bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of endovascular treatment of ruptured aneurysms of the middle cerebral artery compared to other anatomical locations
Authors: Murias Quintana Eduardo , Vega Valdés Pedro , Morales Deza Edison , Gil Garcia Alberto , Cuellar Hugo , Costilla García Serafín , Cadenas Rodríguez María , Delgado Montserrat Gonzalez , Peña Suárez Jorge , Santamarta Liébana Elena , López-García Antonio
Published: August 2016

Objective

The objective of this article is to compare the results of endovascular treatment of ruptured middle cerebral artery (MCA) aneurysms with ruptured aneurysms of other anatomic locations.

Methods

Fifty consecutive ruptured aneurysms of the MCA and 209 aneurysms at other anatomical locations were selected retrospectively. We compared epidemiological, clinical and radiological variables, prognosis and complications.

Results

The MCA aneurysms had a greater size and a poor dome/neck ratio. There were no significant differences in endovascular technique complications, occlusion rate or rebleeding between the two groups ( p > 0.1). There were no significant differences in the mortality and number of dependent patients after one month.

Conclusion

The endovascular treatment of ruptured MCA aneurysms without hematoma is as safe and effective as other aneurysm localizations. Complication rates, occlusion rates and rebleeding of ruptured MCA aneurysms are comparable to other locations.
Reliability of dual- vs single-volume reconstruction of three-dimensional digital subtraction angiography for follow-up evaluation of endovascularly treated intracranial aneurysms
Authors: Adeeb Nimer , Griessenauer Christoph J , Patel Apar S , Moore Justin , Dolati-Ardejani Parviz , Gupta Raghav , Motiei-Langroudi Rouzbeh , Ogilvy Christopher S , Thomas Ajith J
Published: August 2016

Introduction

Single-volume reconstruction of three-dimensional (3D) digital subtraction angiography (DSA) can be effectively used for aneurysm assessment and planning of endovascular embolization. Unfortunately, post-embolization follow-up angiographic images can be obscured by artifact. The dual-volume reconstruction technique was developed in order to reduce artifact and enhance the visualization of the aneurysm, the parent vessel and side branches, and endovascular devices. The purpose of this study was to compare the reliability of dual- vs single-volume reconstruction of 3D DSA in evaluation of follow-up images after endovascular embolization of intracranial aneurysms.

Method

Four cerebrovascular neurosurgeons independently and blindly reviewed 20 randomly selected dual-and single-volume reconstructions of 3D DSAs demonstrating cerebral aneurysms treated with primary coil embolization, stent-assisted coil embolization, or Pipeline embolization. Five images were repeated for each modality (single and dual volume) in order to assess intra-rater reliability. The intraclass correlation coefficient was calculated as a measure of the overall inter-rater agreement. Cohen’s kappa value was used to assess repeat measurement consistency for each rater.

Results

Overall inter-rater agreement using dual- and single-volume reconstruction was 0.81 and 0.75, respectively. Dual-volume reconstruction resulted in superior agreement in assessing location, occlusion status, position of aneurysm recanalization or residual, status of nearby branches, presence of coil migration and presence of intravascular devices (stent or Pipeline).

Conclusion

Three-dimensional reconstruction is an important complementary imaging technique in evaluating the angioarchitecture of aneurysms and recanalization after endovascular embolization. Dual-volume reconstruction imaging was associated with superior inter- and intra-rater reliability.
Relevance feature selection of modal frequency-ambient condition pattern recognition in structural health assessment for reinforced concrete buildings
Authors: Mu He-Qing , Yuen Ka-Veng , Kuok Sin-Chi
Published: August 2016

Modal frequency is an important indicator for structural health assessment. Previous studies have shown that this indicator is substantially affected by the fluctuation of ambient conditions, such as temperature and humidity. Therefore, recognizing the pattern between modal frequency and ambient conditions is necessary for reliable long-term structural health assessment. In this article, a novel machine-learning algorithm is proposed to automatically select relevance features in modal frequency-ambient condition pattern recognition based on structural dynamic response and ambient condition measurement. In contrast to the traditional feature selection approaches by examining a large number of combinations of extracted features, the proposed algorithm conducts continuous relevance feature selection by introducing a sophisticated hyperparameterization on the weight parameter vector controlling the relevancy of different features in the prediction model. The proposed algorithm is then utilized for structural health assessment for a reinforced concrete building based on 1-year daily measurements. It turns out that the optimal model class including the relevance features for each vibrational mode is capable to capture the pattern between the corresponding modal frequency and the ambient conditions.
Geometrical variations in white and gray matter affect the biomechanics of spinal cord injuries more than the arachnoid space
Authors: Fradet Léo , Arnoux Pierre-Jean , Callot Virginie , Petit Yvan
Published: August 2016

Traumatic spinal cord contusions lead to loss of quality of life, but their pathomechanisms are not fully understood. Previous studies have underlined the contribution of the cerebrospinal fluid in spinal cord protection. However, it remains unclear how important the contribution of the cerebrospinal fluid is relative to other factors such as the white/gray matter ratio. A finite element model of the spinal cord and surrounding morphologic features was used to investigate the spinal cord contusion mechanisms, considering subarachnoid space and white/gray matter ratio. Two vertebral segments (T6 and L1) were impacted transversely at 4.5 m s−1, which demonstrated three major results:

While the presence of cerebrospinal fluid plays a significant contributory role in spinal cord protection (compression percentage decreased by up to 19%), the arachnoid space variation along the spine appears to have a limited (3% compression decrease) impact. Differences in the white and gray matter geometries from lumbar to thoracic spine levels decrease spinal cord compression by up to 14% at the thoracic level. Stress distribution in the sagittal spinal cord section was consistent with central cord syndrome, and local stress concentration on the anterior part of the spinal cord being highly reduced by the presence of cerebrospinal fluid.

The use of a refined spinal cord finite element method showed that all the geometrical parameters are involved in the spinal cord contusion mechanisms. Hence, spinal cord injury criteria must be considered at each vertebral level.
High levels of endogenous lipid mediators (N-acylethanolamines) in women with chronic widespread pain during acute tissue trauma
Authors: Stensson Niclas , Ghafouri Bijar , Ghafouri Nazdar , Gerdle Björn
Published: August 2016

Although chronic widespread musculoskeletal pain is a significant health problem, the molecular mechanisms involved in developing and maintaining chronic widespread musculoskeletal pain are poorly understood. Central sensitization mechanisms maintained by stimuli from peripheral tissues such as muscle have been suggested. Lipid mediators with anti-inflammatory characteristics such as endogenous ligands of peroxisome proliferator activating receptor-α, oleoylethanolamide, and palmitoylethanolamide are suggested to regulate nociceptive transmission from peripheral locations on route towards the central nervous system. This case–control study investigates the levels of anti-inflammatory lipids in microdialysis samples collected during the first 2 h after microdialysis probe insertion and explores the association of these lipids with different pain characteristics in women with chronic widespread musculoskeletal pain ( n = 17) and female healthy controls ( n = 19). The levels of oleoylethanolamide, palmitoylethanolamide, and stearoylethanolamide were determined. During sampling of dialysate, pain ratings were conducted using a numeric rating scale. Pain thresholds were registered from upper and lower parts of the body. Oleoylethanolamide and stearoylethanolamide levels were significantly higher ( p ≤ 0.05) in chronic widespread musculoskeletal pain at all time points. Numeric rating scale correlated with levels of stearoylethanolamide in chronic widespread musculoskeletal pain. Higher levels of lipid mediators could reflect an altered tissue reactivity in response to microdialysis probe insertion in chronic widespread musculoskeletal pain.
Increased expression of Trpv1 in peripheral terminals mediates thermal nociception in Fabry disease mouse model
Authors: Lakomá Jarmila , Rimondini Roberto , Ferrer Montiel Antonio , Donadio Vincenzo , Liguori Rocco , Caprini Marco
Published: August 2016

Fabry disease is a X-linked lysosomal storage disorder caused by deficient function of the alpha-galactosidase A (α-GalA) enzyme. α-GalA deficiency leads to multisystemic clinical manifestations caused by the preferential accumulation of globotriaosylceramide (Gb3) in the endothelium and vascular smooth muscles. A hallmark symptom of Fabry disease patients is neuropathic pain that appears in the early stage of the disease as a result of peripheral small fiber damage. The α-GalA gene null mouse model (α-GalA(−/0)) has provided molecular evidence for the molecular alterations in small type-C nociceptors in Fabry disease that may underlie their hyperexcitability, although the specific mechanism remains elusive. Here, we have addressed this question and report that small type-C nociceptors from α-GalA(−/0) mice exhibit a significant increase in the expression and function of the TRPV1 channel, a thermoTRP channel implicated in painful heat sensation. Notably, male α-GalA(−/0) mice displayed a ≈2-fold higher heat sensitivity than wild-type animals, consistent with the augmented expression levels and activity of TRPV1 in α-GalA(−/0) nociceptors. Intriguingly, blockade of neuronal exocytosis with peptide DD04107, a process that inhibits among others the algesic membrane recruitment of TRPV1 channels in peptidergic nociceptors, virtually eliminated the enhanced heat nociception of α-GalA(−/0) mice. Together, these findings suggest that the augmented expression of TRPV1 in α-GalA(−/0) nociceptors may underly at least in part their increased heat sensitivity, and imply that blockade of peripheral neuronal exocytosis may be a valuable pharmacological strategy to reduce pain in Fabry disease patients, increasing their quality of life.
Visual aid tool to improve decision making in acute stroke care
Authors: Saposnik Gustavo , Goyal Mayank , Majoie Charles , Dippel Diederik , Roos Yvo , Demchuk Andrew , Menon Bijoy , Mitchell Peter , Campbell Bruce , Dávalos Antoni , Jovin Tudor , Hill Michael D ,   for the HERMES collaborators and the Stroke Outcomes Research working group (SORCan)
Published: August 2016

Background

Acute stroke care represents a challenge for decision makers. Recent randomized trials showed the benefits of endovascular therapy. Our goal was to provide a visual aid tool to guide clinicians in the decision process of endovascular intervention in patients with acute ischemic stroke.

Methods

We created visual plots (Cates’ plots; www.nntonline.net ) representing benefits of standard of care vs. endovascular thrombectomy from the pooled analysis of five RCTs using stent retrievers. These plots represent the following clinically relevant outcomes (1) functionally independent state (modified Rankin scale (mRS) 0 to 2 at 90 days) (2) excellent recovery (mRS 0–1) at 90 days, (3) NIHSS 0–2 (4) early neurological recovery, and (5) revascularization at 24 h. Subgroups visually represented include time to treatment and baseline stroke severity strata.

Results

Overall, 1287 patients (634 assigned to endovascular thrombectomy, 653 assigned to control were included to create the visual plots. Cates’ visual plots revealed that for every 100 patients with acute ischemic stroke and large vessel occlusion, 27 would achieve independence at 90 days (mRS 0–2) in the control group compared to 49 (95% CI 43–56) in the intervention group. Similarly, 21 patients would achieve early neurological recovery at 24 h compared to 54 (95% CI 45–63) out of 100 for the intervention group.

Conclusion

Cates’ plots may assist clinicians and patients to visualize and compare potential outcomes after an acute ischemic stroke. Our results suggest that for every 100 treated individuals with an acute ischemic stroke and a large vessel occlusion, endovascular thrombectomy would provide 22 additional patients reaching independency at three months and 33 more patients achieving ENR compared to controls.
(De)constructing the sociological imagination? Media discourse, intellectuals and the challenge of public engagement
Authors: Attenborough Frederick T
Published: August 2016

This article explores the interrelationships and tensions between public engagement in higher education and media discourse. It tracks the mediated trajectory of an attempt by a group of academics to connect with audiences beyond academia, comparing a magazine article in which their opinions first became public, to its recontextualisation across various UK newspapers and their Internet spin-offs. A mediated stylistic analysis reveals the discursive, rhetorical and performative techniques via which a sociologically imaginative attempt to transform a seemingly-personal-trouble into a definitively-public-issue got recontextualised as if merely the public projection of personal angst. The article concludes by noting that in an era where public engagement increasingly means mediated public engagement, to take seriously the interactive, intertextual and rhetorical affordances of media discourse is to understand that and how sociologically imaginative work can – but does not always – end up circulating within public debate.
Cabozantinib in the treatment of advanced renal cell carcinoma: clinical trial evidence and experience
Authors: Ruiz-Morales Jose Manuel , Heng Daniel Y.C.
Published: August 2016

The treatment of metastatic renal cell carcinoma (mRCC) is rapidly changing. During first-line treatment with targeted therapy, patients ultimately develop resistance to therapy and the disease progresses. Recently, cabozantinib has demonstrated a better response rate, progression-free survival and overall survival compared with everolimus after failure of prior targeted therapy in patients with advanced or metastatic renal cell carcinoma (RCC). Cabozantinib is a small-molecule tyrosine kinase inhibitor (TKI). It exerts inhibition of MET, vascular endothelial growth factor receptor type 2, AXL, and many other receptor tyrosine kinases that are also implicated in tumor pathobiology, including RET, KIT, and FLT3. MET drives tumor survival, invasion, angiogenesis, and metastasis through several downstream signaling pathways. AXL has recently been described as an essential mediator of cancer metastasis that mediates crosstalk and resistance to TKIs. MET and AXL are thought to be anti-vascular endothelial growth factor receptor (VEGF) resistance pathways and thus cabozantinib represents a logical choice after progression on initial VEGF therapy. Subgroup analyses examining those with good performance status or visceral and bone metastases indicate that the hazard ratios may be better when using cabozantinib versus everolimus. However, there were no clear statistically significant differences between any subgroups.
Tsunami model simulation for 26 December 2004 and its effect on Koodankulam region of Tamil Nadu Coast
Authors: Selvan S Chenthamil , Kankara RS
Published: August 2016

Tsunami inundation model ‘TUNAMI-N2’ was set up for five different scenarios of earthquake (Sumatra 2004, Car Nicobar 1881, North Andaman 1941, Makran 1945 and Worst-case) to assess the potential risk of tsunami along Koodankulam coast. Bathymetry and land topography were extracted from the General Bathymetric Chart of the Oceans, C-MAP and CARTOSAT to set up a four-layered nested model, where the finest grid was set up for 93 m in non-linear mode. The aim of the study was to provide the potential run-up and inundation that could occur in worst situation along the Koodankulam coast. The sensitivity analysis was also carried out to assess the effects of various fault parameters. From sensitivity analysis, it is inferred that the tsunami wave height is directly proportionate to slip amount and inversely proportionate to focal depth. The potential tsunami run-up heights were found between 1.30 and 3.54 m and inundation was between 0 and 90 m at Koodankulam and surrounding regions. But, no horizontal inundation was observed for any scenarios around the Koodankulam plant area as the region. The highest run-up heights of five models were used to evaluate the possible vulnerability of power plant for tsunami hazards.
Real-time prediction of waves using neural networks trained by particle swarm optimization
Authors: Gopinath Deepthi I , Dwarakish GS
Published: August 2016

This work investigates the strength of artificial neural network that is trained by an optimization technique called particle swarm optimization in the task of time series prediction of weekly and monthly significant wave heights. The suggested approach has been implemented at the location of New Mangalore Port in India. Three years of wave data measured during 2005–2007 are analyzed. It is found that the network trained with the help of the particle swarm optimization produces more accurate predictions of the significant wave heights and further with lesser amount of data than the traditionally trained feed-forward back-propagation network.
Shore protection for the coast of Mousuni Island in West Bengal, India
Authors: Sundar V , Sannasiraj SA
Published: August 2016

The Mousuni Island in West Bengal, India is wide-open to Bay of Bengal. This island by virtue of its location is exposed to river flow as well as wave action. It is thus subjected to severe erosion along its south-western coastal stretch and also significantly affecting agriculture due to seawater inundation. This is due to the lower level of bund crest elevation combined with high water levels during coastal flooding. The most suitable method to arrest the shore erosion and salt water intrusion is to divert the flow gradually toward the deeper section of the channel. To meet this requirement, after carrying out a comprehensive profiling of the existing bund, bank connected series of spurs with locally available construction materials and unskilled labor are proposed. In order to design these spurs, the magnitude and direction of sediment movement along the stretch is estimated. The layout of protection measures is proposed based on a detailed analysis of site conditions and the environmental conditions. The tranquility inside the proposed coastal protecting structure is substantiated with a two-dimensional horizontal flow model. Furthermore, the behavior of the shorelines has been studied numerically with the proposed coastal protection measure. The detailed analysis of the results from the numerical model and the protection measure are discussed in this article.
The Legal Landscape of Concussion
Authors: Albano Andrew W. , Senter Carlin , Adler Richard H. , Herring Stanley A. , Asif Irfan M.
Published: August 2016

Context:

Concussion legislation has been enacted in all 50 of the United States, aiming to prevent mild traumatic brain injuries and the potential long-term sequelae of these injuries in youth athletics. Sports medicine providers, in addressing this major public health concern, are tasked with adhering to the established standards of medical care while also considering the legal implications.

Evidence Acquisition:

The PubMed (2011-2016) database was searched using the following search terms: concussion, sports concussion, legislation, and concussion legislation. References from consensus statements, review articles, and book chapters were also utilized.

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Results:

The Lystedt law and its progeny have increased awareness of the signs and symptoms of sports concussion, but adherence to state legislation can pose some challenges.

Conclusion:

The presence of concussion legislation places a responsibility on the sports medicine provider to have a firm understanding of the legality of concussion management in the state(s) in which they practice.
Injuries Sustained by the Mixed Martial Arts Athlete
Authors: Jensen Andrew R. , Maciel Robert C. , Petrigliano Frank A. , Rodriguez John P. , Brooks Adam G.
Published: August 2016

Context:

Mixed martial arts (MMA) is rapidly growing in popularity in the United States and abroad. This combat sport joins athletes from a wide variety of martial art disciplines, each with characteristic and distinguishing injury profiles, together in competition. Because of increasing participation by professionals and amateurs alike, injuries sustained by MMA athletes have been on the rise.

Evidence Acquisition:

A review of relevant publications using the search term mixed martial arts and each of its component combat sports (eg, Muay Thai, Brazilian jiu-jitsu) from 1980 through 2015 was completed using PubMed and Google Scholar.

Study Design:

Clinical review.

Level of Evidence:

Level 5.

Results:

The majority of studies on MMA injuries evaluate those sustained during competition, which range in incidence from 22.9 to 28.6 per 100 fight-participations. Striking-predominant disciplines such as boxing, karate, and Muay Thai have high rates of head and facial injuries, whereas submission-predominant disciplines such as Brazilian jiu-jitsu, judo, and wrestling have high rates of joint injuries.

Conclusion:

Numerous studies have evaluated injuries in athletes who participate in MMA and its component disciplines during competition but much remains to be discovered about injuries sustained during training and in specific patient populations such as adolescents and women.
Diffuse periventricular calcification and brain atrophy: A case of neonatal central nervous system cytomegalovirus infection
Authors: Sanchez Thomas R , Datlow Mitchell D , Nidecker Anna E
Published: August 2016

TORCH refers to the most common congenitally acquired infections: toxoplasma, rubella, cytomegalovirus, and herpes simplex virus. Neonatal cytomegalovirus infection remains a common cause of congenital infection worldwide with effects ranging from hearing impairment to significant neurological morbidity. We report a case of a term neonate with ventriculomegaly on prenatal ultrasound who presented with low birth weight, small head circumference, hepatosplenomegaly, and purpuric rash on physical exam. Central nervous system cytomegalovirus infection typically shows periventricular calcifications and associated deep white matter damage and ventriculomegaly. Ultrasound, computed tomography, and magnetic resonance imaging have different roles in the diagnosis of congenital central nervous system cytomegalovirus infection. Many imaging features of congenital cytomegalovirus are distinctive, and can spur a diagnostic work-up as well as help provide a prognosis.
Stand-alone coil embolization of anterior communicating artery aneurysms: Efficacy and technical issues
Authors: Kocur Damian , Zbroszczyk Miłosz , Przybyłko Nikodem , Hofman Mariusz , Jamróz Tomasz , Baron Jan , Bażowski Piotr , Kwiek Stanisław
Published: August 2016

Objective

We report our experience with endovascular coiling of anterior communicating artery aneurysms with special consideration of angiographic and clinical outcomes and periprocedural complications.

Materials and methods

The analysis included treatment results of 28 patients with ruptured and unruptured aneurysms. The aneurysm size ranged from 1.8 to 9.8 mm (mean 5.2, SD 1.7). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially post-embolization and at a minimum follow-up of six months.

Results

Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 27 (96%) cases and incomplete occlusion in one (4%) case. Imaging follow-up, performed in 15 (53.6%) patients, showed no change in the degree of occlusion in 11 (73%), coil compaction in one (7%) and progressive occlusion in three (20%) patients. Three (20%) patients underwent a second coil embolization. The procedure-related severe morbidity and mortality rate was 6.4% (2/31). Coil prolapse was present in one (3.2%) case and intraprocedural aneurysm rupture in three (9.6%) cases. The clinical follow-up evaluation achieved in 19 (67.9%) patients showed no change in 17 (89.5%) patients and improvement in two (10.5%) patients.

Conclusions

Although the efficacy of coil embolization of anterior communicating artery aneurysms is unquestionable and the procedure-related complications are acceptable, they should not be neglected. Further investigations are needed to better understand protective factors, as well as to establish unequivocally appropriate management strategy of these complications.
Laparoscopic versus open appendectomy in adults and children: A meta‐analysis of randomized controlled trials
Authors: Dai Liping , Shuai Jian
Published: August 2016

Objective

The aim of this study was to evaluate the differences of laparoscopic appendectomy (LA) versus open appendectomy (OA) in adults and children.

Methods

Randomized controlled trials (RCTs) comparing LA and OA in adults and children between January 1992–March 2016 were included in this study. A meta‐analysis was performed to evaluate wound infection, intra‐abdominal abscess, postoperative complications, reoperation rate, operation time, postoperative stay, and return to normal activity.

Result

Thirty‐three studies including 3642 patients (1810 LA, 1832 OA) were included. Compared with OA, LA in adults was associated with lower incidence of wound infection, fewer postoperative complications, shorter postoperative stay, and earlier return to normal activity, but a longer operation time. There was no difference in levels of intra‐abdominal abscess and reoperation between the groups. Subgroup analysis in children did not reveal significant differences between the two techniques in wound infection, postoperative complications, postoperative stay, and return to normal activity.

Conclusion

LA in adults is worth recommending as an effective and safe procedure for acute appendicitis, and further high‐quality randomized trials comparing the two techniques in children are needed.
Social Network Sites, Friends, and Celebrities: The Roles of Social Comparison and Celebrity Involvement in Adolescents’ Body Image Dissatisfaction
Authors: Ho Shirley S. , Lee Edmund W. J. , Liao Youqing
Published: August 2016

This study applies the social comparison theory to examine the effects of adolescents’ engagement in comparison with friends and celebrities on social network sites (SNSs) on (a) their body image dissatisfaction (BID) and (b) their drive to be thin (DT) or muscular (DM). The study also examines celebrity involvement as an antecedent of the outcome variables. Data were collected through a survey of 1,059 adolescents in Singapore. Regression analyses indicate that SNSs use was related to adolescents’ BID. Specifically, social comparison with friends on SNSs was significantly associated with adolescents’ BID, DT, and DM. Gender differences were also observed—social comparison with celebrities was significantly associated with BID and DT among female adolescents. Celebrity involvement was significantly associated with male BID. Theoretical and practical implications were discussed.
Association of Decreased High-Density Lipoprotein Cholesterol (HDL-C) With Obesity and Risk Estimates for Decreased HDL-C Attributable to Obesity
Authors: Bora Kaustubh , Pathak Mauchumi Saikia , Borah Probodh , Das Dulmoni
Published: August 2016

Background: Obesity is an important risk factor for decrease in high-density lipoprotein cholesterol (HDL-C) levels, which predisposes to cardiovascular diseases. But, the relative contribution of obesity toward decreased HDL-C and the risk estimates of decreased HDL-C attributable to obesity are unavailable. Such measures will help in understanding the extent by which the burden of decreased HDL-C can be reduced by tackling obesity. Objectives: The objectives of this study were to ( a) determine the association between decreased HDL-C and obesity and ( b) estimate the attributable risk proportion (ARP) and population attributable risk proportion (PARP) for decreased HDL-C due to obesity. Methods: Body mass index (BMI) and waist circumference (WC) were measured as indices of overweight (or generalized obesity) and central obesity, respectively in 190 subjects (95 cases with low HDL-C and 95 healthy controls with normal HDL-C) from Guwahati city. Crude odds ratio (OR) and adjusted OR with 95% confidence interval (CI) were calculated along with the risk estimates (ARP and PARP). Results: People with overweight or generlized obesity (adjusted OR = 4.90, 95% CI = 3.59-6.68), and people with central obesity (adjusted OR = 3.33, 95% CI = 2.39-4.64) had significantly greater odds of developing decreased HDL-C. Among the exposed, 79.8% of the decreased HDL-C cases could be attributed to overweight (or generalized obesity), while 72.8% cases could be attributed to central obesity. In the overall population, the corresponding figures were 57.1% and 36%, respectively. Conclusion: Decreased HDL-C is strongly associated with and largely attributable to obesity.
Twitter Campaigns Around the Fifth IPCC Report
Authors: Holmberg Kim , Hellsten Iina
Published: August 2016

In this article, we analyzed campaigning on Twitter around the publication of the fifth Intergovernmental Panel for Climate Change (IPCC) Working Group 1 report in September, 2013. In particular, we analyzed how participation in a specific campaign and use of hashtags connected to the campaign developed over time and what kind of sub-flows of tweets or spinoff conversations emerged. The campaign hashtag that we observed later appeared in connection to sharing of an article that was not directly connected to the original campaign. Although both the original campaign and this sub-flow of it were connected to the broader context of climate change, the sub-flow formed a separate community of tweeters that did not overlap with tweeters participating in the original campaign. Twitter campaigns have flexible boundaries both around the shared issues and around the communities of tweeters. Our results show that using information spreading approach does not account for the evolution of campaign spreading on Twitter, as other factors, such as celebrity endorsement, may heavily influence the spread of information and content on Twitter. Thus, our results suggest that although different tweeters participated in the two separate campaigns using shared hashtags, hashtags per se do not always indicate shared communities of tweeters nor can they always be considered as indicators of completely shared issues online.
Developing a Framework for Research Evaluation in Complex Contexts Such as Action Research
Authors: Piggot-Irvine Eileen , Zornes Deborah
Published: August 2016

Early investigation led the Evaluative Study of Action Research (ESAR) team to conclude that the complexity of a global, large scale study (evaluation of more than 100 highly diverse action research [AR] projects) called for an overarching research evaluation framework that differed from traditional frameworks. This article details the flexible, rigorous, Evaluative Action Research (EvAR) framework developed to meet the complex demands of the diverse AR projects and the intent to conduct high engagement research evaluation. The EvAR fulfilled multiple overarching needs to: authentically collaborate, engage, and enhance ownership from the ESAR team and the AR project participants and boundary partners evaluated; be informed in decision making via strong reference support; be responsive and flexible yet meet accountability demands to track, demonstrate, and measure process, outcomes, and impacts of projects; use mixed-method data collection to enhance rigor of findings; and utilize a highly reflective and reflexive approach to the evaluation. Many of the latter needs align with underpinning principles and values in AR itself; that is, it is collaborative, consultative, democratic, reflective, reflexive, dialogical, and improvement oriented. Rationale for the framework is provided alongside full details of phases and implementation elements using the ESAR as an example. Throughout the article, features are highlighted that distinguish this new EvAR framework from others. The advantages of adopting a flexible framework, which aims to enhance engagement of those evaluated, are highly relevant to contexts beyond AR if ownership of evaluation outcomes is a goal.
The Rise of Concussions in the Adolescent Population
Authors: Zhang Alan L. , Sing David C. , Rugg Caitlin M. , Feeley Brian T. , Senter Carlin
Published: August 2016

Background:

Concussion injuries have been highlighted to the American public through media and research. While recent studies have shown increased traumatic brain injuries (TBIs) diagnosed in emergency departments across the United States, no studies have evaluated trends in concussion diagnoses across the general US population in various age groups.

Purpose:

To evaluate the current incidence and trends in concussions diagnosed across varying age groups and health care settings in a large cross-sectional population.

Study Design:

Descriptive epidemiological study.

Methods:

Administrative health records of 8,828,248 members of a large private-payer insurance group in the United States were queried. Patients diagnosed with concussion from years 2007 through 2014 were stratified by year of diagnosis, age group, sex, classification of concussion, and health care setting of diagnosis (eg, emergency department vs physician’s office). Chi-square testing was used for statistical analysis.

Results:

From a cohort of 8,828,248 patients, 43,884 patients were diagnosed with a concussion. Of these patients, 55% were male and over 32% were in the adolescent age group (10-19 years old). The highest incidence of concussion was seen in patients aged 15 to 19 years (16.5/1000 patients), followed by those aged 10 to 14 years (10.5/1000 patients), 20 to 24 years (5.2/1000 patients), and 5 to 9 years (3.5/1000 patients). Overall, there was a 60% increase in concussion incidence from 2007 to 2014. The largest increases were in the 10- to 14-year (143%) and 15- to 19-year (87%) age groups. Based on International Classification of Disease–9th Revision classification, 29% of concussions were associated with some form of loss of consciousness. Finally, 56% of concussions were diagnosed in the emergency department and 29% in a physician’s office, with the remainder in urgent care clinics or inpatient settings.

Conclusion:

The incidence of concussion diagnosed in the general US population is increasing, driven largely by a substantial rise in the adolescent age group. The youth population should be prioritized for ongoing work in concussion education, diagnosis, treatment, and prevention.

Clinical Relevance:

The rise of concussions in the adolescent age group across the general population is concerning, and clinical efforts to prevent these injuries are needed.
Workplace Simulation
Authors: Ismail Norhayati , Sabapathy Chitra
Published: August 2016

In the redesign of a professional communication course for real estate students, a workplace simulation was implemented, spanning the entire 12-week duration of the course. The simulation was achieved through the creation of an online company presence, the infusion of communication typically encountered in the workplace, and an intensive and integrated approach to task design. An analysis of students’ and tutors’ perceptions of the changes shows higher student engagement, with the redesigned course resulting in learning that is both relevant and meaningful to workplace communication, which has implications for the teaching and learning of professional communication skills in higher education.
Conservative Imagination
Authors: Suhrud Tridip
Published: August 2016

This article discusses the mandate and activities of the Sabarmati Ashram Preservation and Memorial Trust (SAPMT). The built and intellectual heritages of Mahatma Gandhi form a key part of the mandate. As a part of this, the trust collaborates with different bodies that deal with Gandhi’s legacy. It has been an important part of different initiatives to preserve and document it the Collected Works of Mahatma Gandhi (CWMG) and the Gandhi Heritage Sites Mission (GHSM). The article also talks about the efforts of disseminating authenticated versions of Gandhi’s writings with the Gandhi Heritage Portal (GHP) and the innovations in archiving that the Trust has made with this. This is a case study which takes a holistic view of different aspects of heritage and talks about the opportunities and challenges that come with it.
Heritage Tourism: How Advertising is Branding the Intangibles?
Authors: Vasavada Falguni , Kour Gurpreet
Published: August 2016

Heritage differentiates a location and promises a memorable experience emanating from the existing unique features of a destination. India is promoting heritage and focusing on preservation of local cultural heritage as assets for sustainable heritage tourism development. Cultural heritage tourism has emerged as both an important economic tool and marketing tool when seeking a competitive advantage in the tourism industry. Heritage promoted in tourism promises a wholesome experience to the visitors and, hence, enhances the value of the destination. The fundamental aim of this study is to understand how heritage is portrayed in tourism advertisements. The methodology comprises of a narrative analysis of advertising campaign texts of Madhya Pradesh and Gujarat tourism. The campaigns have been analyzed to see how heritage has been portrayed and at the second level, tourism campaigns of both the states have been compared in order to evaluate. The analysis indicates that tourism campaigns of both the states heavily use heritage and portray it as a pride of the state and communicate both tangible and intangible aspects of heritage in advertisements.
UNESCO Masterpieces Proclamation Programme and Safeguarding Strategies for Intangible Cultural Heritage: A View from India
Authors: Gopalakrishnan Sudha
Published: August 2016

Three Indian heritage expressions—Kutiyattam, the Oral Tradition of the Vedas and Ramlila—were among a select few from across the world that were proclaimed as ‘Masterpieces of the Oral and Intangible Heritage of Humanity’ by UNESCO in 2001, 2003 and 2005 respectively. It was for the first time that UNESCO had instituted a programme of Proclamation of Masterpieces relating to living cultural traditions and this paved the way for the establishment of a UNESCO Convention on Intangible Cultural Heritage in 2003. In the context of my involvement in the preparation of the nomination dossiers of the three expressions, and subsequently, in the development of an action plan for the revitalization of these exceptional yet endangered forms of living heritage, the article tries to understand the implications of such an international acclaim and its impact on the community that fosters them.
Reducing Disaster Risks to Urban Cultural Heritage: Global Challenges and Opportunities
Authors: Jigyasu Rohit
Published: August 2016

Historic urban areas are becoming increasingly vulnerable to natural as well as man-made hazards such as earthquakes, floods, fires, cyclones and vandalism. In the absence of any comprehensive legal framework for protection, historic urban areas are vulnerable not only to impending disasters but also during emergency and post disaster recovery phases. The major underlying causes for their increasing vulnerability are population growth, urbanization and poverty, especially in developing countries. However these should not be seen merely as a passive victim of disaster. In the face of disasters, traditional communities in historic cities often develop a vocabulary of resilient features in the urban environment that intentionally or unintentionally contribute towards prevention and mitigation, emergency response and recovery. The article will describe these systems in detail through various examples. The article will further elaborate on the key challenges and priorities for disaster risk reduction of historic urban areas. The main goal is to reduce risks to the population and physical fabric in historic urban areas through use of sustainable conservation and development practices and raising awareness among all stakeholders including public agencies, civic society organizations, private sector as well as local communities. The article will further outline the agenda for action for risk reduction and highlight some of the recent national and international initiatives undertaken so far.
Phase 1/2 study of daratumumab, lenalidomide, and dexamethasone for relapsed multiple myeloma
Authors: Plesner Torben , Arkenau Hendrik-Tobias , Gimsing Peter , Krejcik Jakub , Lemech Charlotte , Minnema Monique C. , Lassen Ulrik , Laubach Jacob P. , Palumbo Antonio , Lisby Steen , Basse Linda , Wang Jianping , Sasser A. Kate , Guckert Mary E. , de Boer Carla , Khokhar Nushmia Z. , Yeh Howard , Clemens Pamela L. , Ahmadi Tahamtan , Lokhorst Henk M. , Richardson Paul G.
Published: August 2016

Key Points

Daratumumab plus lenalidomide/dexamethasone elicited an overall response rate of 81% (63% very good partial response or better). Adverse events were manageable and in accord with the individual toxicity profiles of daratumumab and lenalidomide/dexamethasone.
Quantitative ultrasound imaging of Achilles tendon integrity in symptomatic and asymptomatic individuals: reliability and minimal detectable change
Authors: Nadeau Marie‐Josée , Desrochers Amélie , Lamontagne Martin , Larivière Christian , Gagnon Dany H.
Published: August 2016

Background

Quantifying the integrity of the Achilles tendon (AT) is a rehabilitation challenge. Adopting quantitative ultrasound measurements (QUS measurements) of the AT could fill this gap by 1) evaluating the test‐retest reliability and accuracy of QUS measurements of the AT; 2) determining the best protocol for collecting QUS measurements in clinical practice.

Methods

A total of 23 ATs with symptoms of Achilles tendinopathy and 63 asymptomatic ATs were evaluated. Eight images were recorded for each AT (2 visits × 2 evaluators × 2 images). Multiple sets of QUS measurements were taken: geometric (thickness, width, area), first‐order statistics (computed from a grayscale histogram distribution: echogenicity, variance, skewness, kurtosis, entropy) and texture features (computed from co‐occurrence matrices: contrast, energy, homogeneity). A generalizability study quantified the reliability and standard error of measurement (accuracy) of each QUS measurement, and a decision study identified the best measurement taking protocols.

Results

Geometric QUS measurements demonstrated excellent accuracy and reliability. QUS measurements computed from the grayscale histogram distribution revealed poor accuracy and reliability. QUS measurements derived from co‐occurrence matrices showed variable accuracy and moderate to excellent reliability. In clinical practice, using an average of the results of three images collected by a single evaluator during a single visit is recommended.

Conclusions

The use of geometric QUS measurements enables quantification of AT integrity in clinical practice and research settings. More studies on QUS measurements derived from co‐occurrence matrices are warranted.
Characteristics of responders to autologous bone marrow cell therapy for no-option critical limb ischemia
Authors: Madaric Juraj , Klepanec Andrej , Valachovicova Martina , Mistrik Martin , Bucova Maria , Olejarova Ingrid , Necpal Roman , Madaricova Terezia , Paulis Ludovit , Vulev Ivan
Published: August 2016

Background

The present study investigated factors associated with therapeutic benefits after autologous bone marrow cell (BMC) therapy in patients with “no-option” critical limb ischemia (CLI).

Methods and results

Sixty-two patients with advanced CLI (Rutherford category 5 or 6) not eligible for revascularization were randomized to treatment with 40 ml of autologous BMCs (SmartPreP2) by local intramuscular (n = 32) or intra-arterial (n = 30) application. The primary endpoint was limb salvage and wound healing at 12 months. Seven patients (11 %) died during the follow-up from reasons unrelated to stem cell therapy. The BMC product of patients with limb salvage and wound healing (33/55) was characterized by a higher CD34+ cell count (p = 0.001), as well as a higher number of total bone marrow mononuclear cells (BM-MNCs) (p = 0.032), than that of nonresponders (22/55). Patients with limb salvage and wound healing were younger (p = 0.028), had lower C-reactive protein levels (p = 0.038), and had higher transcutaneous oxygen pressure (tcpO2) (p = 0.003) before cell application than nonresponders. All patients with major tissue loss at baseline (Rutherford 6 stage of CLI, n = 5) showed progression of limb ischemia and required major limb amputation. In the multiple binary logistic regression model, the number of applied CD34+ cells (p = 0.046) and baseline tcpO2 (p = 0.031) were independent predictors of limb salvage and wound healing. The number of administrated BM-MNCs strongly correlated with decreased peripheral leukocyte count after 6 months in surviving patients with limb salvage (p = 0.0008).

Conclusion

Patients who benefited from autologous BMC therapy for “no-option” CLI were treated with high doses of CD34+ cells. The absolute number of applied BM-MNCs correlated with the improvement of inflammation. We hypothesize that the therapeutic benefit of cell therapy for peripheral artery disease is the result of synergistic effects mediated by a mixture of active cells with regenerative potential. Patients at the most advanced stage of CLI do not appear to be suitable candidates for cell therapy.

Trial registration

The study was approved and registered by the ISRCTN registry. Trial registration: ISRCTN16096154. Registered: 26 July 2016.