bluuebunny/crossref_metadata_2025 huggingface dataset:
Advanced digital control strategies for switching buck converters: A modeling perspective
Authors: Samad Muhammad Adnan , Xia Yuanqing , Ghith Ehab Seif , Saleem Adeel , Mehmood Kashif , Siddiqui Saima , Marey Samy A. , Aboukarima Abdulwahed M.
Published: November 2024

This paper highlights the significance of digital controllers over analog counterparts, emphasizing the utilization of optimization techniques such as MPC. It explores the benefits of adaptive controllers compared to MPC, showcasing simulations that dynamically adjust controller parameters to accommodate system and environmental variations. Addressing uncertainties, nonlinearities, and time-varying dynamics, the paper employs MPC-DC technique as an adaptive approach aiming to merge the advantages of digital controllers and MPC.The core concept revolves around leveraging the digital controller’s inherent advantages over analog counterparts and enhancing control precision through MPC, particularly in power converter applications. The study introduces a discrete root locus technique for digital controller design, focusing on DC-DC Buck Converters, with subsequent MPC fine-tuning. Demonstrating efficacy, the approach enhances switching converters’ performance, minimizing passive component size and costs while ensuring robust load and line regulation. Moreover, the proposed MPC based digital controller design methodology extends to other switching converters like Boost, Cuk, and Sepic Converters. Finally, the validation via MATLAB/Simulink simulations underscores the efficacy of the proposed model.
Environmental displacement and political instability: Evidence from Africa
Authors: Chesler Angela
Published: November 2024

Does environmental displacement provoke political instability? Though migration has long been considered an intermediary in the causal path between environmental change and political upheaval, the relationship remains theoretically underdeveloped and evidence has been limited. This article examines the impact of displacement caused by sudden-onset natural hazards on disruptive antigovernment events including armed conflict, protests and violent riots. It leverages the new Environmental Displacement Dataset (EnDis), an original dataset that identifies quantities of human movement in response to six types of sudden-onset natural hazards in Africa from 1990 to 2017, including floods, storms, wildfires, landslides, earthquakes and volcanic activity. The results of the analyses show that while environmental displacement is not associated with civil war onset or protests, it does increase the incidence of attacks by armed non-state actors and violent riots. Importantly, these destabilizing effects occurr primarily (1) in the context of displacement driven by floods and storms, and (2) when levels of displacement are well above average. Collectively, these findings portend deepening security crises and violent political upheaval as climate change drives more frequent episodes of extreme weather and excessive environmental displacement.
Assessing Technical Efficiency in the Provision of Elementary Education Across Indian States
Authors: Rosario Jyotsna , Shanmugam K. R.
Published: November 2024

This article assesses the technical efficiency of 28 Indian states in delivering elementary education between 2009–2010 and 2020–2021, using the stochastic frontier model developed by Battese and Coelli. The findings indicate that technical inefficiency accounts for 82 per cent of the interstate disparities in elementary education output. Factors such as public expenditure, schooling infrastructure and the presence of qualified teachers positively impact output. However, the effect of public expenditure diminishes beyond a certain threshold. Higher literacy rates, increased urbanisation and a greater proportion of government schools improve efficiency. Conversely, a higher percentage of scheduled caste and scheduled tribe children and the appointment of contractual teachers decrease efficiency. The overall technical efficiency stands at 79 per cent. Efficiency varies widely across states, ranging from 52 per cent to 94.5 per cent. Goa, Haryana and Kerala demonstrate the highest efficiency, while Arunachal Pradesh, Meghalaya and Manipur rank the lowest. Some states have seen improvements in efficiency, while others have experienced declines. These findings suggest that resource-poor states can benefit from increased public expenditure, whereas efficient resource utilisation is crucial for states facing inefficiencies. This article provides essential insights for policymakers to address regional imbalances and enhance elementary education outcomes.

JEL Codes : H52, I21, I22, I28, C14, D24
An Evaluation of a Trauma-Informed Intervention in Secure Juvenile Detention: The Impact on Youth-Level Incidents of Violence
Authors: Baetz Carly Lyn , Surko Michael , Guo Fei , Marr Mollie , Workman Sara , Havens Jennifer , Horwitz Sarah McCue
Published: November 2024

Few studies have examined the impact of trauma-specific interventions in juvenile justice settings, and juvenile justice-related outcomes are infrequently assessed. This study examined the impact of implementing youth skills groups ( Skills Training in Affective and Interpersonal Regulation [STAIR]) and trauma training for staff (Think Trauma) on individual-level assaults in two secure detention facilities. The impact of the intervention was primarily evidenced in one facility among Black youth. In the same facility, the staff training (pre-skills groups) cohort and skills group cohort (post-staff training) evidenced a significantly greater reduction in violent incident rates as compared to the pre-intervention cohort. These findings highlight the importance of trauma-focused training for staff as a promising step toward reducing violence and improving staff members’ responses to a large subset of vulnerable youth.
Fault detection observer design for T-S fuzzy systems based on membership function-dependent mixed H−/H∞ performance in the finite-frequency domain
Authors: Cai Guoqiang , Dong Jiuxiang
Published: November 2024

This paper focuses on the design of a fault detection observer for T–S fuzzy systems with faults and unknown disturbances, based on a membership function-dependent [Formula: see text] performance index. Currently, common methods for disturbance suppression and fault detection are based on traditional [Formula: see text] performance criteria. Traditional [Formula: see text] performance indices impose the same constraints on the entire system, which does not align with the characteristic that T–S fuzzy systems do not operate continuously in all linear subsystems. Therefore, aiming to improve the performance of the linear subsystems where the system operates for long periods, this paper proposes a membership function-dependent [Formula: see text] performance index and designs a fault detection observer based on this performance index. In addition, considering that the frequency of actual system faults and disturbances is not across the entire frequency domain, the design of the fault detection observer based on the membership function-dependent [Formula: see text] performance index is achieved through the generalized Kalman-–Yakubovich-–Popov lemma in a finite-frequency domain.
Solitary Fibrous Tumor of the Larynx: A Case Report and Brief Literature Review
Authors: Alexander Vincent S. , Ernst Michael D. , Vogel Andrew D. , Wang Cheung , Obermiller Alyssa , Brinsko Andrew , Pattani Shaan , Mangat Meher , Pattani Kavita M.
Published: November 2024

Solitary fibrous tumors (SFTs) are a rare type of soft tissue tumor first identified as arising from pleura and usually arising in the thoracic cavity. The incidence of SFTs arising in the head and neck region is much lower, accounting for about 7% of SFT cases. Involvement of the larynx specifically is exceedingly rare and can have inconspicuous presentations, making them challenging to diagnose. This case report represents a patient with a history of urothelial cancer and obstructive sleep apnea who was ultimately found to have a fibrous tumor of the larynx, which was confirmed by histopathology and immunohistochemistry and treated with transoral microsurgical resection. This case report aims to shed light on an infrequently documented location of a solitary laryngeal fibrous tumor and a unique clinical presentation of this rare pathology and its successful surgical management.
Axillary–coronary artery bypass using a vein graft via the suprasternal route
Authors: Isa Hideki , Tsutsui Masahiro , Suzuki Fumitaka , Ushioda Ryohei , Kunioka Shingo , Kamiya Hiroyuki
Published: November 2024

Redo coronary artery bypass grafting after an in-situ right internal thoracic artery graft to the left anterior descending artery is challenging. For such a 52-year-old male patient with a history of mediastinitis, we performed redo bypass grafting of the right coronary artery using a saphenous vein graft and xiphoid resection via the suprasternal route with the left axillary artery as the inflow source and the graft were patent. The axillary artery is an inflow source for patients with inaccessible aorta. Combining the suprasternal route with a xiphoid resection provides a bail-out option.
Development and Validation of the South African Diet Quality Index for Pregnancy: The NuEMI Study
Authors: Robb Liska , Joubert Gina , Jordaan Elizabeth Margaretha , Ngounda Jennifer , van den Berg Louise , Walsh Corinna May
Published: November 2024

Background

Diet quality indexes (DQIs) consist of combinations of foods and/or nutrient components that represent adherence to dietary guidelines. A high-quality diet during pregnancy contributes to optimal birth outcomes.

Objective

We developed and validated the first DQI for pregnancy for South African women.

Methods

The South African Food Based Dietary Guidelines and pregnancy dietary guidelines were used as theoretical basis for the a priori development of the South African Diet Quality Index for Pregnancy (SA-DQI-P). To validate the SA-DQI-P, we applied it to data collected for the Nutritional status of Expectant Mothers and their newborn Infants (NuEMI) study ( N = 682). We determined the associations between SA-DQI-P scores in tertiles with nutrient intakes, sociodemographic factors, household food security level, and biochemical values.

Results

A lower household density ratio, household access to a toilet, refrigerator, and microwave, a higher educational level, being employed and being food secure were significantly associated with a higher score. After correcting for energy intake, higher scores were significantly associated with higher intakes of protein, total fat, saturated fat, cholesterol, calcium, vitamin A, vitamin E, folic acid, vitamin B12, and vitamin C. Significantly more participants who were vitamin A deficient scored in the lowest tertile than those in higher tertiles.

Conclusion

The SA-DQI-P is the first DQI developed for a South African population and has proven to be valid in ranking diet quality in pregnant women in our sample. Information regarding diet quality of this vulnerable group can assist with planning nutrition intervention programs to improve nutritional status.
Single Stage Management of a Severe Form of Grade 3 Hypertelorism With Sincipital and Basal Encephaloceles—Lessons Learnt!
Authors: Murarka Anil , Sharma Arun , Sharma Anurag , Gupta Sachin , Kakkar Gaurav , Kulkarni Ketan , Dhaliwal Maninder , Raghunathan Veena , Sharma Mohit
Published: November 2024

The article elucidates the management of a case of severe form of grade III hypertelorism with an intercanthal distance of 61 mm in a 4-year-old child. The management was especially challenging because of the patient's young age, degree of hypertelorism, wide cleft and simultaneous presence of 2 big (sincipital & basal) encephaloceles and a lipoma in the midline. This paper attempts to describe the attempted surgery, postoperative course and the learnings derived from its management to probably create a road-map for surgeons faced with such a challenge in future.
A Systematic Review and Meta-Analysis of Older Adults’ Cognitive Impairments and Effects on Road Safety
Authors: Zhang Yunru , Zhu Wenchao , Xiao Yan , Kramer Arthur F. , Lin Yingzi
Published: November 2024

Driving is challenging for older adults, especially those with cognitive impairments. This paper systematically reviewed 39 peer-reviewed studies to examine the impact of cognitive deficits on older adults’ driving abilities, focusing on the discussion of neuropsychological assessments including Trail Making Tests, Useful Field of View, Maze Test, and Mini-Mental Status Exam. The study proposed the concept of Road Safety Cognitive Health, which encompasses the cognitive processes crucial for safe driving, aiming to inform future driver training, licensing regulations, roadway designs, and vehicle technology innovations. Concussively, this research advances understanding of road safety challenges for cognitively impaired older adults and advocates for an integrative approach to ensure their driving safety.
Conceptualizing and Testing Public Expectations for Corporate Social Advocacy: A Strategic Issue Management Approach
Authors: Yim Myungok Chris , Kim Taeyoung
Published: November 2024

This study examines public expectations regarding Corporate Social Advocacy (CSA) using the framework of strategic issue management (SIM). A 14-item, single-factor scale was developed to measure CSA expectations, which was validated through four surveys. The CSA expectancy scale will assist businesses in effectively navigating CSA initiatives, preventing stakeholder support withdrawal, and thus bolstering organizational sustainability and social impact.
Critical Religious Literacies and Opportunities for Alterity across YA Literature
Authors: Hadley Heidi Lyn , Olshefski Christopher Alan , Soules Kate E
Published: November 2024

This critical content analysis draws on a dataset of contemporary young adult texts receiving awards between 2012 and 2023 to examine opportunities for religiously informed alterity for readers, which we argue can be a productive experience for building critical religious literacy in young adult readers. We argue that young adult literature can serve as models of critical religious literacies when authors, characters, and historical figures engage in conflicted meaning-making as they experience slippages between their lived experiences and their religious and secular beliefs. The study aims to develop a framework for developing religious literacy that draws specifically on identity-laden and critical theories of literacy common within the English language arts. Furthermore, this study provides literacy scholars and practitioners with a robust set of textual resources that can be employed to support critical religious literacies.
Religion as Life: Critical Content Analysis of Picturebooks About the Lives of Muslim Children
Authors: Naseef Rahaf , Parlindungan Firman , Short Kathy G. , Zandi Narges
Published: November 2024

Religion remains an aspect of culture often missing from picturebooks, based on the misunderstanding that religion has no place in U.S. public schools. This absence is particularly critical for books reflecting the lives of Muslim children, given the rising Islamophobia in the United States. A critical content analysis to examine representations of Muslim children in contemporary picturebooks set in the United States was conducted through a postcolonial lens. Islamic religious practices are integrated into the daily lives of Muslim children in these books for an audience of Muslim and non-Muslim readers. The books represent Muslim children and their families as culturally and religiously diverse, portray religious differences as resources for communities, and reflect the hybrid identities of Muslim children. The books serve as counternarratives, creating a space for Muslim authors and illustrators to voice and validate their life experiences for a broad audience of readers.
Progress or Regress in Phenomenological Research in Tourism? An Epistemological Assessment of Bibliometric Analysis and Visualization Tools
Authors: Pernecky Tomas , Faisal Abrar
Published: November 2024

Phenomenology has become a popular approach in studying tourism experiences, rising to the forefront of methodological practice in the field. While phenomenological research numbered only in the dozens before the millennium, its application has since expanded to hundreds of studies. This rapid growth not only calls for a meta-analytical examination but also provides an opportunity to assess the suitability of various methodological tools and software for data construction, analysis, and visualization. This study is the first to critically examine the veracity of potential knowledge claims arising from the use of bibliographic data and VOSviewer by conducting a meta-analysis of phenomenological research in tourism. The results reveal that, despite VOSviewer’s visually appealing imagery, notable epistemological pitfalls exist. The critical insights offered are valuable for navigating the evolving technological and methodological landscape in the field, particularly in understanding tourism experiences.
To trust or not to trust? How Hong Kong protesters build and maintain trust in a leaderless movement
Authors: Madsen Jens Koed , So Jeanie
Published: November 2024

Protesters in leaderless movements face serious challenges when searching for reliable and trustworthy information in risky environments. Without formal structures to validate information, protestors are left to their own to evaluate the trustworthiness of information in a context where fake social media accounts and deception is possible. We interview protesters from the Hong Kong Anti-Extradition Law Amendment Bill movement to uncover how they develop trust in fellow protesters and information channels. We find that trust in collective political actions goes beyond the idea of social trust and include the concept of informational trust. Social and informational trust are intertwined with social media as well as with actual practices online and offline. In addition, the so-called ‘sentinel’ structure emerged organically. Information appears to be verified by multiple anonymous and independent sentinels for protestors to believe it. This is a sophisticated attendance to structural information source dependencies. Protestors use a mixture of social, communicative, and dependency cues to decide who and what to trust. They also use social media that has a dual role – simultaneously a community-building information space and a space for misinformation. The paper provides qualitative insight into how protesters deal with social and informational trust in leaderless movements.
Psychological factors in diabetes-related foot complications: A cohort study
Authors: Nguyen Mai Loan , Wong Dana , Barson Elizabeth , Staunton Eva , Fisher Caroline A
Published: November 2024

Living with diabetes has been linked with an increased prevalence of psychological distress. Psychological problems may interfere diabetes-related foot complication (DRFC) self-management. We aimed to characterise psychological functioning in DRFC, and identify clinical factors that may be associated with psychological problems. Eighty-one participants ( Mage = 62.8, SD = 11.3, range = 30–87) with DRFC were recruited from The Royal Melbourne Hospital. Each participant completed a battery of psychological questionnaires. DRFC participants endorsed an elevated prevalence of depression, anxiety, post-traumatic stress and diabetes distress. There were also maladaptive personality traits, differences in emotion regulation skills and negative illness perceptions. Previous mental health disorder, higher HbA1C levels and diabetes-related complications were also associated with greater psychological symptoms. Elevated prevalence of psychological symptoms is apparent in DRFC. Our study highlights the need to use targeted interventions to address psychological difficulties to help DRFC patients cope better with their condition.
The emerging role of the cerebellum in neurodegeneration linked to cognitive impairment
Authors: Lin Yicheng , Kuo Sheng-Han
Published: November 2024

The cerebellum has been largely overlooked in Alzheimer's disease, despite increasing evidence implicating its cognitive capacities and functional networks, which interacts with cerebral cortex to subserve cognition. A study by Lin et al. has indicated that the cerebellum is part of the integrated network in amnestic mild cognitive impairment (aMCI), a prodromal state of Alzheimer's disease. The aMCI patients exhibited weaker cerebello-parietal functional connectivity but stronger cerebellar coupling with precuneus cortex, posterior cingulate gyrus, and caudate nucleus. These alterations in cerebello-cortical connectivity correlated with cognitive performance, suggesting a dynamic change of cerebello-cortical network related to cognitive change in aMCI.
The funnel effect of reserves prompted by leisure activities across the Alzheimer's disease continuum
Authors: Serra Laura , Bonarota Sabrina , Di Domenico Carlotta , Caruso Giulia , Giulietti Giovanni , Rizzuti Martina , Assogna Martina , Rodini Marta , Mencarelli Lucia , Di Lorenzo Francesco , Koch Giacomo , Fadda Lucia , Caltagirone Carlo , Bozzali Marco
Published: November 2024

Background

Reserves' mechanisms explain inconsistencies between accumulation of neuropathological damage and clinical manifestations. Leisure activities are believed to promote reserves.

Objective

This study evaluates whether cognitive, social, and physical leisure activities performed over life-span predict current cognitive functioning in normal aging and Alzheimer's disease (AD) continuum.

Methods

35 AD, 24 amnestic-Mild Cognitive Impairment (a-MCI) patients, 21 individuals with subjective cognitive complaint (SCD), and 25 controls underwent a questionnaire developed to quantify leisure activities in different life periods, the Addenbrooke's Cognitive Examination-Revised (ACE-R), and T1-weighted 3T-MRI scans for brain volumetrics and cortical thickness quantification. Partial/total leisure activities' scores and demographic and brain variables were entered as predictors, while ACE-R scores as dependent variables in linear regression analyses.

Results

Current level of cognition was predicted by (i) social and physical activities performed in middle age and current cognitive activity in AD; (ii) cognitive and social activities performed in middle age, current age and cortical thickness in a-MCI; (iii) recreational activities the set of lifetime, current age, and brain features in SCD; (iv) education and the set of lifetime leisure activities over lifespan in controls.

Conclusions

This study shows a funnel effect due to gradual reduction of stimulatory activities in the transition from healthy aging to AD. Reserve indices taking into account different types of stimulatory activities allow to capture even smallest residual effects of reserves accumulated over lifespan, until their complete depletion at advanced AD stages. These results may help target tailored interventions during normal and pathological aging.
Dietary protein intake interacts with weak handgrip strength and cognitive impairment
Authors: Zhou Lingling , Zhang Cui
Published: November 2024

Background

Handgrip strength correlates with cognitive function, but how gender and dietary protein interact with it is unclear.

Objective

To investigate the relationship between handgrip strength and cognitive function among non-stroke elders, and potential interaction effects of gender and dietary protein.

Methods

Non-stroke older adults with handgrip strength and cognitive tests available were included from National Health and Nutrition Examination Survey (NHANES) database. Multivariable linear regression analyses were used to explore the association between grip strength and cognitive performance. Multivariable logistic regression analyses were to investigate the effect of weak handgrip strength on cognitive impairment. Subgroup analyses were conducted to explore differences among sub-populations. Interaction effects of gender and protein intake were investigated by interaction analyses.

Results

Larger handgrip strength was associated with preferable memory function in men (CERAD Word Learning sub-test: p = 0.005; CERAD Delayed Recall: p = 0.009), better verbal fluency (Animal Fluency test: p = 0.005) and executive function in women (Digit Symbol Substitution Test: p = 0.017). Weak handgrip strength was associated with cognitive impairment, especially in older, female, obese participants or elders with low protein consumption. Participants with weak grip strength, compared to normal strength, were twice as likely to perform poorly in complex cognition evaluations (odds ratio = 2.01, p = 0.028). Interaction effect of protein intake was observed (p-interaction = 0.022). Compared to conditions of low protein intake, high protein intake significantly offset the impact of weak handgrip on cognitive impairment.

Conclusions

The association between grip strength and cognitive performance varies by gender. Non-stroke elders with weak handgrip strength are vulnerable to cognitive impairment. Improving muscle strength and increasing protein intake may be effective to mitigate decline in executive function.
Anti-amyloid treatments for Alzheimer's disease: A study on physicians’ perspectives
Authors: Shir Dror , Shiner Tamara , Bregman Noa
Published: November 2024

Advances in amyloid targeting therapies (ATT) for Alzheimer's disease have introduced new options, necessitating an understanding of physicians’ perspectives as these therapies move from trials to practice. A survey of Israeli specialists found that 84% were familiar with new ATT, but 60% raised doubts about their ability to significantly impact disease progression. Neurologists were more likely to recommend these treatments, but concerns included treatment costs and limited real-world experience. The decision to refer patients was influenced by patient age, financial status, and diagnostic test availability. Strategies to enhance physician education and improve patient access to ATT are suggested.
Pre-existing dementia is associated with 2–3 folds risk for in-hospital mortality and complications after intracerebral hemorrhage stroke
Authors: Zuo Lijun , Hu Yang , Dong YanHong , Seet Raymond CS , Li Zixiao , Wang Yongjun , Zhao Xingquan
Published: November 2024

Background

Pre-existing dementia was related to poor functional outcome after intracerebral hemorrhage (ICH), and its commonly underlying pathologies were considered as cerebral amyloid angiopathy. But the impact of pre-existing dementia on in-hospital mortality in Chinese ICH patients has not been well characterized.

Objective

To investigate the association between pre-existing dementia and in-hospital mortality after ICH.

Methods

Data were extracted from the China Stroke Center Alliance database. Information about the existence of prior to stroke dementia was obtained from next of kin informants and registered in clinical charts. Patients’ characteristics, in-hospital mortality, home discharge and complications were compared between ICH patients with and without pre-existing dementia.

Results

Out of the 72,318 ICH patients, we identified 328 patients with pre-existing dementia. Patients with pre-existing dementia were more likely to experience greater stroke severity as measured by the National Institute of Health Stroke Scale and Glasgow Coma Scale. In the adjusted models, the presence of pre-existing dementia was associated with an increased risk of in-hospital mortality (OR 2.31, 95% CI 1.12–4.77), more frequent in-hospital complications of pulmonary embolism (OR 5.41, 95% CI 1.16–25.14), pneumonia (OR 1.58, 95% CI 1.08–2.33), urinary tract infection (OR 2.37, 95% CI 1.21–4.64), gastrointestinal bleeding (OR 2.39, 95% CI 1.27–4.49) and lower home discharge (OR 0.59, 95% CI 0.38∼0.93).

Conclusions

ICH patients with pre-existing dementia are more likely to suffer from greater stroke severity, poorer outcomes and lower home discharge. Future studies should evaluate the value of intensive risk factor control among individuals with pre-existing dementia for stroke prevention.
Economic evaluations of technology-based interventions used to provide care support for people with mild dementia or mild cognitive impairment and their caregivers: A systematic review
Authors: Vargas-Martínez Ana Magdalena
Published: November 2024

Background

The cost-effectiveness of interventions is a key issue owing to the limited resources of healthcare services.

Objective

To conduct a systematic review of economic evaluations of technology-based healthcare interventions in care support for people with dementia or mild cognitive impairment (MCI) and their caregivers, and of the tools used to assess effectiveness and costs.

Methods

The following databases were used: PubMed, National Health Service Economic Evaluation Database, and Health Technology Assessment. A total of 207 articles from 2012 to 2024 were identified and then screened.

Results

Seventeen studies were included, of which nine were study protocols. Almost half (n = 8) the interventions were multicomponent. The most common components used in the interventions were cognitive stimulation, physical functioning and continuing support. Regarding the efficiency results of these interventions, only three studies provided a full economic evaluation. The most frequent tools in the economic evaluations used to measure effectiveness (measured in quality-adjusted life years) and costs were the European Quality of Life-5 Dimensions and Resource Utilization in Dementia instruments, respectively.

Conclusions

Most of the interventions evaluated were cost-effective. However, these results should be interpreted with caution, given the scarcity of the literature, and further economic evaluations of technology-based healthcare interventions for people with mild dementia or MCI care support and their caregivers are therefore needed. Additionally, a meta-analysis could not be performed due to the heterogeneity of the data.
Altered neurovascular coupling in semantic variant primary progressive aphasia
Authors: Zhang Yanxin , Ji Chunxue , Meng Yaping , He Yong , Su Xiao , Qin Wen , Zhang Nan
Published: November 2024

Background

Semantic variant primary progressive aphasia (svPPA) is one of the main clinical phenotypes of frontotemporal lobar degeneration. Changes in both neuronal activity and cerebral perfusion have been observed in svPPA, suggesting a possible breakdown of neurovascular coupling (NVC).

Objective

To investigate alterations in NVC and their correlations with clinical manifestations in svPPA patients.

Methods

In this study, a cohort consisting of 19 subjects diagnosed with svPPA and 36 cognitively unimpaired controls (CUCs) have been enrolled for analysis. All participants underwent multimodal magnetic resonance imaging (MRI) scans, resting-state functional MRI and arterial spin labelling, and neuropsychological assessments. The amplitude of low-frequency fluctuations (ALFF) and cerebral blood flow (CBF) were obtained to measure neural activity and perfusion, respectively. The calculation of voxel CBF-ALFF correlation and CBF/ALFF ratio enables the assessment of global NVC and regional NVC, respectively. Correlations between the CBF/ALFF ratios and cognitive scores of the svPPA patients were analyzed. The relationships between the CBF/ALFF ratios and the cognitive performance of the svPPA patients were investigated through correlational analyses.

Results

Compared with CUCs, svPPA patients had decreased global CBF-ALFF correlation coefficients ( p < 0.001) and lower CBF/ALFF ratios in bilateral inferior temporal gyrus, fusiform gyrus, left temporal pole and middle temporal gyrus ( p < 0.05). In svPPA patients, the CBF/ALFF ratios in the left inferior and middle temporal gyrus correlated positively with naming ability and general cognition, respectively.

Conclusions

The study indicate that NVC is disrupted in svPPA patients and is relevant to cognitive and language function.
Real-world assessment of caregiver preference and compliance to treatment with twice-weekly versus daily rivastigmine patches in Alzheimer's disease
Authors: García-Alberca José María , De La Guía Paz , Gris Esther , Mendoza Silvia , López De La Rica María , López-Trigo José Antonio , López-Mongil Rosa , García-López Teresa , López-García Raquel , Rodríguez Del Rey Teresa , Gay-Puente Javier , García-Castro Jesús , Casales Federico , Morato Xavier , Boada Mercè , González-Velasco Gemma , Marín-Carmona José Manuel , Páez Nora Inés , León María , Carrillejo Rosario , Rius Francisca , Barbancho Miguel Ángel , Lara José Pablo , Blanco-Reina Encarnación
Published: November 2024

Background

Adherence is critical in patients with Alzheimer's disease (AD) in order to achieve optimal benefit from therapy. However, patient compliance with the treatment remains a challenge.

Objective

To evaluate, in a real-world clinical setting, caregiver preference and treatment compliance with twice-weekly versus daily transdermal rivastigmine patch in mild-to-moderate AD.

Methods

92 patients who had been treated with daily rivastigmine patch for at least six months prior to switching to twice-weekly patch were evaluated. The change in therapeutic regimen was decided by the treating physician in accordance with standard practice. Caregivers’ satisfaction with daily rivastigmine patch was assessed at study entry. Caregiver's preference and satisfaction with twice-weekly patch as well as patient compliance were evaluated at weeks 12 and 24 using the Alzheimer's Disease Caregiver Preference Questionnaire.

Results

A significantly higher proportion of caregivers expressed a preference for the twice-weekly patch over the daily patch ( p < 0.001), and this preference was found to be associated with ease of use ( p < 0.001), ease of following the schedule ( p < 0.001), and ease of compliance ( p < 0.001). Furthermore, caregivers were more satisfied with the twice-weekly patch ( p < 0.0001). At 24 weeks, patient compliance was significantly better with the twice-weekly patch than with the daily patch ( p = 0.002). Caregiver burden significantly improved at the end of the treatment ( p = 0.003). No serious adverse events were reported.

Conclusions

The twice-weekly rivastigmine patch offers a convenient and straightforward dosing regimen for caregivers, with potential to enhance adherence with treatment in AD patients without causing serious adverse events.
Documentation of prodromal features and risk factors of dementia disease in primary care practice
Authors: Michalowsky Bernhard , Teipel Stefan , Riedel-Heller Steffi , Kostev Karel , Bohlken Jens
Published: November 2024

Background

Documented risk factors and prodromal features of dementia in primary care practices may support dementia prevention and early detection in routine care.

Objective

To identify documented prodromal features and risk factors of dementia before the incident dementia diagnosis in German primary care practices.

Methods

This case-control study used documented diagnoses (risk factors, prodromal features) and prescriptions of primary care practices for 73,717 patients with dementia disease and 73,717 matched controls (ratio 1:1). Logistic regression models were used to assess the associations between these documentations and the development of dementia diseases within 12 (1 year), 12–60 (1–5 years), and 60–120 months (5–10 years) before the incident dementia diagnosis.

Results

Mild cognitive impairment, depression, symptoms involving the emotional state, dizziness, and age-related physical debility were documented prodromal features associated with developing dementia diagnosis across all periods. Difficulties in gait and mobility and conduct disorders occurred significantly more often five years before the diagnosis. In terms of documented risk factors, hearing loss, visual disturbances, diabetes mellitus, and cerebrovascular diseases were associated with dementia across all periods. Mental and behavioral disorders due to the use of alcohol, intracranial injury, Parkinson's disease, chronic fatigue, intellectual disabilities, pneumonia, and epilepsy were also more often documented 60 months before the diagnosis.

Conclusions

Next to mild cognitive deficits, several factors, such as disorders of conduct and emotions, gait, mobility, and mental health, can be identified and monitored in primary care practices, helping physicians focus on potential consequences for cognitive decline and subsequent dementia.
Deep-learning assessment of hippocampal magnetic susceptibility in Alzheimer's disease
Authors: Shibata Haruto , Uchida Yuto , Kan Hirohito , Sakurai Keita , Madokoro Yuta , Iwano Sayaka , Maurya Sunil Kumar , Muñoz-González Ángel , Ardakani Ilya , Yamada Kentaro , Matsukawa Noriyuki
Published: November 2024

Background

Quantitative susceptibility mapping (QSM) is pivotal for analyzing neurodegenerative diseases. However, accurate hippocampal segmentation remains a challenge.

Objective

This study introduces a method for extracting hippocampal magnetic susceptibility values using a convolutional neural network (CNN) model referred to as 3D residual UNET.

Methods

The model was pre-trained on whole QSM images and hippocampal segmentations from 3D T1-weighted images of 297 patients with Alzheimer's disease and mild cognitive impairment. Fine-tuning was conducted through manually annotated hippocampal segmentations from the QSM images of 60 patients. The performance was assessed using the Dice similarity coefficient (DSC) and Pearson correlation coefficient.

Results

The developed model was applied to another 98 patients, 49 with AD and 49 with mild cognitive impairment (MCI), and the correlation between the hippocampal magnetic susceptibility and volume was evaluated. The mean DSC for the hippocampal segmentation model was 0.716 ± 0.045. The correlation coefficient between the magnetic susceptibility values derived from manual segmentation and the CNN model was 0.983. The Pearson correlation coefficient between magnetic susceptibility and hippocampal volume from the CNN model was −0.252 ( p = 0.012) on the left side and −0.311 ( p = 0.002) on the right.

Conclusions

The 3D residual UNET model enhances hippocampal analysis precision using QSM, which is capable of accurately extracting magnetic susceptibility.
Assessing the accuracy gap in early postoperative complication surveillance: ICD-10 codes versus manual curation—clinical and economic implications
Authors: Dencker Emilie Even , Bonde Alexander , Lorenzen Stephan Sloth , Troelsen Anders , Sillesen Martin
Published: November 2024

Background and objective:

Assessing surgical outcomes, notably postoperative complications (PCs), is crucial for healthcare systems. However, reliance on International Classification of Diseases, 10th revision (ICD-10) codes, may be suboptimal. This study aims to compare the accuracy of ICD-10 codes against manual curation of electronic healthcare records (EHRs) for identifying 13 individual PCs and evaluate associated resource utilization.

Methods:

EHR data from 11,827 surgical cases across 18 Danish hospitals in November 2021 were analyzed. PCs were identified and extracted through both manual curation and ICD-10 codes. Outcomes such as readmission, admission days, intensive care unit (ICU) stays, reoperations, and radiology procedures were assessed as proxies for resource consumption. Statistical and economic analyses quantified resource utilization and associated costs.

Results:

In total, 1047 PCs were found through manual curation and 439 PCs were found through ICD-10 codings. Only 218 of the PCs found through ICD-10 codes were retrieved during manual curation—corresponding to a correct ICD-10 coding of 20.8% of PCs. Patients with PCs experienced significantly higher resource utilization, including a 6.6 times higher readmission rate, 6 additional admission days, 2 extra ICU days, 7.7 times more reoperations. PCs incurred substantial economic costs, with additional admission days alone accounting for €25.5 million annually, over four times higher than estimates from ICD-10 codes.

Conclusions:

ICD-10 codes inadequately capture early PCs highlighting the need for improved detection strategies. The actual costs associated with PCs far exceed current estimates, emphasizing the necessity for enhanced monitoring for informed decision-making. In the Danish healthcare system, ICD-10 codes only capture approximately 21% of PCs, making it inadequate for surgical quality monitoring. The actual costs related to PCs, based on study assumptions, are more than four times higher than estimated from current standard. This calls for novel strategies for PC detection to improve healthcare as well as political and financial decision-making.
Political brand culture of Pakistan Tehreek-e-Insaf: An internal perspective
Authors: Khan Dawood , Armannsdottir Guja , Pich Christopher
Published: November 2024

The purpose of this study is to contribute to the body of research on political brand identity by specifically exploring political brand culture as a key element of political brand identity. Thus, this study addresses a significant gap in the literature on political brand identity using the developing world context of Pakistan Tehreek-i-Insaf party [PTI]. Adopting a qualitative methodology, this research involved in-depth interviews with PTI members to uncover the underlying values, beliefs, and cultural elements that shape the party’s brand culture. The findings reveal that PTI’s brand culture is an intricate and complex network of values, beliefs, and strategies that shape its identity and influence its interactions with both internal stakeholders and the broader public. These core values not only define PTI’s culture but also distinguish it from its competitors. The originality of this study lies in its development of a new framework for understanding political brand culture, comprising Brand Core Values, Collaborative Engagement, and Brand Strategy & Goals. This framework provides a nuanced tool for both academics and practitioners to analyse and manage brand cultures across various contexts, offering valuable insights for enhancing brand coherence and resilience during times of change.
Towards anti-colonial approaches in social work: Enhancing culturally safe HIV care for Indigenous communities in Manitoba and Saskatchewan
Authors: Christianson Tara , Still Marni , Souleymanov Rusty
Published: November 2024

The social work profession, with historical ties to colonial harm, must adopt decolonizing and anti-colonial approaches to promote culturally safe HIV care for Indigenous communities. This study examines how the COVID-19 pandemic disrupted health and social services throughout Manitoba and Saskatchewan, significantly limiting access to essential services and traditional practices for Indigenous peoples living with HIV. Using a Two-Eyed Seeing approach, this study integrates Indigenous and Western research approaches. Community-based participatory research and Indigenous Storywork comprised the overall research design. An Indigenous Elder, a cultural knowledge holder, and a community guiding circle of Indigenous peoples living with HIV helped guide the project. Qualitative interviews were conducted with 51 participants, recruited through community organizations, social media, and peer networks. The pandemic's impact on health, access to services, and ceremonies were explored. Data was analyzed using thematic analysis grounded in Indigenous Storywork principles. The pandemic significantly impacted traditional ceremonies, vital for the spiritual and communal well-being of Indigenous peoples living with HIV. Participants displayed resilience by adapting spiritual practices amidst restrictions. Social workers and other service providers acknowledged the crucial role of ceremonies in offering spiritual and cultural connection but showed varying levels of knowledge in connecting Indigenous clients to ceremonial practices, some facing organizational and systemic barriers. This study advocates for a systemic shift in social work to adopt decolonizing and anti-colonial practices that integrate Indigenous knowledge, ceremonies, and medicines. Such an approach advances culturally safe HIV care that respects Indigenous sovereignty, promotes wholistic well-being, and actively addresses structural colonial violence.
Manifestations of affective nationalism and representations of national ‘others’ in literature education: An ethnographic study
Authors: Aristidou Xanthia , Zembylas Michalinos , Charalambous Constadina
Published: November 2024

Situated in the conflict-affected Cypriot context, this paper aims to explore the affective dimension of nationalism as manifested in the representations of national ‘others’ in a Greek-Cypriot secondary school. Drawing on data from a linguistic ethnographic study looking at the negotiations of ethnic and intercultural education discourses, we focus on a series of classroom interactions discussing a poem written by a Turkish-Cypriot poet and how this text was interpreted by Greek-Cypriot students in focus group discussions. Our analysis shows how Turks and Turkish-Cypriots are affectively construed as national ‘others’, perpetuating dichotomies of ‘we’ and ‘they’. We also discuss the ambivalent feelings the particular poem brought, challenging hegemonic representations and feelings attached to those. The paper concludes with implications for education policies and practices.
Campus Sexual Assault: A Qualitative Review and Meta-Synthesis of Students’ Experiences of Campus Prevention Initiatives
Authors: McQueen Karen , Murphy-Oikonen Jodie , Hamm Jasmin
Published: November 2024

Sexual violence is a worldwide issue that impacts many individuals, often with serious and long-lasting effects. Students represent a high-risk group for sexual violence on campuses. As a result, various government initiatives have called for Universities and Colleges to develop policies and sexual violence prevention initiatives. However, much of the focus has been on the effect of the initiatives with less attention to students’ experiences. Thus, the purpose of this qualitative systematic review with meta-synthesis was to critically appraise and synthesize the evidence (e.g., themes) regarding students’ experiences with campus sexual assault prevention initiatives. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis and Joanna Briggs Institute guidelines were followed. Six databases were systematically searched, which yielded 2,090 papers. This resulted in 21 published papers meeting the inclusion criteria of a primary, English language, qualitative or mixed-methods study exploring students’ experiences of campus sexual assault initiatives. Two researchers independently extracted data and completed quality appraisals. The meta-synthesis identified four synthesized findings: (1) dichotomous perceptions of sexual violence initiatives, (2) the need for enhanced awareness, (3) modality matters, and (4) intended and unintended outcomes. Overall, these findings suggest that students valued the attention to the issue of sexual violence; however, they identified concerns that warrant attention. This has important implications for program and policy development as having programs that meet students’ needs may result in enhanced student engagement which may, in turn, lead to increased efficacy. Moreover, initiatives that may result in harm to survivors require careful consideration.