issue has often been neglected and warrants further research. In this review, we summarize the current state of the principal AD fluid biomarkers and discuss the effect of sex on these biomarkers.
The Role of Resistance Training Dosing on Pain and Physical Function in Individuals With Knee Osteoarthritis: A Systematic Review
Authors: Turner Meredith N. , Hernandez Daniel O. , Cade William , Emerson Christopher P. , Reynolds John M. , Best Thomas M.
Published: December 2019

Context:

Dosing parameters are needed to ensure the best practice guidelines for knee osteoarthritis.

Objective:

To determine whether resistance training affects pain and physical function in individuals with knee osteoarthritis, and whether a dose-response relationship exists. Second, we will investigate whether the effects are influenced by Kellgren-Lawrence grade or location of osteoarthritis.

Data Sources:

A search for randomized controlled trials was conducted in MEDLINE, Embase, and CINAHL, from their inception dates, between November 1, 2018, and January 15, 2019. Keywords included knee osteoarthritis, knee joint, resistance training, strength training, and weight lifting.

Study Selection:

Inclusion criteria were randomized controlled trials reporting changes in pain and physical function on humans with knee osteoarthritis comparing resistance training interventions with no intervention. Two reviewers screened 471 abstracts; 12 of the 13 studies assessed were included.

Study Design:

Systematic review.

Level of Evidence:

Level 2.

Data Extraction:

Mean baseline and follow-up Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and standard deviations were extracted to calculate the standard mean difference. Articles were assessed for methodological quality using the CONSORT (Consolidated Standards of Reporting Trials) 2010 scale and Cochrane Collaboration tool for assessing risk of bias.

Results:

The 12 included studies had high methodological quality. Of these, 11 studies revealed that resistance training improved pain and/or physical function. The most common regimen was a 30- to 60-minute session of 2 to 3 sets of 8 to 12 repetitions with an initial resistance of 50% to 60% of maximum resistance that progressed over 3 sessions per week for 24 weeks. Seven studies reported Kellgren-Lawrence grade, and 4 studies included osteoarthritis location.

Conclusion:

Resistance training improves pain and physical function in knee osteoarthritis. Large effect sizes were associated with 24 total sessions and 8- to 12-week duration. No optimal number of repetitions, maximum strength, or frequency of sets or repetitions was found. No trends were identified between outcomes and location or Kellgren-Lawrence grade of osteoarthritis.
Left ventricular free wall rupture in myocardial infarction: A retrospective analysis from a single tertiary center
Authors: Varghese Swaroop , Ohlow Marc-Alexander
Published: December 2019

Objective

Left ventricular free wall rupture (LVFWR) is a rare but severe complication of acute myocardial infarction (AMI). During the era of pre-thrombolysis, autopsies revealed an incidence of approximately 8%.

Method

The objective of this retrospective study was to analyze the current incidence of LVFWR and to identify predictors by comparing the AMI-cohort with LVFWR to those without. The control group involved a random selection of one in every ten patients who presented with acute myocardial infarction between 2005 and 2014.

Result

A total of 5143 patients with AMI were treated at the Central Hospital, Bad Berka (71% men, median age 68 years). Out of these, seven patients with LVFWR were identified with an overall incidence of 0.14%. Clinically, LVFWR patients presented late to admission since symptom onset (median 24 h vs. 6.1 h; p < 0.0001), were more likely in cardiogenic shock (28.6% vs. 3.2%; p = 0.02) and were usually accompanied by emergency physicians (71.4% vs. 20.7%; p = 0.006). Higher troponin T (median 8.6 vs. 0.5 ng/ml; p < 0.0002), higher CRP (median 50 vs. 0.5 mg/l; p = 0.05) as well as a lower hematocrit-values (0.33 vs. 0.42; p = 0.04) were observed. All LVFWR patients were operated (100% vs. 1.6%; p < 0.001). The patients had lower rates of beta-blocker treatment (57.1% vs. 95.8%; p = 0.003). The 30-day mortality was significantly higher (42.9% vs. 6.8%; p = 0.01).

Conclusion

Compared to the thrombolytic era, the current incidence of LVFWR with AMI, who reach the hospital alive, is significantly lower. However, 30-day mortality continues to be high.
The Potential Burden of Home Dialysis on Patients and Caregivers: A Narrative Review
Authors: Jacquet Sabriella , Trinh Emilie
Published: December 2019

Purpose of review:

Home dialysis modalities offer several benefits for patients with end-stage kidney disease when compared with facility-based thrice-weekly hemodialysis. To increase uptake of home dialysis, many centers are encouraging a “home-first” approach. However, it is important to appreciate that “one size may not fit all” and that dialysis modality selection is a complex decision that needs to be individualized. The purpose of this review was to explore aspects associated with home dialysis that may be associated with burden for patients and their caregivers and to discuss strategies to alleviate these concerns.

Sources of information:

Original research articles were identified from PubMed using search terms “peritoneal dialysis,” “home hemodialysis,” “home dialysis,” “barriers,” “quality of life” and “burden.”

Methods:

We performed a focused narrative review examining potential sources of burden with home dialysis therapies after conducting a critical appraisal of the literature and identifying the major recurring themes.

Key findings:

Home dialysis is associated with burden for certain patients. Indeed, some patients may experience ongoing concerns regarding the risks of adverse events and of inadequately performing dialysis on their own. Psychosocial issues affecting quality of life may also arise and include fear of social isolation, sleep disturbances, perceived financial burden, anxiety, and fatigue. Patients who depend on a caregiver may worry about creating a stressful home environment for their close ones. Furthermore, the demands associated with being a caregiver may lead to psychosocial distress in the caregivers themselves. All these factors may lead to burnout and consequently, therapy discontinuation necessitating an unplanned transition to in-center hemodialysis leading to adverse outcomes. However, certain strategies may help alleviate burden especially if concerns are identified early on.

Limitations:

As we did not apply any formal tool to assess the quality of the studies included, selection bias may have occurred. Nonetheless, we have attempted to provide a comprehensive review on the topic using numerous diverse studies and extensive review of the literature.

Implications:

Future studies should focus on better identifying patient priorities and strategies to facilitate dialysis modality selection and improve quality of life.
The paradox of technical governance: A public opinion survey’s political process and its results
Authors: Peng Yaping
Published: December 2019

The logic of technical governance goes as follows: the knowledge of society can be obtained by the state via technology, and thus social problems are identified and solutions are found. Questions have been raised about whether technical governance would ever work. For many the answer is negative and doubtful. However, one defense remains: technical governance fails not because the idea is inherently flawed but because the technology is not good. Would technical governance succeed with better methodology and more technical rigor? In order to challenge this defense, this paper examines the operation of opinion polls—a form of technical governance supported by rigorous quantitative social research methodology—run by a sub-district government in the city ‘S’. In particular, this paper asks whether it is possible for a government-run poll to reflect manipulated public opinion, despite the strictest compliance with quantitative polling methodology. The finding of this paper gives an affirmative answer. It argues that on the surface, polls are statistical surveys, but in actuality they are a political process controlled by the government despite their compliance with all statistical requirements. The power structure of the local government determines the questionnaire items, their multiple-choice answers (the screening, compressing, and quantifying of social scenarios), and the final make-up of the public opinion index. The rigorousness of methodology does not guarantee the authenticity of ‘public opinion’ in final poll figures. More likely, the outcome is controlled by those who organize polls. Hence, quantifiable technical governance presents a contradiction: the state manufactures biased public opinions precisely when it is looking for unbiased public opinions. In the end, the government constructs an image of society that is its own reflection.
Application of multishot diffusion tensor imaging in spinal cord tumors
Authors: Li Jiefei , He Le , Zhang Yuqi
Published: December 2019

Objective:

To explore the usefulness of multishot diffusion tensor imaging (DTI) for evaluating the neurological function of patients with spinal cord tumors

Methods:

Routine magnetic resonance imaging and multishot DTI were performed in five patients with spinal cord tumors. The values of fractional anisotropy (FA) and radial diffusivity (RD) were analyzed.

Results:

Multishot DTI of spinal cord tumors allowed for defining the margins of tumors and determining the relationship of tumors with the adjacent white matter structures of the spinal cord. Multishot DTI demonstrated significantly increased RD and decreased FA of spinal cord tumors compared with those of the normal spinal cord.

Conclusions:

Multishot DTI is a potentially useful modality for differentiating resectable tumors from nonresectable ones based on preoperative imaging alone as well as for differentiating intramedullary tumors from extramedullary ones. Further prospective studies are warranted to confirm these results.
Ten challenges for EEG-based affective computing
Authors: Hu Xin , Chen Jingjing , Wang Fei , Zhang Dan
Published: December 2019

The emerging field of affective computing focuses on enhancing computers’ ability to understand and appropriately respond to people’s affective states in human-computer interactions, and has revealed significant potential for a wide spectrum of applications. Recently, the electroencephalography (EEG) based affective computing has gained increasing interest for its good balance between mechanistic exploration and real-world practical application. The present work reviewed ten theoretical and operational challenges for the existing affective computing researches from an interdisciplinary perspective of information technology, psychology, and neuroscience. On the theoretical side, we suggest that researchers should be well aware of the limitations of the commonly used emotion models, and be cautious about the widely accepted assumptions on EEG-emotion relationships as well as the transferability of findings based on different research paradigms. On the practical side, we propose several operational recommendations for the challenges about data collection, feature extraction, model implementation, online system design, as well as the potential ethical issues. The present review is expected to contribute to an improved understanding of EEG-based affective computing and promote further applications.
Increasing Work Skills for Students With Significant Disabilities: A Six-Step Model for Transition Worksite Programs
Authors: Choiseul-Praslin Belkis , McConnell Amber
Published: December 2019

Students with significant disabilities typically experience poor postschool employment outcomes. However, when provided opportunities to work and engage within their communities, they can gain necessary work-specific and workplace social skills to improve outcomes. This article outlines a six-step model for community-based employment programs designed to support students with significant disabilities. The six steps include (a) interagency collaboration, (b) staff training, (c) scheduling, (d) skill acquisition, (e) data tracking, and (f) student involvement. One teacher’s experience as she worked to create such a program is used as a guide to indicate how the steps can be transferred to other schools.
Positron emission tomography imaging of vascular endothelial growth factor with 64Cu-labeled bevacizumab for non-invasive diagnosis of endometriosis
Authors: Amartuvshin Tumenjargal , Hanaoka Hirofumi , Yamaguchi Aiko , Tsushima Yoshito
Published: December 2019

Introduction:

Non-invasive diagnosis of endometriosis remains challenging. A promising approach for diagnosing endometriosis is the molecular imaging of vascular endothelial growth factor because angiogenesis plays a role in the establishment of endometriosis. This study aimed to evaluate the potential of copper-64-labeled bevacizumab, an anti–vascular endothelial growth factor antibody, for endometriosis imaging.

Methods:

Mouse endometriosis model was prepared by autologous transplantation. The vascular endothelial growth factor expression was evaluated by immunohistochemical staining. Biodistribution study and positron emission tomography imaging were performed at 1, 24, and 48 h after the injection of radiolabeled bevacizumab.

Results:

The immunohistochemical staining revealed that vascular endothelial growth factor is expressed around the stroma and glandular epithelial cells in the endometriosis lesion. The biodistribution study showed a high uptake of indium-111 bevacizumab in the endometriosis lesion. Positron emission tomography imaging with copper-64-labeled bevacizumab clearly visualized the endometriosis lesions at 24 and 48 h after injection.

Conclusion:

These results indicate the potential usefulness of copper-64-labeled bevacizumab for endometriosis imaging.
Skin endometriosis between the breasts of a young girl: A case study and literature review
Authors: Taghavi Mohammad Reza , Mollazadeh Samaneh , Bagheri Mansoori Mohammad , Asadi Mehdi
Published: December 2019

Objective:

Endometriosis is defined as the presence of functional endometrial glands and stroma outside the uterine cavity. Skin involvement is a rare presentation of this common complication. The purpose of this study is to introduce a markedly atypical case of the skin endometriosis with periodic pains located between the breasts of the 24-year-old girl.

Care report:

In this case, the patient with unknown periodic discharges and painful lesion presented in different consulting diagnostics centers for her complaint. After various diagnostic procedures and treatments, she underwent an excision biopsy to evaluate endometriosis. The history of periodic fluid findings of this case aid to indicate endometriosis. This case also emphasizes the significance of suspecting not only the atypical locations of endometriosis but also presentations of endometriosis. Follow-up tests indicated that she was risk-free of endometriosis relapsing status.

Conclusion:

The atypical endometriosis sites can present with varied ranges of symptoms, especially ones occurred periodically with menses in young females.
Good Governance Principles as a Requirement to Achieve Sustainable Development: A Comparative Study Between Yemen and India
Authors: Al-Sharafi Mohammed A. H. , Dhande Nishikant C. , Muley Aniket
Published: December 2019

Good governance can be presented as the perfect base to achieve the sustainable development strategy. In turn, decentralisation principle is considered as the main mechanism that works as the base for the good governance, in addition to the accountability, predictability, and transparency. This article is a part of a field study aimed to explore and investigate the reality of the sustainable development management in Yemen and India. The ‘Good Governance’ is an important element. The aim of this study is to investigate and explore the extent and the level of adopting the Good Governance principles, as a requirement for achieving sustainable development, in the managerial activities in both countries Yemen and India. The result of an analysis by the chi-square (χ2) test indicated that there is a weakness of applying the decentralisation principle in Yemen. The study ascertains the weakness of the accountability principle, the deficit of the predictability principle, and the weakness of the transparency principle among the managerial practices in Yemen and the lack of analysis in the governmental departments, suggesting the needs to enhance the related process. Although the findings showed that the situation in India is much better compared to Yemen, compared to the developed countries we can say that India also needs more enhancement in this regard in order to facilitate the achievement of the sustainable development for societies in both urban and rural areas.
Challenges and Solutions for Improved Oral Health: Examples from Motivational Interviewing Trials
Authors: Jamieson L.M. , Garcia R.I. , Sohn W. , Albino J.
Published: December 2019

Knowledge Transfer Statement:

Irrespective of country, socially disadvantaged children experience greater levels of preventable dental disease than their more socially advantaged peers. Motivational interviewing (MI) is recognized as a potential intervention tool for reducing prevalence of child dental disease. The challenges of implementing MI in 4 trials involving socially vulnerable children are highlighted in this commentary, with some potential solutions offered.