bluuebunny/crossref_metadata_2025 huggingface dataset:
C.06 Somatotopic organization of the human spinothalamic tract: CT-guided mapping in awake patients undergoing cordotomy
Authors: Honey CM , Ivanishvili Z , Honey CR , Heran MK
Published: June 2018

Background: After correlating in vivo macrostimulation-induced pain or temperature sensation during percutaneous cervical cordotomy with simultaneous CT imaging of the electrode tip location, we present a modern description of the somatotopy of the human cervical spinothalamic tract Methods: Twenty patients with medically refractory, unilateral, nociceptive pain due to malignancy received contralateral cervical percutaneous cordotomy. In a post-hoc analysis of the data, each individual’s cervical spinal cord was measured from the CT image using PACS software. The location of the electrode tip during each stimulation-induced response was then superimposed on a diagram of their cord Results: The lower limb responses were found more superficial and posterior to those of the upper limb. Interestingly, the region for upper limb responses surrounded that for lower limb primarily anteriorly and medially (deep) but also posteriorly Conclusions: This work simultaneously combined awake physiologic localization of fibers within the human -spinothalamic tract (STT) with neuroimaging documenting their precise anatomical localization within the spinal cord. The resultant map of the STT demonstrates, for the first time, that fibers from the lower limb are located superficially and posteriorly within the anterolateral spinal cord with the fibers from the upper limb surrounding them primarily deep and anteriorly but also posteriorly
P.020 Novel GRIN2A variant in family members with variable phenotypic expression of epilepsy
Authors: Alanezi A , Campbell C , Karp N , Andrade A
Published: June 2018

Background: Epilepsy aphasia spectrum of disorders is characterized by developmental and language regression with EEG abnormalities that include electrical status epilepticus of sleep (ESES). Landau-Kleffner syndrome (LKS) and epileptic encephalopathy with continuous spike-wave during sleep (CSWS) are the most severe presentations. GRIN2A mutations have been recognized as causative. Methods: we present two sisters with different epilepsy phenotypes. A variant of unknown clinical significance (VUS) in GRIN2A gene was found in one of the sisters and her similarly affected father. Results: The first sister presented with focal onset seizures at the age of 3 years accompanied by language and cognitive regression and EEG features consistent of ESES, meeting criteria for LKS. Multiple anticonvulsants were tried until she responded well to steroids regaining developmental milestones. Her 5-year-old sister recently presented with focal onset seizures. Her language development is appropriate. Her EEG showed independent multifocal spikes but no ESES during sleep. Her seizures were controlled on monotherapy anticonvulsants. Conclusions: We observed a variable EEG-clinical phenotype and different severity among these family members as expected with GRIN2A-related disorders. This report contributes to evidence of the GRIN2A variant pathogenicity.
P.028 Each revision of the McDonald diagnostic criteria for multiple sclerosis allow earlier diagnosis in more patients
Authors: Mahjoub Y , Metz LM ,   Minocycline in CIS Investigators ()
Published: June 2018

Background: The 2005, 2010, and 2017 McDonald diagnostic criteria for multiple sclerosis (MS) were compared at baseline in participants of a Canadian multicentre clinical trial of minocycline in clinically isolated syndrome (CIS). Methods: The cohort included 142 participants. Baseline clinical and imaging data were used to determine if participants met criteria for dissemination in space (DIS) and time (DIT) as required for each version of the criteria. We also explored the impact of permitting a clinical diagnosis of transverse myelitis to represent a spinal cord lesion, and for multifocal clinical onset to represent DIS. Results: The clinical trial excluded patients meeting the 2005 McDonald criteria at baseline. The 2010 criteria were met by 28.9% (41/142) of participants. If a multifocal clinical presentation was considered evidence of DIS 29.6% (42/142) met the 2010 criteria. The 2017 criteria were met by 36.7% (52/142). Allowing a clinical diagnosis of transverse myelitis to confirm a spinal lesion, or multifocal onset to confirm evidence of DIS, led to a diagnosis in 38% (54/142) and 38.7% (55/142), respectively. Conclusions: This study confirms that each revision of the McDonald diagnostic criteria allowed an MS diagnosis in more CIS patients at onset. Exploration of other modifications suggests further improvement may be possible.
P.054 Clinical characteristics and outcomes of patients treated for acromegaly at The Ottawa Hospital
Authors: Alkherayf F , Li T , Malcolm J , Arnaout A , Lochnan H , Keely E , Agbi C , Doyle M
Published: June 2018

Background: Acromegaly is associated with significant morbidity. The purpose of this study was to establish characteristics and outcomes of patients treated for acromegaly at The Ottawa Hospital, to compare our results with published reports from other centers and to identify opportunities to improve patient care. Methods: A retrospective chart review of patients surgically and medically treated for acromegaly between January 1, 2007 and December 31, 2016 was completed. Demographic information, biochemical data, presenting features, disease comorbidities, treatment interventions, and were collected. Results: Fifty-one patients were identified using CCI/ICD-10 codes and IGF-1 levels. Similar to other centers, the majority of patients had a macroadenoma (78.4% vs 11.8%) with a high percentage invading the cavernous sinus (57.5%). While surgical intervention was performed in 90% of patients, only 23.3% of patient achieved surgical cure (IGF-1 normalization within reference range). Approximately 30% of patients were controlled with adjuvant medical therapy while more than 40 % had elevated IGF-1 levels at last follow-up. Radiotherapy was less commonly used. Conclusions: Despite a multi-modal treatment approach for acromegaly, outcomes are variable. This study highlights the need for further research to better understand factors associated with surgical cure, response to medical therapy and the role of radiotherapy.
P.059 A systematically conducted review of the Full Outline of UnResponsiveness (FOUR) score and its use in outcome prediction
Authors: Almojuela A , Zeiler FA , Hasen M , Honey CM
Published: June 2018

Background: Our goal was to perform a scoping systematic review of the literature on the application of the FOUR score within critically ill patients. Methods: 6 databases were searched. Two reviewers independently screened the results. Inclusion and exclusion criteria were applied to each article to obtain final articles for review. Results: The initial search yielded 1709 citations. Of those used, 49 were based on adult and 6 on pediatric populations. All but 8 retrospective adult studies were performed prospectively. Patient categories included traumatic brain injury, intraventricular hemorrhage, intracerebral hemorrhage, subarachnoid hemorrhage, ischemic stroke, general/combined neurology and neurosurgery, post-cardiac arrest, medicine/general critical illness, and patients in the emergency department. A total of 9092 adult patients were studied. 14 studies demonstrated good inter-observer reliability of the FOUR score. 9 studies demonstrated prognostic value of the FOUR score in predicting mortality and functional outcomes. 31 studies demonstrated equivalency or superiority of the FOUR score compared to GCS in prediction of mortality and functional outcomes. Similar results were seen for the pediatric population. Conclusions: The FOUR score has been shown to be a useful outcome predictor in many patients with depressed level of consciousness. It displays good inter-rater reliability among physicians and nurses.
P.068 Hippocampal volume may predict early non-response to surgery in Trigeminal Neuralgia
Authors: Danyluk H , Elliott C , Wheatley M , Broad R , Sankar T
Published: June 2018

Background: Surgical treatment of trigeminal neuralgia (TN) can be highly effective, but durability of pain relief varies and factors influencing surgical failure are poorly understood. We hypothesized that structural brain differences—assessed using magnetic resonance imaging (MRI)—might distinguish surgical responders from early non-responders. Methods: We retrospectively identified 35 TN patients treated surgically from 2005-2017 with high-resolution, -pre-operative MRI scans adequate for quantitative structural analysis. Patients were classified as non-responders if, within 12-months after surgery, they: 1) underwent or were offered another surgical procedure; or 2) reported persistent, inadequately-controlled pain. Volumes of pain-relevant subcortical structures (amygdala, thalamus, and hippocampus) were measured on T1-weighted MRI scans using an automated approach (FSL-FIRST). Results: Surgical responders had significantly larger hippocampi bilaterally compared to early non-responders. Thalamus and amygdala volumes did not differ between groups. Conclusions: Pre-operative differences in brain structure, notably in the hippocampus, may predict durability of response to surgery in patients with TN.
P.071 Novel mutations in SPG7 identified from patients with late-onset spasticity
Authors: Almomen MM , Martens KA , Hanson A , Korngut L , pfeffer G
Published: June 2018

Background: Hereditary spastic paraplegia (HSP) is a group of genetic diseases that cause progressive degeneration of the corticospinal tract. Historically, this disease was divided into two types:the classic subtype, with leg weakness and hypertonic bladder, and the complicated subtype, with features such as cerebellar ataxia or optic atrophy.Mutations in SPG7 (encoding paraplegin) leads to complicated HSP causing cerebellar ataxia, progressive external ophthalmoplegia in addition to the classical symptoms. AFG3L2 is a binding partner of paraplegin and mutations in AFG3L2 cause a similar syndrome Methods: From a neurogenetic clinic , we identified 11 patients with late-onset HSP. Sequencing of SPG7 and AFG3L2 was performed using a customised assay, and/or clinical diagnostic sequencing panels.SPG7 transcript level quantification was performed from whole blood RNA on a digital droplet qPCR system. Results: We identified 4 patients with pathogenic variants or variants of unknown significance in SPG7. No AFG3L2 mutations were identified. We provide evidence for pathogenicity for three mutations that were not previously associated with SPG7-related disease, based on their occurrence in context of the correct phenotype, and the reduction of transcript levels measured with RT-qPCR.A curious association of the heterozygous p.Gly349Ser mutation in association with an ALS-like syndrome is reported. Conclusions:SPG7 mutations sequencing has high diagnostic yield in late onset paraparesis
P.072 Agreement between children and their parents’ ratings of the health-related quality of life of children with Duchenne Muscular Dystrophy
Authors: Brar S , Campbell C , McColl E , Martens W , McDermott M , Tawil R , Hart K , Herr B , Kirschner J , Guglieri M , Griggs R ,   The Muscle Study Group ()
Published: June 2018

Background: When measuring young Duchenne Muscular Dystrophy (DMD) patients’ health-related quality of life (HRQoL), parent-proxy reports are heavily relied on. Therefore, it is imperative that the relationship between parent-proxy and child self-report HRQoL is understood. This study examined the level of agreement between children and their parent-proxy rating of the child’s HRQoL. Methods: We used FOR-DMD clinical trial baseline data. HRQoL, measured using the PedsQL inventory, was reported by 178 parent and child (ages 4 to 7 years) dyads. Intracorrelation coefficients (ICC) measured absolute agreement while paired t-tests determined differences in the average HRQoL ratings between groups. Results: The level of agreement between child and parent-proxy ratings of HRQoL was poor for the generic PedsQL scale (ICC: 0.29) and its subscales; and, similarly low for the neuromuscular disease module (ICC:0.16). On average, parents rated their child’s HRQoL as poorer than the children rated themselves in all scales except for psychosocial and school functioning. Conclusions: Child and parent-proxy HRQoL ratings are discordant in this study sample, as occurs in other chronic pediatric diseases. This should be taken into account when interpreting clinical and research HRQoL findings in this population. Future studies should examine reasons for parents’ perception of poorer HRQoL than that reported by their children.
P.076 Safety of Eteplirsen, a phosphorodiamidate morpholino oligomer, in Duchenne Muscular Dystrophy patients amenable to Exon 51 skipping
Authors: Mah J , Lynch J , Campbell C
Published: June 2018

Background: Duchenne muscular dystrophy (DMD) is an X-linked disorder affecting 1:3500-5000 live male births, causing a life-limiting form of muscular dystrophy. Whole exon deletions disrupting the reading frame result in near-absence of sarcolemmal dystrophin, essential for muscle function. Eteplirsen is a phosphorodiamidate morpholino oligomer (PMO) designed to induce production of internally-truncated dystrophin in certain patients. Methods: As of June 2016, 150 patients (4-19 years of age) with DMD received eteplirsen in 7 clinical trials. 143 patients received ≥1 intravenous infusion of eteplirsen (range: 0.5 - 50 mg/kg). 81 (54%) received treatment for ≥1 year (Range: 1-4+ years). Results: Common (>15%) adverse events (AEs) were cough, headache, vomiting, back pain, extremity pain, contusion, nasopharyngitis, upper respiratory tract infection, nasal congestion, arthralgia and rash. Non-serious facial flushing, erythema and mild transient temperature elevation occurred with eteplirsen. 10 (6.7%) patients experienced severe AEs; 12 (8%) patients experienced serious AEs. All serious and all but 1 severe AEs were considered unrelated to eteplirsen by the treating physicians. Serial echocardiograms in 12 treated patients demonstrated no functional decline over 4+ years. Conclusions: Eteplirsen’s tolerability will continue to be assessed in ongoing clinical trials.

An updated data summary will be presented.
P.086 A randomized trial of a simple intervention to improve neurosurgery rotation experience for senior medical students
Authors: Ahuja CS , Alotaibi NM , Wang S , Davidson B , Mainprize T , Kulkarni AV , Spears J , Massicotte E
Published: June 2018

Background: High volumes, ill patients, and steep learning curves can make neurosurgical rotations challenging for medical students. Furthermore, existing rotations often lack neurosurgery-specific orientation materials and level-appropriate pre-reading resources reducing the educational yield of short rotations. This is compounded by the lack of mandatory neurosurgical rotations across medical schools. We hypothesized that a “Neurosurgery Clerkship Manual” covering key orientation, knowledge, and practical topics would enhance educational experiences and generate sustained knowledge retention. Methods: Students rotating through neurosurgery at three hospitals were randomized to receive(intervention) or not receive(control) free access to the manual before their rotation. Participants completed surveys before, immediately after, and 4-weeks after the rotation assessing expectations, experiences, and clinically-relevant knowledge. Results: 61 participants were randomized between 2014 and 2017 with 43(70.5%) completing all three questionnaires. Baseline demographics, characteristics, and experiences were not significantly different. Those receiving the manual reported increased rotation enjoyment(p=0.02), decreased stress levels (p=0.05), and a greater feeling of being “part of the team”(p=0.01). There were also reductions in feeling like they were “not learning” (p=0.01). Finally, those receiving the manual demonstrated significantly better knowledge after the rotation (91.6%vs80.9%;p=0.04) which was sustained at 4-weeks post-rotation (89.2%vs79.0%;p=0.05). Conclusions: A simple and inexpensive clerkship manual can improve the neurosurgery rotation experience and knowledge retention for medical students.
P.106 Functional approach using intraoperative brain mapping and neurophysiological monitoring for surgery of arteriovenous malformations in eloquent areas
Authors: Lopez-Ojeda P , Sanmillan J , Fernandez-Coello A , Fernandez-Conejero I , Ali-Ciurana Y , Gabarros A
Published: June 2018

Background: Surgical resection of arteriovenous malformations (AVMs) in eloquent areas is significantly associated with greater surgical morbidity. We describe a functional approach for surgical treatment of these lesions Methods: A total of 20 patients with AVMs in eloquent areas were surgically treated and retrospectively analyzed. Individualized functional approach, using brain mapping and/or neurophysiological monitoring was performed in each case according to every case specific features and location. Seventeen patients underwent surgery under assleep conditions and 3 -patients underwent awake intraoperative mapping Results: There was no mortality. Four patients had hemorrhagic complications (20%). Ten (50%) presented neurological immediate postoperative worsening. Eight of them achieved complete recovery in follow up and 2 showed a permanent deficit. At 6 months follow up all the patients (100%) had good clinical outcome (mRS less than 2). There were no intraoperative seizures but 5 patients (26.3%) developed postoperative seizures. Fifteen patients (75%) had total AVM resection. Language and/or motor function were identified in all but one patient (95%). Each case required changes in surgical strategy to preserve the motor and/or language functions during surgery. Conclusions: Intraoperative monitoring and brain mapping are valuable and safe for the treatment of eloquent AVMs by indentifying and protecting motor and language function during resection.
P.109 Causes of albuminocytologic dissociation and the impact of an age-adjusted reference limit on review of 2,627 CSF samples
Authors: Brooks JA , McCudden C , Breiner A , Bourque P
Published: June 2018

Background: We set out to test the discriminative power of an age-adjusted upper reference limit (URL) for CSF total protein (CSF-TP) in identifying pathological causes of albuminocytologic dissociation (ACD). Methods: We reviewed the charts of 2,627 adult patients who underwent a lumbar puncture at a tertiary care center over a 20-year period. Samples with CSF-TP above 45 mg/dL (0.45 g/L) were included. Samples with white blood cell count > 5×109/L, red blood cell count > 50×109/L, and glucose < 2.5 mmol/L (45 mg/dL) were excluded. Patients with CSF-TP elevated above 45 mg/dL were considered to have ‘pseudo’ albuminocytologic dissociation (ACD) or ‘true’ ACD if their CSF-TP was in excess of age-adjusted norms. Results: Among all patients with ACD, a pathological source of CSF-TP elevation was identified in 57% (1490/2627) of cases, 51% of those with ‘pseudo’ ACD, and 75% with ‘true’ ACD (p< 0.001). Use of an age-adjusted upper reference limit favored the detection of polyneuropathy patients (13.5% proportionate increase) and excluded a larger number of patients with isolated headache (10.7% proportionate decrease; p < 0.0001). Conclusions: Elevated CSF-TP is a relatively common finding. Use of age-adjusted upper reference limits for CSF-TP values improve diagnostic specificity and help to avoid over-diagnosis of ACD.
P.128 Episodic ataxia and encephalitis: A novel presentation of RESLES in a 3-year-old girl
Authors: Srivastava R , Yaworski A , Jain S , Goez H , Kassiri J , Richer L
Published: June 2018

Background: Reversible splenial lesion syndrome (RESLES) is a rare clinico-radiological entity associated with multiple etiologies including infection, metabolic, and epileptic disorders. We describe the case of a child with a reversible splenial lesion who presented with encephalopathy and prior history of episodic ataxia. Methods: A 3-year-old girl presented to the Stollery Children’s hospital with three days of respiratory symptoms followed by acute onset ataxia and encephalopathy. Blood, respiratory samples, and cerebral spinal fluid (CSF) were drawn to investigate for infectious, autoimmune, and metabolic causes. Magnetic resonance imaging (MRI) brain was done and repeated. Results: A respiratory panel tested positive for respiratory syncytial virus (RSV), enterovirus, and rhinovirus. CSF analysis revealed elevated white blood cell count (283). MRI brain demonstrated diffusion restriction involving the posterior body and splenium of the corpus callosum and bilateral middle cerebral peduncles, which resolved nine days later. The patient received high-dose steroids with gradual improvement in the encephalopathy and ataxia. Conclusions: This report contributes to the complexities in clinical understanding of RESLES, as it highlights a novel presentation with ataxia and encephalopathy. The patient’s diagnosis was complicated by previous ataxic episodes of unknown etiology, which allows further consideration of a metabolic or genetic ataxic syndrome and its relationship to encephalopathy.
P.138 Minimally invasive treatment of syringomyelia using tubular retractors
Authors: Yang K , Sourour M , Zagzoog N , Reddy K
Published: June 2018

Background: Multiple modalities have been used in the treatment of syringomyelia, including direct drainage, shunting into peritoneal, pleural and subarachnoid spaces. The authors report their experience of surgical treatment of syringomyelia in a minimally invasive fashion. Methods: We conducted a single-center retrospective chart review on our syringomyelia cases treated with minimally invasively using Metrx Quadrant retractor system since January 2011. Lateral fluoroscopy was used to guide the placement of the retractor onto the lamina of the corresponding level. This was followed by laminectomy and a small durotomy. Once the syrinx cavity was identified and the proximal end of the tubing was inserted into the syrinx cavity, the tubing was tunneled into the pleural incision subcutaneously. Insertion of the pleural end of the shunt was performed under the microscope, with removal of a small amount of the rib at its upper edge. Results: 10 procedures were performed in 7 patients by the senior author. Etiologies of syringomyelia included Chiari malformation, trauma, diastematomyelia and kyphoscoliosis. All patients improved neurologically. No patients had immediate postoperative complications. One patient underwent two revisions of syringopleural shunts due to multilobulated nature of syringomyelia. Conclusions: Our case series presents a novel, minimally invasive technique for shunting of syringomyelia with results comparable to open procedures.
P.140 A new international nomenclature of far and extreme lateral approaches to the craniocervical junction
Authors: Alshafai Ns , Klepinowski T
Published: June 2018

Background: Far and extreme lateral approaches have become a mainstay treatment for lesions located at the anterolateral aspect of foramen magnum and its vicinity. However, there is a significant discrepancy between authors on what these approaches truly are, which leads to producing papers naming different techniques the same and same techniques differently. Methods: We performed literature search employing PubMed-MEDLINE and Scopus databases. The search terms referred to the nomenclature of far lateral approach (FLA), extreme lateral approach (ELA), and their variants. Finally, important papers on the topic from article references were also included, if deemed contributory. Results: In total, 37 articles were collected. Surprisingly, we found that not a single paper has addressed the confusing nomenclature directly yet. Nine truly separate variants of FLA and ELA were found. We implemented them intraoperatively depending on both patient and lesion characteristics. The essence about each is summarized. Conclusions: In the CNSF meeting, we will shortly discuss causes behind confusion and debate each FLA and ELA variants according to a number of authors and their unique yet sometimes confusing understanding of the approaches. Ultimately, a logical proposal for the unification is provided to stir up discussion
C.01 Endoscopic versus open microvascular decompression of trigeminal neuralgia: a systematic review and comparative meta-analysis
Authors: Zagzoog N , Attar A , Takroni R , Alotaibi M , Reddy K
Published: June 2018

Background: Microvascular decompression (MVD) is commonly used in the treatment of trigeminal neuralgia with positive clinical outcomes. Fully endoscopic microvascular decompression (E-MVD) has been proposed as a minimally invasive, effective alternative, but a comparative review of the two approaches in the literature has not been conducted. Methods: We performed a meta-analysis comparing patient outcome rates and complications for both techniques. From a pool of 1,039 studies, 22 articles were selected for review: 12 open MVD and 10 E-MVD. The total number of patients was 6,734. Results: Good pain relief was achieved in 81% of MVD and 88% of E-MVD patients, with a mean recurrence rate of 14% and 9% respectively. Average rates of complications in MVD versus E-MVD included facial paresis or weakness, 9%, 3%; -hearing loss, 4%, 1%; cerebrospinal leak, both 3%; cerebellar damage and infection, 2%, <1%; and mortality <1%, 0% respectively. Conclusions: The reviewed literature revealed similar clinical outcomes with respect to pain relief for both approaches. Recurrence rate and incidence of complications, notably facial paresis and hearing loss were higher for MVD. We concluded that E-MVD appears to offer at least as good a surgical outcome as MVD, with possibly a shorter operative time, smaller craniectomy and lower recurrence rates.
Fire Disaster Readiness: Preparation for the Evacuation of Medical Facilities During Fires in Haifa, Israel, 2016
Authors: Kreinin Anatoly , Lyansberg Alexey , Yusupov Miriam , Moran Daniel S.
Published: June 2018

When a fire occurs, there is little time to escape. In less than 30 seconds, a fire can rage out of control, filling the area with heat and toxic thick smoke (Purdue University Fire Department, 2017; http://www.purdue.edu/ehps/fire/fire-101.html.) In 2010, following the successful evacuation of Maale Ha’Carmel Mental Health Center during a raging forest fire in the area, a comprehensive investigation was performed to evaluate the management of the evacuation process and to systematically elicit lessons learned from the incident. In 2016, a forest fire erupted in the same geographic area that required the evacuation of Fliman Geriatric Rehabilitation Hospital, and methodical debriefing identified the strengths and weaknesses of the evacuation process in that hospital. The lessons learned from the evacuation of these two health care facilities, which were at the focus of major fires in Israel in 2010 and in 2016, are presented. (Disaster Med Public Health Preparedness. 2019;13:375–379)
How Are We Doing? An Examination of Gender Representation in Industrial and Organizational (I-O) Psychology
Authors: Gardner Danielle M. , Ryan Ann Marie , Snoeyink Megan
Published: June 2018

There has been an explosion of within-profession studies examining standings on gender representation in advancement, publication patterns, and conference presentations. However, industrial and organizational (I-O) psychology has yet to take such an introspective look and fully join these conversations. This manuscript aims to initiate and encourage such discussion. Through a brief review of relevant background information and the collection and analysis of recent archival data, we seek to examine where we have been with regard to gender representation, where we currently stand, and what steps are needed moving forward. We aim to stimulate continued examinations on this topic while recommending appropriate action items relevant to achieving equity in representation in our field.
Candidate selection methods and electoral performance in comparative perspective
Authors: Vicentini Giulia
Published: June 2018

The purpose of the article is try to assess whether inclusive procedures of selection are more likely to appoint a candidate who can be competitive in the general elections compared with less inclusive ones. Accordingly, I took into account nomination processes (NPs) to select/appoint the prime ministerial/presidential candidate for general elections held in four Western European countries (France, Italy, Spain, the United Kingdom) over approximately the last two decades. Using an original data source and innovative indicators, I assessed the inclusiveness of each NP and the party/candidate’s performance in the following general election in order to look for a possible relation. The outcome shows a very weak negative correlation between the two variables. Thus, while it does not appear that inclusive systems of selection have a clear positive impact at the electoral level, it is likewise hard to maintain that systems such as primary elections cause electoral failure.
Physical mechanisms governing drag reduction in turbulent Taylor–Couette flow with finite-size deformable bubbles
Authors: Spandan Vamsi , Verzicco Roberto , Lohse Detlef
Published: June 2018

The phenomenon of drag reduction induced by injection of bubbles into a turbulent carrier fluid has been known for a long time; the governing control parameters and underlying physics is, however, not well understood. In this paper, we use three-dimensional numerical simulations to uncover the effect of deformability of bubbles injected in a turbulent Taylor–Couette flow on the overall drag experienced by the system. We consider two different Reynolds numbers for the carrier flow, i.e. $Re_{i}=5\times 10^{3}$ and $Re_{i}=2\times 10^{4}$; the deformability of the bubbles is controlled through the Weber number, which is varied in the range $We=0.01{-}2.0$. Our numerical simulations show that increasing the deformability of bubbles (that is, $We$) leads to an increase in drag reduction. We look at the different physical effects contributing to drag reduction and analyse their individual contributions with increasing bubble deformability. Profiles of local angular velocity flux show that, in the presence of bubbles, turbulence is enhanced near the inner cylinder while attenuated in the bulk and near the outer cylinder. We connect the increase in drag reduction to the decrease in dissipation in the wake of highly deformed bubbles near the inner cylinder.
The British Institute of Florence and the British Council in Fascist Italy: from Harold E. Goad to Ian G. Greenlees, 1922–1940
Authors: Colacicco Tamara
Published: June 2018

The first British cultural institute on foreign soil was founded in Florence in 1917. However, it was the creation of the British Council in London in 1935 that marked the beginning of the strengthening of the British cultural presence abroad. The aim of this drive was to promote knowledge of British culture and civic and political life overseas, to defend national prestige and, given the escalating expansionist policies of Nazi Germany and Fascist Italy, to encourage the preservation of dialogue between the major European powers, underpinned by democratic principles. Bridging a gap in research into the relationship between Italy and Great Britain in the interwar period, this article reconstructs the case study of British cultural diplomacy in Florence between 1922 and Mussolini’s declaration of war, analysing how British culture was used in politics and propaganda and investigating the relationship of the management of both the British Institute of Florence and the British Council with Fascism. In doing so, it offers original insight into British history and the country’s cultural institutions in Fascist Italy, and into the wider field of Anglo-Italian political and cultural relations during the period of dictatorship in Italy.
Immersive Virtual Reality Experiences for All-Sky Data
Authors: Fluke C. J. , Barnes D. G.
Published: June 2018

Spherical coordinate systems, which are ubiquitous in astronomy, cannot be shown without distortion on flat, two-dimensional surfaces. This poses challenges for the two complementary phases of visual exploration—making discoveries in data by looking for relationships, patterns, or anomalies—and publication—where the results of an exploration are made available for scientific scrutiny or communication. This is a long-standing problem, and many practical solutions have been developed. Our allskyVR approach provides a workflow for experimentation with commodity virtual reality head-mounted displays. Using the free, open source s2plot programming library, and the A-FrameWebVR browser-based framework, we provide a straightforward way to visualise all-sky catalogues on a user-centred, virtual celestial sphere. The allskyVR distribution contains both a quickstart option, complete with a gaze-based menu system, and a fully customisable mode for those who need more control of the immersive experience. The software is available for download from https://github.com/cfluke/allskyVR.
Improvements in clinical characteristics of patients with non-alcoholic fatty liver disease, after an intervention based on the Mediterranean lifestyle: a randomised controlled clinical trial
Authors: Katsagoni Christina N. , Papatheodoridis George V. , Ioannidou Panagiota , Deutsch Melanie , Alexopoulou Alexandra , Papadopoulos Nikolaos , Papageorgiou Maria-Vasiliki , Fragopoulou Elizabeth , Kontogianni Meropi D.
Published: June 2018

Lifestyle interventions remain the cornerstone therapy for non-alcoholic fatty liver disease (NAFLD). This randomised controlled single-blind clinical trial investigated the effect of Mediterranean diet (MD) or Mediterranean lifestyle, along with weight loss, in NAFLD patients. In all, sixty-three overweight/obese patients (50 (sd11) years, BMI=31·8 (sd4·5) kg/m2, 68 % men) with ultrasonography-proven NAFLD (and elevated alanine aminotransferase (ALT) and/or γ-glutamyl transpeptidase (GGT) levels) were randomised to the following groups: (A) control group (CG), (B) Mediterranean diet group (MDG) or (C) Mediterranean lifestyle group (MLG). Participants of MDG and MLG attended seven 60-min group sessions for 6 months, aiming at weight loss and increasing adherence to MD. In the MLG, additional guidance for increasing physical activity and improving sleep habits were given. Patients in CG received only written information for a healthy lifestyle. At the end of 6 months, 88·8 % of participants completed the study. On the basis of intention-to-treat analysis, both MDG and MLG showed greater weight reduction and higher adherence to MD compared with the CG (allP<0·05) at the end of intervention. In addition, MLG increased vigorous exercise compared with the other two study groups (P<0·001) and mid-day rest/naps compared with CG (P=0·04). MLG showed significant improvements in ALT levels (i.e. ALT<40 U/l (P=0·03) and 50 % reduction of ALT levels (P=0·009)) and liver stiffness (P=0·004) compared with CG after adjusting for % weight loss and baseline values. MDG improved only liver stiffness compared with CG (P<0·001) after adjusting for the aforementioned variables. Small changes towards the Mediterranean lifestyle, along with weight loss, can be a treatment option for patients with NAFLD.
Effectiveness of a home fortification programme with multiple micronutrients on infant and young child development: a cluster-randomised trial in rural Bihar, India
Authors: Larson Leila M. , Young Melissa F. , Bauer Patricia J. , Mehta Rukshan , Girard Amy Webb , Ramakrishnan Usha , Verma Pankaj , Chaudhuri Indrajit , Srikantiah Sridhar , Martorell Reynaldo
Published: June 2018

Research demonstrates the importance of nutrition for early brain development. Few studies have examined the effectiveness of multiple micronutrient powders (MNP) on child development. This study examined the impacts of home fortification with MNP on motor and mental development, executive function and memory of children living in Bihar. This two-arm cluster-randomised effectiveness trial selected seventy health sub-centres to receive either MNP and nutrition counselling (intervention) or nutrition counselling alone (control) for 12 months. Front-line health workers delivered the intervention to all households in study communities with a child aged 6–18 months. Data were collected using cross-sectional surveys at baseline and endline by selecting households from intervention (baseline,n2184; endline,n2170) and control (baseline,n2176; endline,n2122) communities using a two-stage cluster-randomised sampling strategy. Children in the intervention group had a significantly larger improvement from baseline to endline compared with those in the control group on scores for motor and mental development (Cohen’sd, motor=0·12; 95 % CI 0·03, 0·22; mental=0·15; 95 % CI 0·06, 0·25). Greater impacts of MNP on motor and mental development were observed in children from households with higher stimulation scores at baseline compared with those with lower stimulation (Cohen’sd, motor=0·20v. 0·09; mental=0·22v. 0·14;Pinteraction<0·05). No significant treatment differences were seen for executive function or memory. Home fortification with MNP through the existing health infrastructure in Bihar was effective in improving motor and mental development and should be considered in combination with other child development interventions such as stimulation.
Time to address the double inequality of differences in dietary intake between Scotland and England
Authors: Barton Karen L. , Chambers Stephanie , Anderson Annie S. , Wrieden Wendy L.
Published: June 2018

Geographical disparities in health outcomes have been evident across the UK for decades. Recent analysis on the dietary differences between Scotland and England that might go some way to explain these health differences is limited. This study aimed to assess whether, and to what degree, aspects of diet and nutrition differ between Scottish and English populations, specifically between those with similar household incomes. A period of 12 years of UK food purchase data (2001–2012) were pooled and used to estimate household-level consumption data for Scotland and England. Population mean food consumption and nutrient intakes were estimated, adjusting for known confounders (year, age of household reference person, age they left full-time education and income). Comparison was also made within equivalised income quintiles. Analysis showed that the foods and nutrients that should be increased in the diet (highlighted in the Scottish Dietary Goals) were lower in Scotland than in England (e.g. fruit and vegetables 267 g/d; 99 % CI 259, 274v.298 g/d; 99 % CI 296, 301),P<0·001). Similarly, foods and drinks linked with poor health outcomes were higher in Scotland. These regional inequalities in diet were even more pronounced in the lower-income groups (e.g. red and processed meat consumption in the lowest-income quintile was 65 g/d; 99 % CI 61, 69 in Scotlandv. 58 g/day; 99 % CI 57, 60 in England,P<0·001, but similar in the highest-income quintile (58 g/d; 99 % CI 54, 61v. 59 g/d; 99 % CI 58, 60, respectively). A poorer diet in Scotland compared with England, particularly among disadvantaged groups, may contribute to differences in excess mortality between countries.
Low 10-year reproducibility of glycaemic index and glycaemic load in a prospective cohort study
Authors: Mullie Patrick , Deforche Benedicte , Mertens Evelien , Charlier Ruben , Knaeps Sara , Lefevre Johan , Clarys Peter
Published: June 2018

When relating glycaemic index (GI) and glycaemic load (GL) to health outcomes, many prospective cohort studies assess the nutritional exposure only once in time, that is, at the start of the study, presuming a stability in nutritional consumption during the course of the study. The aim of this study is to investigate the reproducibility of GI and GL. This is a prospective cohort study in which 562 middle-aged Belgian adults noted all foods and drinks consumed during 3 d in 2002 and 2012. GI and GL were calculated after reference tables. The Pearson correlation coefficients between 2002 and 2012 were 0·27 for GI and 0·41 for GL. For GI, 33 % of the participants remained in the same quintile between 2002 and 2012, whereas 31 % moved to a non-adjacent quintile. For GL, this was 34 and 28 %, respectively. The lowest and the highest quintiles of GI were the most stable, with 40 and 44 % of the participants staying in the same quintile. This was only 22 % for the fourth quintile. The same tendency was present for GL – that is, the most extreme quintiles were the most stable. This study shows 10-year correlation coefficients for GI and GL below 0·50. Multiple nutritional assessments and limiting the analysis to the extreme quintiles of GI and GL will limit a possible misclassification in the prospective cohort studies owing to the low reproducibility.
Integrated pest management for resource-limited farmers: challenges for achieving ecological, social and economic sustainability
Authors: Bottrell D. G. , Schoenly K. G.
Published: June 2018

Hailed as the single most important paper published on crop protection in the 20th century, Sternet al. in 1959 formed the conceptual basis for modern integrated pest management (IPM) worldwide. The ecological foundation for IPM envisioned by its authors is as valid today as in 1959. However, adoption by developing country farmers has been low and its advances short-lived. The present paper examines the concept of integration in IPM and criteria for determining whether its control tactics have been integrated harmoniously. The effects of local and regional landscape patterns on pests and on the design of IPM are reviewed, arguing that the agroecosystem must be understood and managed as a living system with the goal of enhancing and conserving agrobiodiversity and keeping ecosystem services intact. Key to IPM adoption is convincing farmers to integrate non-chemical alternatives (e.g. biological control, plant diversification) as primary management components and to apply pesticides judiciously and only after non-chemical components fail to manage pests effectively. Research, extension and policy changes are identified to increase the efficiency, adoption and sustainability of IPM on resource-limited farms. The over-arching challenge is devising communication and support systems that allow resource-limited farmers to try, adopt and sustain IPM that enhances yields and profits in light of the many uncertainties and challenges. Use of information technology, media development, crowdsourcing and rural sociology is advocated to connect farmers to the technical sources required to enhance yields and profits and reduce risks to them, the farming community and the environment.
Application of the Ito theory for Monte Carlo simulation of plasma diffusion
Authors: Gurin Anatolii , Goloborod’ko Victor
Published: June 2018

In this paper the full set of stochastic differential equations (SDEs) are presented describing the guiding centre motion of test charged particles in a plasma with an arbitrary inhomogeneous magnetic field, when the drift approximation is applicable. The derivation is based on the Ito formula which is used to determine stochastic differentials of functions of the non-gyro-averaged velocity diffusion in strict correspondence with the general kinetic equations involving Coulomb collision operators. The drift SDEs are obtained by calculating the Ito stochastic integrals within time intervals admitting the gyro-averaging procedure. The proposed SDEs reproduce the well-known Monte Carlo operators for orbital invariants, however additionally accounting for the spatial drift caused by the cross-field diffusion process with a classical diffusion coefficient. All SDE coefficients are explicitly expressed in terms of the Rosenbluth potentials in a gyro-tropic or isotropic background plasma. The SDEs are presented in particular for the case of an axisymmetric toroidal magnetic configuration to describe the spatial two-dimensional poloidal diffusion process providing a detailed description of neoclassical orbital effects.
Eikonal-Glauber Thomas–Fermi model for atomic collisions with many-electron atoms for plasma applications
Authors: Lee Myoung-Jae , Jung Young-Dae
Published: June 2018

We have derived the universal eikonal-Glauber Thomas–Fermi model for atomic collision cross-sections with many-electron atoms, such as iron and tungsten atoms, including the influence of atomic screening in fusion devices and plasma technologies. The eikonal-Glauber method is employed to obtain the analytic expressions for the effective atomic charge, the scattering phase shift and the atomic cross-section in terms of the atomic form factor and the Mott–Massey screening parameter. The result shows that the effective atomic charge would be the same as the case of the net nuclear charge for the large momentum transfer domain and becomes zero without momentum transfer due to the influence of bound atomic electrons. It is shown that the eikonal scattering phase shift and the total eikonal-Glauber scattering cross-section increase with increasing charge number$Z$of the nucleus of the target atom. It is also found that the charge dependence of the total eikonal-Glauber scattering cross-section decreases with an increase of the scaled collision energy since the atomic form factor is small for large collision energies.
A data-driven method for identifying shorter symptom criteria sets: the case for DSM-5 alcohol use disorder
Authors: Raffo Cheryl D. , Hasin Deborah S. , Appelbaum Paul , Wall Melanie M.
Published: June 2018

Background

Although the DSM is a widely used diagnostic guide, lengthy criteria sets can be problematic and provide the primary motivation to identify short-forms. Using the 11 diagnostic criteria provided by the DSM-5 for alcohol use disorder (AUD), the present study develops a data-driven method to systematically identify subsets and associated cut-offs that yield diagnoses as similar as possible to use all 11 criteria.

Method

Relying on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), our methodology identifies diagnostic short-forms for AUD by: (1) maximizing the association between the sum scores of all 11 criteria with newly constructed subscales from subsets of criteria; (2) optimizing the similarity of AUD prevalence between the current DSM-5 rule and newly constructed diagnostic short-forms; (3) maximizing sensitivity and specificity of the short-forms against the current DSM-5 rule; and (4) minimizing differences in the accuracy of the short-form across chosen covariates. Replication is shown using NESARC-Wave 2.

Results

More than 11 000 diagnostic short-forms for DSM-5 AUD can be created and our method narrows down the optimal choices to eight. Results found that ‘Neglecting major roles’ and ‘Activities given up’ could be dropped with practically no change in who is diagnosed (specificity = 100%, sensitivity ⩾ 99.6%) or the severity of those diagnosed (κ = 0.97).

Conclusions

With a continuous improvement model adopted by the APA for DSM revisions, we offer a data-driven tool (a SAS Macro) that identifies diagnostic short-forms in a systematic and reproducible way to help advance potential improvements in future DSM revisions.