Confirmatory Findings Research Articles

Identifying Alzheimer’s genes via brain transcriptome mapping

BackgroundAlzheimer’s disease (AD) is one of the most common neurodegenerative disorders characterized by progressive decline in cognitive function. Targeted genetic analyses, genome-wide association studies, and imaging genetic analyses have been performed to detect AD risk and protective genes and have successfully identified dozens of AD susceptibility loci. Recently, brain imaging transcriptomics analyses have also been conducted to investigate the relationship between neuroimaging traits and gene expression measures to identify interesting gene-traits associations. These imaging transcriptomic studies typically do not involve the disease outcome in the analysis, and thus the identified brain or transcriptomic markers may not be related or specific to the disease outcome.ResultsWe propose an innovative two-stage approach to identify genes whose expression profiles are related to diagnosis phenotype via brain transcriptome mapping. Specifically, we first map the effects of a diagnosis phenotype onto imaging traits across the brain using a linear regression model. Then, the gene-diagnosis association is assessed by spatially correlating the brain transcriptome map with the diagnostic effect map on the brain-wide imaging traits. To demonstrate the promise of our approach, we apply it to the integrative analysis of the brain transcriptome data from the Allen Human Brain Atlas (AHBA) and the amyloid imaging data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort. Our method identifies 12 genes whose brain-wide transcriptome patterns are highly correlated with six different diagnostic effect maps on the amyloid imaging traits. These 12 genes include four confirmatory findings (i.e., AD genes reported in DisGeNET) and eight novel genes that have not be associated with AD in DisGeNET.ConclusionWe have proposed a novel disease-related brain transcriptomic mapping method to identify genes whose expression profiles spatially correlated with regional diagnostic effects on a studied brain trait. Our empirical study on the AHBA and ADNI data shows the promise of the approach, and the resulting AD gene discoveries provide valuable information for better understanding biological pathways from transcriptomic signatures to intermediate brain traits and to phenotypic disease outcomes.

The Turkish Adaptation of the Stress-Related Growth Scale Short Form: A Validity and Reliability Study

The present study aimed to adapt the Stress-Related Growth Scale Short Form into Turkish and to examine the psychometric properties of the Turkish form. The research was performed with three separate study groups consisting of a total of 631 university students. Linguistic equivalence studies of the scale have shown that the original and Turkish forms are equivalent. Item analyzes and confirmatory factor analysis findings showed that the original factor structure of the scale with 15 items and one dimension was confirmed in Turkish university students, and the fit values of the model were within acceptable limits. In criterion validity, significant correlations were found between the Stress-Related Growth Scale Short Form and other variables. Research findings have shown that the Stress-Related Growth Scale Short Form was a valid and reliable measurement instrument.

Frequency of Fatty Liver Changes on Ultrasound Abdomen in Non Diabetic Young Patients Having Chronic Right Hypochondrium Pain

With a prevalence of around 20 – 30% in world population, Fatty liver is becoming the most commonly occurring ailment. Aims: To check the frequency of fatty liver changes on ultrasound abdomen in non diabetic young patients presenting with chronic right hypochondrium pain of more than two weeks duration. Study Design: Cross-sectional study. Methodology: Patients (n=375) with an age range of 18 to 50 years presenting to the OPD with complaint of chronic right hypochondrium pain of more than 2 weeks duration were included into the study. Demographic details, Total serum cholesterol mg/dl, triglycerides and LFTs (ALT, AST U/L) were recorded. Patients were sent for ultrasound abdomen for confirmatory diagnosis and findings trained were recorded. All this information was recorded on Performa. Statistical analysis: Data was analyzed using SPSS version 26. Results were presented as frequency and percentage. Age was presented as mean± SD. Results: Out of total 375 patients 175 (45.6%) were male and 200 (52.1%) were female. Mean age of the patients was 32.65 ± 6.94 years. 56.5% (n=217) had fatty liver changes on ultrasound. 143 (65.8%) patients had grade I fatty changes, 58 (26.7%) had grade II and 16 (7.4%) had grade III liver disease. Conclusion: It was concluded that frequency of fatty liver changes detected on ultrasound was high in non diabetic young patients. Liver enzymes (especially ALT) showed an increasing trend as the disease severity increased on ultrasound. Keywords: LFTs, Chronic, Fatty Liver, Grading and Ultrasound.

Visual dysfunction in survivors of COVID-19: Case series

Research ObjectivesThis case series aims to expand knowledge on COVID-19 diagnosis and functional vision status and highlight the importance of best practices with regards to comprehensive vision screening.DesignCase Series.SettingOutpatient rehabilitation clinics in Minnesota, USA and Texas, USA.ParticipantsFive adults admitted to rehabilitation with diagnosed post-acute sequelae of COVID-19, inclusive of visual dysfunction. Three participants had no remarkable history of visual dysfunction or acquired brain injury; two participants had prior neurological history: one with mild traumatic brain injury and one with concussion, both are significant for visual dysfunction following the acute events.InterventionsAll patients were treated in acute and outpatient rehabilitation settings following the positive visual screen.Main Outcome MeasuresN/A.ResultsThis case series highlights visual dysfunction in five patients diagnosed with COVID-19, with and without prior history of neurological disorders. All five participants described newly acquired or a recrudescence of visual symptoms which impacted daily function. 5 out of 5 patients had confirmatory findings following comprehensive visual assessment. Visual symptoms consistent between the cases included, but were not limited to, blurred vision, diplopia, photophobia, impaired near-point focus, headaches, and general visual discomfort and asthenopia throughout their day.ConclusionsIndividuals diagnosed with COVID-19 present with a wide-range of symptoms and often neurological sequelae, without a predictable pattern. Despite the substantial impact of COVID-19 globally, and the massive increase in research efforts, certain domains remain poorly understood. One such domain is vision and the impact that visual impairment attributed to COVID-19 has on functional independence. This case series supports new evidence for visual sequelae in COVID-19 with and without history of a neurological disorder. Such findings motivate new research questions such as the pathophysiological differences between acute onset versus recrudesced visual dysfunction. It is imperative that consistent and comprehensive visual screening is performed for individuals who are diagnosed with COVID-19. Universal awareness of potential visual dysfunction following COVID-19 infection is essential for timely screening, referrals and treatment to optimize patient outcomes.Author(s) DisclosuresThere are no relevant author disclosures.

The financing of uncertain future investments

PurposeThe purpose of this study is to investigate the effects of two important financing sources, debt and cash, on a firm’s investment decisions and explores the intertemporal impact of this financing on future investment volatility.Design/methodology/approachThis paper first reports our results using ordinary least squares (OLS) estimation and then employ an instrumental variable (IV) strategy which addresses potential endogeneity that arises from future investment volatility on current capital structure and cash levels.FindingsThis paper finds firms with low levels of debt or high levels of cash experience higher future investment volatility, and the probability of large future investment increases with high cash levels. This study’s findings are economically important; for example, a one-standard-deviation increase from the mean of debt ratio implies an approximate 7.8% decrease in future investment volatility; and a one-standard-deviation increase from the mean of a firm’s cash level leads to a 47% increase in the probability of a large investment in the next year.Originality/valueThe findings of this study help firms understand the impact of their present financing decisions on the plausibility of their future investments. This paper contributes to the literature by making both novel and confirmatory findings. This paper was structured to include confirmatory findings for two reasons. First, this paper uses different methods to construct investment volatility and the related investment spike. Second, and more importantly, the hypotheses are interrelated and communicate how firms plan for and execute against uncertain future investments. Growth options are ephemeral, and the hypotheses structure provides a guideline for how a firm finances future growth options.

The Development and Validation of the Familial Support of Multiracial Experiences Scale

The purpose of this study was to develop a measure of familial support of Multiracial individuals’ unique racial experiences to advance the field’s understanding of how familial processes influence Multiracial development. A sample of 422 Multiracial college students (77.7% female, Mage = 20.05) from three different regions of the United States completed the survey. Exploratory factor analysis results suggested a two-factor measure. Multiracial Conscious Support, a 15-item subscale, represented support strategies unique to Multiracial individuals’ experiences of discrimination and identity exploration. The second 7-item subscale, Multiple Heritage Validation, represented validation of membership in multiple racial groups. The factor structure was supported by confirmatory factor analysis findings with a separate sample. Support was found for the reliability and validity of each subscale. This study provides evidence validating the first measure of familial support of Multiracial experiences, highlighting two themes of support addressing unique experiences of being Multiracial, and validating multiple racial group memberships.

Correlation Between Clinical Diagnosis, MRI, and Arthroscopy in Diagnosing Shoulder Pathology.

IntroductionShoulder disorders are frequently encountered by clinicians and are a common cause of musculoskeletal pain in the general population. Clinical tests specific to each shoulder pathology, MRI, and arthroscopy are the most relied upon modalities of diagnosis used by many clinicians. The aim of this study was to correlate clinical tests and MRI with arthroscopy as the gold standard and whether a negative MRI with a positive clinical test could justify an arthroscopy.Materials and methodsA total of 120 consecutive patients who had a history of shoulder pain or instability were evaluated by clinical tests and MRI, and underwent arthroscopy. Based on the confirmatory findings of arthroscopy, they were classified as True Positive (TP), True Negative (TN), False Positive (FP) and False Negative (FN) for each modality i.e., clinical tests and MRI.ResultsClinical assessment of rotator cuff tears in comparison to arthroscopy yielded a sensitivity of 96.88%, specificity of 92.86% and diagnostic accuracy of 95%, whilst MRI had a sensitivity of 90.62%, specificity of 92.86% and diagnostic accuracy of 91.67%. In anterior labral lesions, clinical assessment had a sensitivity of 94.44%, specificity of 97.62 % and diagnostic accuracy of 96.67%, whilst MRI had a sensitivity of 83.33%, specificity of 92.86%, with diagnostic accuracy of 90%. Interestingly, in the clinical assessment of superior labral tear from anterior to posterior (SLAP) lesions, a sensitivity of 90%, specificity of 95%, and diagnostic accuracy of 93.33% were observed while MRI had a sensitivity of 60%, specificity of 92.50%, and diagnostic accuracy of 81.67%.ConclusionOn the basis of these results, clinical assessment appears to be an effective tool in diagnosing shoulder pathologies, whereas MRI, though reliable in the identification of rotator cuff tears and instability, does not identify patients with SLAP lesions effectively. This study reinforces the importance of a good clinical examination of the shoulder, especially in chronic pain and an uncertain MRI, therefore improving patient management.

Association of Economic Well-Being With Comorbid Conditions in Patients Undergoing Carpal Tunnel Release

Medical comorbidities have been associated with the development of carpal tunnel syndrome (CTS), severity at the time of presentation, and outcomes of carpal tunnel release (CTR). Socioeconomic factors have also been associated with worse function in patients with CTS at presentation and after surgery. However, the effects of economic well-being on the prevalence of medical comorbidities in patients with CTS have not been well-described. The objective of this study was to determine whether economic well-being is associated with medical comorbidities in a cohort of patients undergoing CTR. Patients (n= 1,297) who underwent CTR at a single tertiary care referral center over a 5-year period from July 2008 to June 2013 were retrospectively identified. The exclusion criteria were acute trauma or infection, revision surgery, incomplete medical records, and neoplasm excision. Additionally, patients were excluded if they lacked documented confirmatory or normal electrodiagnostic study findings prior to CTR. Finally, this study comprised a cohort of 892 patients with electrodiagnostic study-confirmed CTS who underwent CTR. The economic well-being of patients was assessed using the Distressed Communities Index. The comorbidities of diabetes mellitus, chronic kidney disease, hypertension, hypothyroidism, cervical radiculopathy, tobacco use, and body mass index were assessed. Bivariate comparisons were used to determine the associations between the tiers of economic well-being and comorbidities. Lower economic well-being was associated with body mass index, diabetes mellitus, chronic kidney disease, and tobacco use in these patients. Although hypertension, hypothyroidism, and cervical radiculopathy were not associated with economic well-being, their comparisons were underpowered. Patients experiencing economic distress have a higher comorbidity burden, and as such, may be at an increased risk of complications or poorer outcomes. The association between economic well-being and comorbidities in this population suggests the need for a multidisciplinary care model that addresses both compressive neuropathy and the associated economic factors. Prognostic II.

Fatigue following pediatric acquired brain injury: Interplay with associated factors in a clinical trial population compared to healthy controls.

The aims of the present study were to compare fatigue levels in children with pediatric acquired brain injury (pABI) with healthy controls (HCs), and examine the interplay of fatigue with associated factors. We used baseline data from a preregistered randomized controlled trial. Seventy-six children aged 10-17 (median 13 years) with pABI in the chronic phase (88% with confirmatory cerebral imaging findings) and executive function (EF) complaints were included, most with moderate disability according to The Glasgow Outcome Scale Extended (GOSE-E) categorization. HCs consisted of 60 children aged 10-17 (median 13 years). All 127 participants completed measures of fatigue and intelligence. pABI participants were also assessed for behavioral problems, health-related quality of life (HRQoL), and EF. Nonparametric statistics were employed, in addition to a network analysis to model the unique associations between parent-reported fatigue and related factors. Parents reported significantly more fatigue in the pABI-group (75% of scores in clinical range; < 70) compared to HCs (11.7% of scores in clinical range). No strong associations were found between fatigue and injury characteristics, but findings indicated more fatigue in the older than younger age-group for pABI participants. Network modeling revealed a central role for HRQoL, behavioral, and EF symptoms in relation to fatigue. Fatigue is reported to be highly prevalent in the chronic phase of pABI. When addressing fatigue, our findings demonstrate the advantage of including multidimensional measures of fatigue and examining associated psychological and cognitive constructs, such as HRQoL, behavioral problems, and EF. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

National Presidential Election Turnout: 1952 to 2020

In an era when elections scholars expected American national presidential election turnout to increase, its steep, prolonged post-1960 decline sparked deep concern and generated an avalanche of individual-level analyses searching for explanation. The post-1960 decline, however, no longer dominates turnout’s trajectory; it has been on the upswing since 1996. This complicates our understanding as we have yet to settle on turnout’s description, much less its explanation. Here we introduce the first political science-oriented, multivariate modeling of American national presidential election turnout. Our results offer a mix of important confirmatory and original findings. First, we discover that modeling turnout’s decline as a post-1968 secular disturbance reveals turnout’s expected steady increase across the modern era (1952–2020). Second, we show that turnout’s increase can be traced to increased polarization working its influence indirectly through the direct, positive turnout affects of voter external efficacy and negative presidential campaign advertising (1960–2012).

The Validation of Solution Building Inventory in the Turkish Population 🇨🇳 🇫🇷 🇮🇷

This study aims to adapt Solution Building Inventory (SBI) to Turkish and examine its psychometric properties. The study group consisted of 278 individuals (195 females and 83 males), whose age range was between 18 and 23 years old. Solution Building Inventory, Dispositional Hope Scale, and Positive and Negative Affect Scale were used as measurements. The results of the exploratory factor analysis showed the suitability of the data for factor analysis and revealed a two-factor structure explaining 49.38% of the total variance. Confirmatory factor analysis findings showed that the model had a good fit in the 11-item and two-dimensional structure of the scale. Besides, the correlation coefficients of the relationship between the SBI and other scales were expectedly provided equivalent and convergent validity. In reliability analyzes, the Cronbach alpha internal consistency coefficient of the scale was found to be .85 for the scale in general, while it was calculated as .78 for the supporting solutions sub-dimension and .85 for the creating solutions sub-dimension. As a result, SBI is a measurement tool with proven validity and reliability in Turkish. Chinese (Simplified) (https://drive.google.com/file/d/1xuDuERmdIV8qEKy409KouUtzKg0iB-7W/view?usp=drive_link) French (https://drive.google.com/file/d/1qv_ICHog1TaT8ZRphDHhZCo1VI7kHjkc/view?usp=drive_link) Persian (https://drive.google.com/file/d/1T3pdgGgR4GoydgJYWHF2WeNOphKZBdyZ/view?usp=drive_link)

The Relationship Between Valence and Chills in Music: A Corpus Analysis.

Chills experienced in response to music listening have been linked to both happiness and sadness expressed by music. To investigate these conflicting effects of valence on chills, we conducted a computational analysis on a corpus of 988 tracks previously reported to elicit chills, by comparing them with a control set of tracks matched by artist, duration, and popularity. We analysed track-level audio features obtained with the Spotify Web API across the two sets of tracks, resulting in confirmatory findings that tracks which cause chills were sadder than matched tracks and exploratory findings that they were also slower, less intense, and more instrumental than matched tracks on average. We also found that the audio characteristics of chills tracks were related to the direction and magnitude of the difference in valence between the two sets of tracks. We discuss these results in light of the current literature on valence and chills in music, provide a new interpretation in terms of personality correlates of musical preference, and review the advantages and limitations of our computational approach.

The Selfitis Behavior Scale: An Adaptation Study

This study aimed to adapt the Selfitis Behavior Scale (SBS) to measure university students' selfitis behavior in Turkey. Within the scope of the study, the SBS was translated from English to Turkish. Data were collected in the validity and reliability studies from four study groups, including 343 university students. According to the confirmatory factor analysis findings, the SBS had good fit indices. As is expected, the criterion-related validity study found moderate- and highlevel positive correlations between the SBS subscales and total scores and the Selfie Attitude Scale (SAS) subscales and total scores. The other criterion-related validity study demonstrated that individuals taking a higher number of selfies than the sum of the scale and subscales scored significantly higher than individuals taking a lower number of selfies. The internal consistency coefficient was calculated to be .92 for the SBS total score, .78 for the Environmental Enhancement Subscale (SBS-EE), .68 for the Social Competition Subscale (SBS-SC), .72 for the AttentionSeeking Subscale (SBS-AS), .84 for the Mood Modification Subscale (SBS-MM), .82 for the SelfConfidence Subscale (SBS-S), and .70 for the Subjective Conformity Subscale (SBS-SCon). The test-retest correlation values found by applying the measurement tool once in four weeks were .77 (SBS), .70 (SBS-EE), .60 (SBS-SC), .82 (SBS-AS), .80 (SBS-MM), .61 (SBS-S), and .61 (SBSSCon), respectively. The mentioned findings demonstrated that the SBS was a valid and reliable measurement tool capable of measuring the selfitis behavior of university students in Turkey.

Musculoskeletal Brucellosis in Adults in the United Arab Emirates: A Retrospective Study

Introduction: Brucellosis is a zoonotic infection caused by the aerobic Gram-negative bacteria coccobacilli, and is considered a public health problem in the Mediterranean region and Arabian Peninsula. This paper studied the clinical characteristics of musculoskeletal brucellosis and the outcomes of treatment in Al Ain City, United Arab Emirates. Method: A retrospective chart review study was conducted at Tawam Hospital over seven years: January 2009–January 2016. Risk factors for brucellosis, musculoskeletal (MSK) manifestations, duration of Brucella infection (acute, subacute, chronic), and treatment were studied. Results: A total of 99 patients were diagnosed with brucellosis during the study period; the mean age was 44 years, the majority were males (71%), and the male to female ratio was 3:1. The most common risk factor for Brucella infection in the cohort was drinking raw milk (43.4%). Fever was the most common presenting symptoms (93%), followed by arthralgia, fatigue, and loss of appetite in 35, 21, and 14%, respectively. The clinical manifestations of brucellosis in the cohort were MSK involvement (30%), hepatitis (17%), epididymo-orchitis (2%), and endocarditis (1%). Thirty percent of patients (n=30) had MSK-specific symptoms and only one-third (n=10) had confirmatory positive radiographic findings. The majority of patients had lumbar and sacroiliac joint involvement. Most of the patients received antibiotics for a 4–8-week duration and the overall relapse rate of Brucella infection was 10%. Conclusion: This study demonstrates that MSK involvement is a common manifestation in brucellosis, occurring in one-third of the cases. The index of suspicion should be high in brucellosis-endemic countries for early recognition and treatment.

The utility of Vibratip in accurate identification of loss of protective sensation in the contralateral foot of patients admitted with a diabetic foot ulcer

Background and aimsDiabetic foot ulcer (DFU) is a debilitating complication of type 2 DM. Complexity of foot examination often precludes proper clinical assessment of the foot during routine evaluation. We assessed the utility of novel device, vibratip, both singly and in combination with standard bedside tools for assessment of loss of protective sensation. Methods75 patients admitted with DFU were included in the study. Clinical examination of the contralateral foot was done - temperature perception, vibration, pinprick sensation, Achilles tendon reflex and Neuropathy disability score were assessed. Testing using 10 g Monofilament, Vibratip and biothesiometer were also done. Considering the biothesiometer as the reference standard, three bedside tests (Vibratip, 10 g monofilament and 128 Hz tuning fork) were compared against it singly and in combinations. ResultsWhen compared against biothesiometer, vibratip performed significantly well with a positive predictive value of 90.3% and specificity of 84.2%. Sensitivity, however, was only 50%. On combining bedside tests, the best combination strategy was seen with vibratip and 10 g monofilament, which improved the sensitivity to 62.5%. Combining all three bedside tests further improved sensitivity to 64.3%. ConclusionAll the patients with an at-risk foot may not be identified with vibratip alone. Nevertheless, an abnormal result is almost always associated with loss of protective sensation, and such persons should be suitably educated. LimitationsDue to small size of the study population, it is not possible to generalize the findings to all patients with diabetes mellitus. A larger study would be required to provide more confirmatory findings.

The Role of Diagnostic Nasal Endoscopy and a Computed Tomography Scan (Nose and PNS) in the Assessment of Chronic Rhinosinusitis: A Comparative Evaluation of the Two Techniques

Introduction: The objective components of chronic rhinosinusitis (CRS) diagnosis require confirmatory findings from either diagnostic nasal endoscopy (DNE) or a computed tomography (CT) scan. Chronic rhinosinusitis affects a significant population worldwide, imposing a huge toll on the human economy as well as on quality of life. Thus, it is particularly important to define a cost-effective and easily available diagnostic tool for it. Hence, we have conducted this study with the aim of assessing the effectiveness of DNE in comparison with CT for evaluating CRS. Material and Methods: Eighty participants fulfilling the diagnostic symptom criteria of CRS underwent CTs of their noses and paranasal sinuses (PNS) and DNE. Standard Lund–Mackay and Lund–Kennedy scores were awarded to all participants based on the CT and DNE. A comparative analysis was done. Results: DNE in comparison to CT had 92.31% sensitivity, 73.33% specificity, 93.75% positive predictive value, 68.75% negative predictive value, and 88.75% diagnostic accuracy. Conclusion: We suggest that nasal endoscopy be used as an early diagnostic tool in the clinical assessment of suspected CRS patients (based on the diagnostic symptom criteria). DNE helps to decrease the usage of CT, thereby decreasing cost and radiation exposure. Computed tomography may be added for patients having anatomical defects (affecting endoscopic visualization) or refractory disease, and where surgery has been planned.

The protean manifestations of central nervous system IgG4-related hypertrophic pachymeningitis: a report of two cases

BackgroundIgG4-related hypertrophic pachymeningitis is a relative newly recognized and rare manifestation of IgG4-related disease, an immune-mediated fibroinflammatory tumefactive disorder. Fewer than 80 patients have been reported in the literature, and it can mimic common neurosurgical conditions. We describe the clinical presentation of two patients that were initially considered to have a subdural collection, tuberculous meningitis, and a cervical spinal meningioma, but were eventually diagnosed with this disease.Case presentationTwo ethnic Chinese men, 86 and 62 years old, experienced a 4-week history of headache. Both patients had a history of autoimmune disease, namely glomerulonephritis and Grave’s disease, respectively. Magnetic resonance brain imaging revealed diffuse dural thickening with the latter patient exhibiting homogeneous and intense gadolinium-contrast enhancement. Since the 86-year-old patient also had progressive bilateral visual loss, giant cell arteritis was suspected and a 2-week course of glucocorticoid therapy was prescribed, but his symptoms failed to improve. The 62-year-old patient also had accompanying low-grade fever and was treated empirically as having tuberculous meningitis although there were no confirmatory microbiological findings. This patient further developed right hemiparesis, and additional imaging revealed a C4/5 intradural-extramedullary contrast-enhancing lesion resembling a meningioma causing cord compression. Both patients underwent neurosurgical intervention with the former undergoing a dural biopsy and the latter having the cervical lesion resected. The final diagnosis was IgG4-related hypertrophic pachymeningitis with the hallmark histological features of lymphoplasmacytic infiltration of IgG4+ plasma cells, storiform fibrosis, and obliterative phlebitis. In addition, their serum IgG4 levels were elevated (i.e., > 135 mg/dL). Both patients received at least 6 months of glucocorticoid therapy while the latter also had azathioprine. Their symptoms improved significantly and recurrent lesions were not detected on follow-up imaging.ConclusionsA high index of suspicion for this condition is suggested when a male patient with a history of autoimmune disease and compatible radiological findings, experiences subacute headache that is disproportionate to the degree of dural involvement. Neurosurgeons should consider early meningeal biopsy to establish a definitive histological diagnosis in order for early effective immunosuppressive treatment to be initiated and to avoid unnecessary morbidity.

A Visual Analytics Approach for Ecosystem Dynamics based on Empirical Dynamic Modeling.

An important approach for scientific inquiry across many disciplines involves using observational time series data to understand the relationships between key variables to gain mechanistic insights into the underlying rules that govern the given system. In real systems, such as those found in ecology, the relationships between time series variables are generally not static; instead, these relationships are dynamical and change in a nonlinear or state-dependent manner. To further understand such systems, we investigate integrating methods that appropriately characterize these dynamics (i.e., methods that measure interactions as they change with time-varying system states) with visualization techniques that can help analyze the behavior of the system. Here, we focus on empirical dynamic modeling (EDM) as a state-of-the-art method that specifically identifies causal variables and measures changing state-dependent relationships between time series variables. Instead of using approaches centered on parametric equations, EDM is an equation-free approach that studies systems based on their dynamic attractors. We propose a visual analytics system to support the identification and mechanistic interpretation of system states using an EDM-constructed dynamic graph. This work, as detailed in four analysis tasks and demonstrated with a GUI, provides a novel synthesis of EDM and visualization techniques such as brush-link visualization and visual summarization to interpret dynamic graphs representing ecosystem dynamics. We applied our proposed system to ecological simulation data and real data from a marine mesocosm study as two key use cases. Our case studies show that our visual analytics tools support the identification and interpretation of the system state by the user, and enable us to discover both confirmatory and new findings in ecosystem dynamics. Overall, we demonstrated that our system can facilitate an understanding of how systems function beyond the intuitive analysis of high-dimensional information based on specific domain knowledge.

Clinical indications for total abdominal hysterectomy among women seen in Dar es Salaam regional referral hospitals, Tanzania: a prospective, observational hospital-based study.

Total abdominal hysterectomy is among the commonest gynaecologic surgeries observed in Africa. However, there exists a gap in published data to support this hypothesis. Information on hysterectomies reported from sub-Saharan Africa reflects mostly obstetric indications. A prospective hospital-based study was conducted in Dar es Salaam, Tanzania from March-October 2017. Women attending the facilities with clinical conditions necessitating abdominal hysterectomies were the target population. Each woman was followed from the time of planning for surgery until at most 72-hours post-surgery or discharge from the wards whichever came first. Continuous variables were summarized using median (with corresponding inter-quartile range). Categorical variables were summarized using frequency (%). Data outputs were created using SAS version 9.4. Verbal informal consent was sought from each individual prior to inclusion to this study. We recruited and prospectively followed-up 107 patients. Median age of participants was 42 (IQR: 37-47) years. Uterine leiomyoma (84.1%) was the leading indication for hysterectomy. Only about a third (30.8%) of followed-up women had provisional diagnoses at the time of surgery. None of the study participants reported receipt for confirmatory histological findings of her uterus up to the hospital discharge time post-surgery.

"Oh, that I Had Wings Like a Dove..." Psalm 55 and Breaking the Silence about Violence against Women

In this article, the author looks at suffering in Ps 55 from the perspective of women as victims of sexual violence. The research problem and gap addressed concern residual questions regarding the world of the text and the setting of the lament in earlier stages of its redaction and composition. The discussion takes its inspiration from a reading of Ulrike Bail wherein the speaker of Ps 55 appears to be resorting to forms and contents of expression associated with the trauma of rape. In supplementary relation to this, a reader response approach is adopted aiming to show how a female persona as the projected narrator and her language of distress relate to conceptions of sexual assault. The study thus offers confirmatory findings from Ps 55 of how women use words and ways of lamentation to break the silence and seek to cope with the devastating physical and psychological effects of rape. https://doi.org/10.17159/2312–3621/2021/v34n1a16