bluuebunny/crossref_metadata_2025 huggingface dataset:
Diroximel fumarate (DRF) in patients with relapsing–remitting multiple sclerosis: Interim safety and efficacy results from the phase 3 EVOLVE-MS-1 study
Authors: Naismith Robert T , Wolinsky Jerry S , Wundes Annette , LaGanke Christopher , Arnold Douglas L , Obradovic Dragana , Freedman Mark S , Gudesblatt Mark , Ziemssen Tjalf , Kandinov Boris , Bidollari Ilda , Lopez-Bresnahan Maria , Nangia Narinder , Rezendes David , Yang Lili , Chen Hailu , Liu Shifang , Hanna Jerome , Miller Catherine , Leigh-Pemberton Richard
Published: November 2019

Background:

Diroximel fumarate (DRF) is a novel oral fumarate for patients with relapsing–remitting multiple sclerosis (RRMS). DRF and the approved drug dimethyl fumarate yield bioequivalent exposure to the active metabolite monomethyl fumarate; thus, efficacy/safety profiles are expected to be similar. However, DRF’s distinct chemical structure may result in a differentiated gastrointestinal (GI) tolerability profile.

Objective:

To report interim safety/efficacy findings from patients in the ongoing EVOLVE-MS-1 study.

Methods:

EVOLVE-MS-1 is an ongoing, open-label, 96-week, phase 3 study assessing DRF safety, tolerability, and efficacy in RRMS patients. Primary endpoint is safety and tolerability; efficacy endpoints are exploratory.

Results:

As of March 2018, 696 patients were enrolled; median exposure was 59.9 (range: 0.1–98.9) weeks. Adverse events (AEs) occurred in 84.6% (589/696) of patients; the majority were mild (31.2%; 217/696) or moderate (46.8%; 326/696) in severity. Overall treatment discontinuation was 14.9%; 6.3% due to AEs and <1% due to GI AEs. At Week 48, mean number of gadolinium-enhancing lesions was significantly reduced from baseline (77%; p < 0.0001) and adjusted annualized relapse rate was low (0.16; 95% confidence interval: 0.13–0.20).

Conclusion:

Interim data from EVOLVE-MS-1 suggest DRF is a well-tolerated treatment with a favorable safety/efficacy profile for patients with RRMS.
Reduced neurite density in the brain and cervical spinal cord in relapsing–remitting multiple sclerosis: A NODDI study
Authors: Collorone Sara , Cawley Niamh , Grussu Francesco , Prados Ferran , Tona Francesca , Calvi Alberto , Kanber Baris , Schneider Torben , Kipp Lucas , Zhang Hui , Alexander Daniel C , Thompson Alan J , Toosy Ahmed , Wheeler-Kingshott Claudia AM Gandini , Ciccarelli Olga
Published: November 2019

Background:

Multiple sclerosis (MS) affects both brain and spinal cord. However, studies of the neuraxis with advanced magnetic resonance imaging (MRI) are rare because of long acquisition times. We investigated neurodegeneration in MS brain and cervical spinal cord using neurite orientation dispersion and density imaging (NODDI).

Objective:

The aim of this study was to investigate possible alterations, and their clinical relevance, in neurite morphology along the brain and cervical spinal cord of relapsing–remitting MS (RRMS) patients.

Methods:

In total, 28 RRMS patients and 20 healthy controls (HCs) underwent brain and spinal cord NODDI at 3T. Physical and cognitive disability was assessed. Individual maps of orientation dispersion index (ODI) and neurite density index (NDI) in brain and spinal cord were obtained. We examined differences in NODDI measures between groups and the relationships between NODDI metrics and clinical scores using linear regression models adjusted for age, sex and brain tissue volumes or cord cross-sectional area (CSA).

Results:

Patients showed lower NDI in the brain normal-appearing white matter (WM) and spinal cord WM than HCs. In patients, a lower NDI in the spinal cord WM was associated with higher disability.

Conclusion:

Reduced neurite density occurs in the neuraxis but, especially when affecting the spinal cord, it may represent a mechanism of disability in MS.
The temporal and causal relationship between inflammation and neurodegeneration in multiple sclerosis
Authors: Milo Ron , Korczyn Amos D , Manouchehri Navid , Stüve Olaf
Published: November 2019

It is currently incompletely understood whether inflammation and neurodegeneration are causally related in multiple sclerosis (MS). The sequence of a potential causal relationship is also unknown. Inflammation is present in rather all clinical stages of MS. Its role in the pathogenesis of MS is supported by histopathological analyses, genetic data, and numerous animal models of MS. All approved disease-modifying therapies that reduce clinical relapses and diminish the accumulation of lesions on neuroimaging are anti-inflammatory. Axonal loss and accelerated brain volume loss can also be detected from clinical disease onset throughout all stages. The expression of neurofilament light chain in cerebrospinal fluid and serum, a scaffolding protein in axons and dendrites, is a biomarker of neuronal injury associated with clinical relapses and reflects neuronal loss during episodes of acute inflammation. The recent association of human endogenous retrovirus (HERV) and its envelope proteins with MS illustrates a pathogenic pathway that causally links central nervous system (CNS)–intrinsic proinflammatory effects and inhibition of myelin repair and neuroregeneration. A review of current data on the causal relationship between inflammation and neurodegeneration in MS identified numerous plausible pathomechanisms that link the two events. Observations from most experimental models appear to favor a pathogenesis in which inflammation precedes neurodegeneration.
Cerebellar volume loss in radiologically isolated syndrome
Authors: George Ilena C , El Mendili Mohamed Mounir , Inglese Matilde , Azevedo Christina J , Kantarci Orhun , Lebrun Christine , Siva Aksel , Okuda Darin T , Pelletier Daniel
Published: November 2019

Radiologically isolated syndrome (RIS), in which asymptomatic demyelinating-appearing lesions are detected incidentally on MRI, can be a pre-clinical form of multiple sclerosis (MS). In this study, we measured cerebellar volumes on 3D T1-weighted 3T MR images in 21 individuals with RIS and 38 age- and sex-matched healthy controls (HC). Normalized cerebellar white matter volume and the anterior cerebellar gray matter volume were significantly decreased in RIS compared to HC ( p = 0.003 and p = 0.005, respectively). Our findings support reports of regional brain atrophy in RIS prior to the development of a seminal attack related to inflammatory demyelination.
Mutualism as market practice: An examination of market performativity in the context of anarchism and its implications for post-capitalist politics
Authors: Lloveras Javier , Warnaby Gary , Quinn Lee
Published: November 2019

This article interrogates the performative effects of mutualist ideas in the context of market-making. Mutualism is a variety of anarchism associated with the work of Pierre-Joseph Proudhon, who argued for the centrality of market exchanges and mutual credit as a means for emancipating workers from capitalist exploitation. The discussion is informed by an ethnographic inquiry within a Local Exchange Trading System in Spain – the Moneda Social Puma – which illustrates how actors put mutualist ideas to work. This research makes three contributions: first, it frames a view of market multiplicity and plasticity that broadens the current scope of market studies beyond a managerialist focus. Second, it reveals how actors mobilise anarchist theories to shape – rather than escape – markets. Third, this work elucidates how actors negotiate and stabilise conflicting forms of valuation as mutualist ideas are implemented. In particular, we draw attention to a set of infrastructural practices and mutual credit arrangements whereby the market is cooperatively managed as a common. We conclude by reflecting on the implications of our work for extant debates concerning post-capitalist politics, markets and anarchism.
State-based network similarity visualization
Authors: Murugesan Sugeerth , Bouchard Kristofer , Brown Jesse , Kiran Mariam , Lurie Dan , Hamann Bernd , Weber Gunther H
Published: November 2019

We introduce an approach for the interactive visual analysis of weighted, dynamic networks. These networks arise in areas such as computational neuroscience, sociology, and biology. Network analysis remains challenging due to complex time-varying network behavior. For example, edges disappear/reappear, communities grow/vanish, or overall network topology changes. Our technique, TimeSum, detects the important topological changes in graph data to abstract the dynamic network and visualize one summary representation for each temporal phase, a state. We define a network state as a graph with similar topology over a specific time interval. To enable a holistic comparison of networks, we use a difference network to depict edge and community changes. We present case studies to demonstrate that our methods are effective and useful for extracting and exploring complex dynamic behavior of networks.
Exploring nursing and allied health perspectives of quality oral care after stroke: A qualitative study
Authors: Ferguson Caleb , George Ajesh , Villarosa Amy R , Kong Ariana C , Bhole Sameer , Ajwani Shilpi
Published: November 2019

Background:

Maintaining good oral health remains a challenge among those hospitalised after stroke. Stroke nurses and allied health clinicians have a potential role in providing oral care, but no studies in Australia to date have explored their perceptions and needs.

Aims:

To explore the perspectives of nursing and allied health stroke clinicians regarding oral care for stroke patients across acute care and stroke rehabilitation settings.

Methods:

This study followed an exploratory qualitative design, using a constructivist approach. Participants from two metropolitan public hospitals were purposively recruited to participate in focus groups. Data was thematically analysed.

Results:

Twenty-one clinicians participated. Clinicians’ knowledge and practices relating to oral healthcare for stroke patients were inadequate. Most staff felt they did not have adequate knowledge, resources and training to administer oral care in this setting and proposed enhancing education of stroke clinicians, patients and informal caregivers, as well as improving quality point of care resources. There was overall support for the integrated dental care after stroke model of care.

Discussion:

This study revealed many gaps in current care and highlighted areas for improvement. Patients and their caregivers needed to be actively engaged as partners to improve oral healthcare within acute and rehabilitation stroke settings.

Conclusion:

This study provided insight into nurses’ and allied health stroke clinicians’ current knowledge and practices of oral care in various stroke settings. The findings from this study will inform development of a model of care to train stroke nurses in providing oral care.
Homeschooling and authenticity
Authors: Sarajlic Eldar
Published: November 2019

In this article, I address the relation between children’s authentic identity development and homeschooling. I show the limitations of claims that homeschooling protects children’s authenticity. I argue that the aim of homeschooling is the reproduction of parental beliefs and culture, which is inimical to the development of authentic children’s identities. Thus, I consider homeschooling prima facie unjustified. However, I do not advocate for a prohibition of homeschooling. Instead, I argue that parents could justify their homeschooling practices by satisfying specific authenticity-based requirements. I develop the outline of these requirements in the second part of the article.
Lifelong Learning for Equity and Social Cohesion: A New Challenge for Higher Education
Authors: Halimi Suzy , Hristoskova Stefanka
Published: November 2019

The Council of Europe's project on lifelong learning has addressed a range of issues that it had identified priorities for lifelong learning at a number of inter-governmental meetings during the 1990s. The project was based on the generation of a number of case studies, expert report and national papers from across Europe, these were considered at three workshops held in 1999 and 2000, which focused on the following themes:

• Meeting the needs of all students in a changing society;

• Application of information and communication technologies in lifelong learning;

• Structures and qualifications in lifelong learning.

This paper gives an overview of some of the main outcomes of this work and the implications of the findings of the project for governments and institutions, particularly Higher Education Institutions in Europe.
A Critical Review of the U.S. Literature on Race and Adult Education – Implications for Widening Access
Authors: Johnson-Bailey Juanita , Cervero Ronald M.
Published: November 2019

A commonly stated goal for adult education is its aspiration to create equality of opportunity but often the opposite occurs. The historical treatment of race within adult education in the U.S and Canada serves as an illustration of how leaders within the field have defined what matters and furthermore of their understanding of key issues.

The paper argues that to discuss race in adult education, we must recognize the absence of the concept of whiteness. Adult education literature is considered from this position and in particular the paper examines how race has been treated historically in adult education using three perspectives on race that inform contemporary action in adult education. Specific suggestions for widening access for adults in higher education are made.

It is argued that rather than ‘a no-barrier thinking’, we need ‘barrier-thinking’ so that we may construct a future where race does not matter. A three-part strategy based on an examination of the hidden curriculum, negotiation for a new educational structure and actively resisting from within an enfranchised position of comfort is set forth for consideration.
Mature Age Entry Schemes: A Comparative Analysis of Student Profiles in Five Universities in Southern Africa
Authors: Mpofu Stanley
Published: November 2019

This study is an attempt to extend earlier analyses (Davies, 1995; Mpofu, 1997) of the target clientele of mature age entry schemes to a level where we understand who exactly avails themselves for these programmes, in five universities in Southern Africa. To say that the enrolees of these programmes vary from country to country and, in some cases, from institution to institution (within the same country), is perhaps to state the obvious. However, in the absence of empirical research to determine the actual participants in several institutions, implementers of these programmes in these institutions and elsewhere will continue to rely on speculations and unsubstantiated claims with regard to whom is likely to enrol in the programmes.
The Archbishop's Conference: Missed Opportunity or Vain Hope?
Authors: Elsdon Konrad
Published: November 2019

For the last 50-odd years we might, just possibly, have had a comprehensive, all-inclusive and properly funded national system for the education of adults, drawing upon all potential sources of learning, provision and organisation, learner-centred but professionally staffed, accessible and genuinely democratic: in truth a genuine “education for the people” of an active society. What we now have is ‘lifelong learning’ interpreted as economically bankable skills training during the employable lifespan. This paper reveals how an extraordinary group of the country's leaders – ‘the great and the good’ of church, state, politics, industry, academia and the professions – sought to incorporate ‘genuine’ Adult Education in the 1944 Education Act, how their efforts seemed to thrive, were undermined, frustrated, and at last forgotten. It does not explain how present philosophies of education came to usurp the place of their predecessors.
Access Initiatives in Botswana and Nigeria
Authors: Oduaran Akpovire
Published: November 2019

Botswana and Nigeria are important pivots in the new movement for democracy in Africa. In both countries, there are vigorous moves to project democracy into every aspect of life. Democratic participation in education has implied the widening of access. For it is assumed that only enlightened and educated participation in the affairs of the community and state can guarantee the future of democracy in Botswana and Nigeria. It is realised that if this guarantee must come, then basic education for all and then continuous learning opportunities should ultimately dominate educational planning and implementation in both countries. The achievement of the goal of widening access is a laudable one, which unfortunately is frequently fraught with far too many obstacles. These obstacles are not insurmountable, and the perspectives emerging from Botswana and Nigeria may further enrich our knowledge of how African and other nations may collaborate to widen access based on comparative advantage.
Informal Learning: A Neglected Species
Authors: McGivney Veronica
Published: November 2019

If we want to encourage wider participation in organised learning and promote a culture of lifelong learning then learning should be conceptualised in a broader, more inclusive and less linear way. Despite an ostensible policy interest in informal learning it is largely ignored and the signs are that it will not be given any priority by the English Learning and Skills Councils. This may be because the existence of a hierarchy of what is valued as learning and because informal learning is so disparate and widespread, it is difficult to track what is taking place. As a result it is difficult to assess the outcomes in ways that would be acceptable to policy-makers and funding bodies.

To bring about a culture of lifelong learning the assumption that people who do not engage in formal learning are deficient in learning and skills should be challenged. There should be recognition that many who do not engage in formal learning have gained a wealth of knowledge and experience from their informal learning. This means that we must abandon the term ‘non-learner’.
Reflections on the Memorandum on Lifelong Learning
Authors: Davies Pat
Published: November 2019

In this paper the build up to the recent European Commission Memorandum on Lifelong Learning is described through an analysis of previous actions since the Maastricht Treaty. The particular messages of the Memorandum and the subsequent consultation process are detailed. A primary objective is that there should in the future be ‘joined-up’ policies and activities between different EC programmes. However, there should be concern that while breaking down boundaries between sectors, new boundaries are being constructed around different forms of learning, with the holistic nature of formal, informal and non-formal nature becoming lost.
A New Human-Derived Acellular Dermal Matrix for 1-Stage Coverage of Exposed Tendons in the Foot
Authors: Melandri Davide , Marongiu Francesco , Carboni Andrea , Rubino Corrado , Razzano Sergio , Purpura Valeria , Minghetti Paola , Bondioli Elena
Published: November 2019

The closure of wounds associated with soft tissue defects is surgically challenging, frequently requiring extensive plastic surgery and free flaps. The combination of ADM and STSG is an innovative method used to cover such wounds. The human-derived ADMs (H-ADMs) are the most described in the literature but according to European legislations, Companies H-ADMs outside the EC are not allowed to commercialize them in Europe, H-ADMs being “human products” and not “medical devices”, so being ruled by European legislations on transplants. The Skin Bank of the Bufalini Hospital (Cesena, Italy) obtained in 2009 the approval for the production and distribution of the first human cadaver-donor derived ADM from the Italian National Transplant Center and National Health Institute, we called with the Italian acronym M.O.D.A. (Matrice Omologa Dermica Acellulata). We present here the first use of a new H-ADM for treatment of distal lower extremity wounds with exposed tendons managed in one-stage pocedure with STSG. The excellent performance suggests that in cases where autologous tissue is unavailable or undesirable, the use of M.O.D.A. in one-stage procedure represents a promising alternative for covering wounds associated with tendons exposition.
Transparency in Autonomous Teammates
Authors: Panganiban April Rose , Matthews Gerald , Long Michael D.
Published: November 2019

Human–Machine teaming is a very near term standard for many occupational settings and still requires considerations for the design of autonomous teammates (ATs). Transparency of system processes is important for human–machine interaction and reliance but standards for its implementation are still being explored. Embedding social cues is a potential design approach, which may capture the social benefits of a team environment, yet vary with task setting. The current study examined the manipulation of transparency of benevolent intent from an AT within a piloting task requiring suppression of enemy defenses. Specifically, the benevolent AT maintained task communication as in a neutral condition, but included messages of support and awareness of errors. Benevolent communication reduced reported workload and increased reported team collaboration, indicating that this team intent was beneficial. In addition, trust and acceptance of the AT were rated higher by individuals tasked with depending on the system to protect them from missile threats. The need for information from ATs is beneficial, however may vary depending on team type.
Improving Traffic Incident Management Using Team Cognitive Work Analysis
Authors: Cattermole-Terzic Vanessa , Horberry Tim
Published: November 2019

Effective traffic incident management requires separate responder agencies, with different and sometimes competing priorities and purposes, to come together as a team. Their priorities include optimizing casualty outcomes, minimizing the disruption to the flow of traffic, and maintaining responder team safety. In this study, team Cognitive Work Analysis was used in a desktop exercise setting to analyze a complex traffic incident management exercise. The study investigated decisions made at the scene of an incident to determine system issues and system support solutions. Participants were all senior officers and decision makers in traffic incident management environments. Results indicated that team Cognitive Work Analysis was highly beneficial in determining gaps in team coordination, communication, and structures. Information regarding shared and not shared work elements between agencies highlighted novel coordination and education requirements within and between agencies, such as disparate priorities at the scene creating the risk of interoperability issues. Analyses of operational, coordination, and structural strategies offered new insights into the traffic incident management work domain and recommendations for improvements to the safety and performance of the overall traffic incident management system.
A sensor-less contact torque estimation and haptic feedback method in minimally invasive surgery
Authors: Bai Dongming , Chen Bai , Qi Fei , Ju Feng , Wang Yaoyao
Published: November 2019

To satisfy the needs of surgeons for judging the contact state of the catheter robot and modify the operation accordingly, a novel contact torque estimation and haptic feedback method is proposed in this article. Using the vibrotactile feedback, the proposed method reminds the surgeon which bending unit of the robot contacts with human tissue and guides him to realize the disengagement. Based on a novel simplification of the driving force of the robot, a quasi-statics model is established to estimate the contact torque. Simulations are conducted based on Finite Element Method (FEM) to verify the accuracy of the quasi-statics model and the estimation method. A robot system composed of a catheter robot, a PC, a master-operator, and a wearable vibration glove is assembled according to this method. To verify the feasibility of this method, a contact torque estimation experiment and a vibrotactile feedback experiment are conducted in this article. The results show that this method is accurate and effective.
Histological stroke clot analysis after thrombectomy: Technical aspects and recommendations
Authors: Staessens S , Fitzgerald S , Andersson T , Clarençon F , Denorme F , Gounis MJ , Hacke W , Liebeskind DS , Szikora I , van Es ACGM , Brinjikji W , Doyle KM , De Meyer SF
Published: November 2019

The recent advent of endovascular procedures has created the unique opportunity to collect and analyze thrombi removed from cerebral arteries, instigating a novel subfield in stroke research. Insights into thrombus characteristics and composition could play an important role in ongoing efforts to improve acute ischemic stroke therapy. An increasing number of centers are collecting stroke thrombi. This paper aims at providing guiding information on thrombus handling, procedures, and analysis in order to facilitate and standardize this emerging research field.
Inhalation with intravenous loading dose of colistin in critically ill patients with pneumonia caused by carbapenem-resistant gram-negative bacteria
Authors: Choe Junsu , Sohn You Min , Jeong Suk Hyeon , Park Hyo Jung , Na Soo Jin , Huh Kyungmin , Suh Gee Young , Jeon Kyeongman
Published: November 2019

Background:

Despite the increasing use of colistin in clinical practice, the optimal dosing, and administration route have not been established. This study aimed to evaluate the clinical outcome and safety of intravenous (IV) colistin with a loading dose (LD) and adjunctive aerosolized (AS) colistin administration in critically ill patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria (CRGNB).

Methods:

We retrospectively reviewed 191 critically ill patients who received colistin for the treatment of HAP or VAP caused by CRGNB. Patients were divided into three groups: non-LD IV (patients received only IV colistin without LD), LD IV (patients received only IV colistin with LD), and AS–LD (patients received IV colistin with LD and adjunctive AS colistin).

Results:

There was no difference in clinical response between the three groups. However, the rate of microbiological eradication was significantly higher in the AS–LD group (60%) than in the non-LD IV (31%), and LD IV (33%) groups ( p = 0.010). Patients treated with adjunctive AS colistin in combination with LD IV had significantly lower 30-day mortality rates than patients treated with IV colistin alone ( p = 0.027). After adjusting for potential confounding factors, adjunctive AS colistin was still significantly associated with lower mortality (adjusted OR 0.338, CI 95% 0.132–0.864, p = 0.024). However, nephrotoxicity did not change according to the use of LD regimen and AS colistin administration ( p = 0.100).

Conclusions:

Adjunctive AS colistin in combination with IV colistin with LD was related to an improved 30-day mortality and microbiological outcome without an increase in nephrotoxicity in critically ill patients with HAP and VAP caused by CRGNB. The reviews of this paper are available via the supplemental material section.
Are headforms a poor surrogate for helmet fit?
Authors: Liu Kristie , Aponte Daniel I , Greencorn David J , Robbins Shawn M , Pearsall David J
Published: November 2019

International standards organizations require ice hockey helmets to be impact tested while mounted to a surrogate headform, with anthropometrics of a 50th percentile male. However, human head shapes are not identical, nor are there consistent guidelines for fitting a helmet to the ordinary user. The interaction between head shape and helmet fit impacts helmet safety: the contact area between a headform and helmet interior has been identified as a critical determinant of protection afforded by a helmet. The objective of this study was to compare quantitative measures of helmet fit between an adult male sample and three 50th percentile male headforms. This study recruited 42 adult male participants who wore a medium-sized ice hockey helmet (560–600 mm interior circumference) in an attempt to compare their quantitative helmet fit to those of three 50th percentile adult male headforms. Through three-dimensional modeling, fit was quantified by assessing dimensional differences in two transverse cross-sectional planes of the head and using principal component analysis to determine the largest components of fit. Significant differences were found between the headforms and the participants’ heads in anthropometrics and dimensional differences. The headforms were smaller than the participants’ heads, demonstrating average gapping with the interior of the helmet. The principal components of fit extracted included mediolateral deformation, gapping/compression at the rear aspect of the head-helmet interface, and general congruence of the head shape to the helmet liner. These findings demonstrated a vast discrepancy between helmet fit on the 50th percentile headforms and the ordinary helmet user.
In Silico Analysis of an Exercise-Safe Artificial Pancreas With Multistage Model Predictive Control and Insulin Safety System
Authors: Garcia-Tirado Jose , Colmegna Patricio , Corbett John P. , Ozaslan Basak , Breton Marc D.
Published: November 2019

Background:

Maintaining glycemic equilibrium can be challenging for people living with type 1 diabetes (T1D) as many factors (eg, length, type, duration, insulin on board, stress, and training) will impact the metabolic changes triggered by physical activity potentially leading to both hypoglycemia and hyperglycemia. Therefore, and despite the noted health benefits, many individuals with T1D do not exercise as much as their healthy peers. While technology advances have improved glucose control during and immediately after exercise, it remains one of the key limitations of artificial pancreas (AP) systems, largely because stopping insulin at the onset of exercise may not be enough to prevent impending, exercise-induced hypoglycemia.

Methods:

A hybrid AP algorithm with subject-specific exercise behavior recognition and anticipatory action is designed to prevent hypoglycemic events during and after moderate-intensity exercise. Our approach relies on a number of key innovations, namely, an activity informed premeal bolus calculator, personalized exercise pattern recognition, and a multistage model predictive control (MS-MPC) strategy that can transition between reactive and anticipatory modes. This AP design was evaluated on 100 in silico subjects from the most up-to-date FDA-accepted UVA/Padova metabolic simulator, emulating an outpatient clinical trial setting. Results with a baseline controller, a regular MPC (rMPC), are also included for comparison purposes.

Results:

In silico experiments reveal that the proposed MS-MPC strategy markedly reduces the number of exercise-related hypoglycemic events (8 vs 68).

Conclusion:

An anticipatory mode for insulin administration of a monohormonal AP controller reduces the occurrence of hypoglycemia during moderate-intensity exercise.
Mobile Health (mHealth) apps focused on menopause: Are they any good?
Authors: Gkrozou F , Tsonis O , Godden M , Siafaka V , Paschopoulos M
Published: November 2019

Objective

Nowadays, smartphones are becoming an indispensable tool due to the popular use of useful applications (apps) that can be downloaded and installed to aid our everyday lives. The quantity of apps manifested as tools for mobile health (mHealth) is undoubtedly high. The mHealth apps are very popular and cover various and different aspects of health. The first app for women in menopause was presented in 2014. Since then, more apps have been developed. The aim of this study is to identify mHealth apps that address the menopause with a focused view on the degree of medical professional involvement and documented evidence base practice in their design, as well as, underline their potential role in raising awareness regarding health in the community.

Methods

The official app stores by Google, Apple, Windows and Blackberry were chosen to pool the apps. The keywords used were ‘apps for menopause’, ‘women in menopause’ and ‘menopause’. Eligible apps were selected based on the target consumer, each app’s price, documentation of evidence base practice and documentation of medical professional involvement.

Results

This search revealed 35 relevant apps, of which 10 were excluded as they were identified as duplicates available for download by more than one app store. Authors excluded also further three mHealth apps, since they were not written in English, and the assessment was difficult due to the language barrier. A total of 22 mHealth menopause apps were included in this study. Medical professional involvement was noted in 27.3% of the mHealth menopause apps, and 22.7% of the total apps used evidence-based information. The mHealth menopause apps were free of charge in 86.4%. Ninety-one percent of the apps were designed for the consumers, while only 9% of them were suitable for medical professionals.

Conclusions

In conclusion, there is a need to improve the mHealth apps available for menopause, by including more medical staff in their development and by establishing clear regulation around the development and the context of an mHealth app.
Social Media, Interrupted: Users Recounting Temporary Disconnection on Instagram
Authors: Jorge Ana
Published: November 2019

This article looks at the discourses of Instagram users about interrupting the use of social or digital media, through hashtags such as “socialmediadetox,” “offline,” or “disconnecttoreconnect.” We identified three predominant themes: posts announcing or recounting voluntary interruption, mostly as a positive experience associated to regaining control over time, social relationships, and their own well-being; others actively campaigning for this type of disconnection, attempting to convert others; and disconnection as a lifestyle choice, or marketing products by association with disconnection imaginary. These discourses reproduce other public discourses in asserting the self-regulation of the use of social media as a social norm, where social media users are responsible for their well-being and where interruption is conveyed as a valid way to achieve that end. They also reveal how digital disconnection and interruption is increasingly reintegrated on social media as lifestyle, in cynical and ironic ways, and commodified and co-opted by businesses, benefiting from—and ultimately contributing to—the continued economic success of the platform. As Hesselberth, Karppi, or Fish have argued in relation to other forms of disconnection, discourses about Instagram interruptions are thus not transformative but restorative of the informational capitalism social media are part of.
Texting the waters: An assessment of focus groups conducted via the WhatsApp smartphone messaging application
Authors: Chen Julienne , Neo Pearlyn
Published: November 2019

Focus groups are a well-used research method in the social sciences. Typically, they are conducted in person to generate research insights through group discussion and interaction. As digital technologies advance, there have been efforts to consider how to conduct focus groups in an online format, often using computer-based tools such as email, chat and videoconferencing. In this article, we test the potential of smartphone-based mobile messaging as a new method to elicit group-level insights. Based on empirical analysis and comparison of in-person and WhatsApp group chat focus groups conducted in Singapore, we find that WhatsApp group chat does have the potential to generate well-elaborated responses and group interaction, particularly among younger, digitally fluent participants. However, the quantity and richness of the conversation still do not match that of the in-person focus groups, and further innovation may be needed to improve mobile messaging as a qualitative research method.
On the use of participatory methodologies for video game research: Exploring disaster risk reduction in video games
Authors: Gampell Anthony Viennaminovich , Gaillard JC , Parsons Meg
Published: November 2019

Video game scholars examining the shortcomings of previous video game research reference the need for new and innovative methodologies. Existing video game research seemingly inhibits organic learning experiences by setting specific research targets or providing players with gameplay instructions, hence utilising methodological approaches that study the learning process from the outside. With the increasing popularity of both serious and mainstream disaster video games, a necessity exists for innovative research to explore how video games can be used as learning tools. Based upon the researchers’ own enquiry, this article demonstrates the potential use, benefits and challenges of participatory methodologies for the conduct of video game research. This article pushes back upon traditional video game research methods, reviewing the methodological approaches of existing video game literature and demonstrates how participatory methodologies are currently being used for disaster video game research. An examination of participatory methodologies, being used in disaster video game research, reviews the strengths and challenges of each research approach. Rationalising the potential of participatory methodologies, in the context of constructivist learning theory and active participation, to foster the learning process and explore learning from the inside. As such this article provides an innovative methodological framework, which can be used as a template when considering future video game research.
Long-term clinical outcomes of scarf osteotomy in regional hospital Hong Kong
Authors: Weng-Io Ng , Kwok-Bill Chan , Yuk-Nam Yeung
Published: November 2019

Background:

Lack of local data concerning the long-term clinical outcomes of scarf osteotomy in Hong Kong.

Methods:

This is a retrospective review of 75 patients (88 feet) who underwent scarf osteotomy with a mean follow-up of 94.20 months (60–144 months). Clinical ratings were based on visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) scale. Weight-bearing radiographs were used to perform angular measurements: (i) hallux valgus angle (HVA), (ii) intermetatarsal angle, (iii) distal metatarsal articular angle, and (iv) tibial sesamoid position before operation and at the time of latest follow-up.

Results:

The mean overall AOFAS scales improved from 29.66 (5–49) points preoperatively to 86.83 (39–100) points at the time of final follow-up. The VAS improved from 6.61 (5 to 9) to 0.66 (0 to 4). The average HVA correction was 25.42 (8–46). The 8- to10-year recurrence rate (HVA > 20) was 31.80%. A higher degree of preoperative HVA predicts higher recurrence rate.

Conclusion:

Scarf osteotomy is an effective procedure for symptom control and improvement in radiological parameters for hallux valgus deformity. However, recurrence rate is relatively high.
Book review: Iqbal Husain, ed., &, tr., The World of the Rebels of 1857, Proclamations, Tracts and Documents, 1857–1859
Authors: Moosvi Shireen
Published: November 2019

Iqbal Husain, ed., &, tr., The World of the Rebels of 1857, Proclamations, Tracts and Documents, 1857–1859 (Delhi: Primus Books), 2019, viii + 211 + 134 p., ₹1,395 (Hb).
Book review: Ruby Lal, In Pursuit of Playfulness: The Girl-Child/Woman in Nineteenth-Century India
Authors: Habib Irfan
Published: November 2019

Ruby Lal, In Pursuit of Playfulness: The Girl-Child/Woman in Nineteenth-Century India, Indian Reprint (Delhi: Primus Book), 2019, 222 pp., ₹695 (Pb).
Book review: Shubhra Chakravarti and Utsa Patnaik, eds., Agrarian and Other Histories: Essays for Binay Bhushan Chaudhuri
Authors: Moosvi Shireen
Published: November 2019

Shubhra Chakravarti and Utsa Patnaik, eds., Agrarian and Other Histories: Essays for Binay Bhushan Chaudhuri (New Delhi: Tulika Books), 2017, 326 pp., ₹995 (Hb).
Measuring Patient-Reported Shared Decision-Making to Promote Performance Transparency and Value-Based Payment: Assessment of collaboRATE’s Group-Level Reliability
Authors: Forcino Rachel C , Thygeson Marcus , O’Malley A James , Meinders Marjan J , Westert Gert P , Elwyn Glyn
Published: November 2019

Shared decision-making (SDM) between clinicians and patients is a key component of patient experience, but measurement efforts have been hampered by a lack of valid and reliable measures that are feasible for routine use. In this study, we aim to investigate collaboRATE’s reliability, calculate required sample sizes for reliable measurement, and compare Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience survey items to collaboRATE. CollaboRATE’s provider group-level reliability reached acceptable reliability at 190 patient reports, while the CAHPS SDM measure demonstrated similar reliability at a sample size of 124. The CAHPS communication measure reached acceptable reliability with 55 patient reports. A strong correlation was observed between collaboRATE and CAHPS communication measures ( r = 0.83). As a reliable measure of SDM, collaboRATE may be useful for both building payment models that support shared clinical decision-making and encouraging data transparency with regard to provider group performance.
Mapping the impact of exposure to maternal immune activation on juvenile Wistar rat brain macro- and microstructure during early post-natal development
Authors: Wood Tobias C. , Edye Michelle E. , Harte Michael K. , Neill Joanna C. , Prinssen Eric P. , Vernon Anthony C.
Published: November 2019

Maternal immune activation is consistently associated with elevated risk for multiple psychiatric disorders in the affected offspring. Related to this, an important goal of our work is to explore the impact of maternal immune activation effects across the lifespan. In this context, we recently reported the effects of polyriboinosinic-polyribocytidylic acid–induced maternal immune activation at gestational day 15, immediately prior to birth, at gestational day 21 and again at post-natal day 21, providing a systematic assessment of plasma interleukin 6, body temperature and weight alterations in pregnant rats and preliminary evidence for gross morphological changes and microglial neuropathology in both male and female offsprings at these time points. Here, we sought to complement and extend these data by characterising in more detail the mesoscale impact of gestational polyriboinosinic-polyribocytidylic acid exposure at gestational day 15 on the neuroanatomy of the juvenile (post-natal day 21) rat brain using high-resolution, ex vivo anatomical magnetic resonance imaging in combination with atlas-based segmentation. Our preliminary data suggest subtle neuroanatomical effects of gestational polyriboinosinic-polyribocytidylic acid exposure (n = 10) relative to saline controls (n = 10) at this time-point. Specifically, we found an increase in the relative volume of the diagonal domain in polyriboinosinic-polyribocytidylic acid offspring (p < 0.01 uncorrected), which just failed to pass stringent multiple comparisons correction (actual q = 0.07). No statistically significant microstructural alterations were detectable using diffusion tensor imaging. Further studies are required to map the proximal effects of maternal immune activation on the developing rodent brain from foetal to early post-natal life and confirm our findings herein.
Percutaneous Chevron/Akin (Peca) Versus Open Scarf/Akin (Sa) Osteotomies Treatment in Hallux Valgus: A Systematic Review and Meta-Analysis of 137 Feet
Authors: Stéfani Kelly Cristina , Moraes Leonardo , Ferreira Gabriel Ferraz , Borges Vinicius
Published: November 2019

Category:

Bunion

Introduction/Purpose:

The surgical treatment of hallux valgus presents several techniques described in the literature. Recently the percutaneous technique appeared as a less invasive option in the correction of the deformity and more and more used by the surgeons.

Methods:

The meta-analysis was performed through studies found from the systematic review of articles included in electronic databases (Medline, Scopus, Embase and the Cochrane Library) until June 2018 (Systematic Review Registry PROSPERO: CRD42018096613). The pooled analysis was synthesized from clinical outcomes such as visual analogue scale of pain and AOFAS score, radiographic outcomes and evaluation of complications, with 95% confidence interval. The pooled data were weighted using the fixed model effect.

Results:

Two studies, including 137 feet with hallux valgus diagnosis were added in the analysis, comparing open surgery using the Scarf and Akin (SA) technique versus the percutaneous Chevron and Akin (PECA). In the synthesis of the result, pain in the perioperative period was lower in the PECA group, with a reduction of 1.96 points in the fixed effect model (95% CI = -2.28 to - 1.65, p = 0.53, i2 = 0%, t2 = 0), without presenting differences between techniques in the radiographic result, nor in the risk of complications. The PECA technique demonstrated longer radioscopy time when compared to SA.

Conclusion:

The use of the percutaneous method (PECA) to correct hallux valgus when compared to the open technique (SA) demonstrated less pain in the perioperative period, similar potential of radiographic correction and an equal risk of complications, with a longer radioscopy time.