Cut-off Criteria Research Articles

Revisiting extraprostatic extension based on invasion depth and number for new algorithm for substaging of pT3a prostate cancer

Extraprostatic extension (EPE) is a factor in determining pT3a stage in prostate cancer. However, the only distinction in EPE is whether it is focal or non-focal, causing diagnostic and prognostic ambiguity. We substaged pT3a malignancies using classification of EPE to improve personalized prognostication. We evaluated 465 radical prostatectomy specimens with a digital image analyzer by measuring the number, radial distance and two-dimensional square area of the EPE. The most significant cut-off value was proposed as an algorithm for the pT3a substaging system to predict biochemical recurrence (BCR). A combination of the radial distance and the number of EPEs predicted BCR the most effectively. The optimal cut-off criteria were 0.75 mm and 2 mm in radial distance and multifocal EPE (hazard ratio: 2.526, C-index 0.656). The pT3a was subdivided into pT3a1, < 0.75 mm and any number of EPEs; pT3a2, 0.75–2 mm and one EPE; and pT3a3, > 2 mm and any number of EPEs or 0.75–2 mm and ≥ 2 EPEs. This combined tier was highly significant in the prediction of BCR-free survival. The combination of radial distance and number of EPEs could be used to subdivide pT3a prostate cancer and may aid in the prediction of BCR.

P-46 Integrated transcriptomics and the exploration of cancer-promoting genes CDKN3 in esophageal squamous cell cancer

The aims of the present study were to explore the critical genes related to the development of ESCC by integrated transcriptomics and to investigate the clinical significance by experimental validation. The datasets of protein-coding gene expression which are involved in ESCC were downloaded from the GEO database. The “Robustrankaggreg” package was used for data integration, and the different expression genes (DEGs) were identified based the cut-off criteria as follows: adjust p-value < 0.05, |Log2 fold change (FC)| ≥ 1.5; The protein expression of seed gene in 184 cases of primary ESCC were detected by immunohistochemistry; The relationship between the expression level of seed genes and clinical significance were analyzed. A total of 244 DEGs were identified by comparing gene expression patterns between ESCC patients and the controls based on integrating dataset of GSE77861, GSE77861, GSE100942, GSE26886, GSE17351, GSE38129, GSE33426, GSE20347 and GSE23400; The CDKN3 were identified as the seed gene of top cluster by use of PPI network and plug-in MCODE; The level of CDKN3 mRNA was significantly increased in ESCC patients compared to controls. The positive expression rate of CDKN3 protein in ESCC tissue samples was 32.0% and 61.4% in control, respectively, and differences were statistically significant. There was a significant correlation between the expression level of CDKN3 and lymph node metastasis or clinical staging of ESCC patients. Integrated transcriptomics is an efficient approach to system biology. By this procedure, our study improved the understanding of the transcriptome status of ESCC.

Optimizing Human Intestinal Enteroids for Environmental Monitoring of Human Norovirus.

Human noroviruses (HuNoV) are the leading cause of gastrointestinal illness and environmental monitoring is crucial to prevent HuNoV outbreaks. The recent development of a HuNoV cell culture assay in human intestinal enteroids (HIEs) has enabled detection of infectious HuNoV. However, this complex approach requires adaptation of HIEs to facilitate HuNoV replication from environmental matrixes. Integrating data from 200 experiments, we examined six variables: HIE age, HIE basement membrane compounds (BMC), HuNoV inoculum processing, HuNoV inoculum volume, treatment of data below limit of detection (LOD), and cutoff criteria for determining positive HuNoV growth. We infected HIEs with HuNoV GII.4 Sydney positive stool and determined 1.4 × 103 genome equivalents per HIE well were required for HuNoV replication. HIE age had minimal effect on assay outcomes. LOD replacement and cutoff affected data interpretation, with lower values resulting in higher estimated HuNoV detection. Higher inoculum volumes lead to minimal decreases in HuNoV growth, with an optimal volume of 250uL facilitating capture of low concentrations of HuNoVs present in environmental isolates. Processing of HuNoV inoculum is valuable for disinfection studies and concentrating samples but is not necessary for all HIE applications. This work enhances the HuNoV HIE cell culture approach for environmental monitoring. Future HIE research should report cell age as days of growth and should clearly describe BMC choice, LOD handling, and positive cutoff.

A quick test of cognitive speed (AQT): regression-based norms for cognitively healthy 80 to 94-year olds

ABSTRACT Slowed processing speed is part of normal aging but also a symptom of many diseases, including dementia. A Quick Test of Cognitive Speed (AQT) consists of three conditions: color naming (AQT1), form naming (AQT2) and dual color-form naming (AQT3) and offers a user-friendly assessment of processing speed that is used internationally to identify cognitive impairment in elderly patients. Appropriate age-norms have however been lacking. This study provides regression-based norms derived from a Swedish sample of 158 cognitively healthy 80 to 94-year olds. The results show age effects in all three conditions, a non-linear education effect in AQT1, and age by gender interactions in AQT2 and AQT3: men performed worse with increasing age, but women remained on a par. However, irrespective of age and gender, AQT2 and AQT3 mean raw and predicted scores were slower than the hitherto recommended cutoff criteria for suspected cognitive impairment.

Foramen Magnum Angle: A New Parameter for Basilar Invagination of Type B

To describe the foramen magnum angle (FMA) as a new parameter for basilar invagination (BI) type B. The FMA was performed on sagittal slice of magnetic resonance imaging (MRI) as a line from the hard palate to the opisthion (angle vertex), and another line from the opisthion to the basion. The MRIs from 31 participants with BI type B and 96 controls were used. Intraclass correlation coefficient, descriptive data, and receiver operating characteristic (ROC) curve were used for statistical analysis at the 95% confidence interval. The interobserver agreement of the FMA was 0.952. Patients with BI type B had a FMA significantly greater (25.9° ± 9.3°) than control participants (11.6° ± 4.9°) (P < 0.001). The area under the ROC curve showed a diagnostic value of 0.947. The FMA showed sensitivity 0.900 and specificity 0.854 for the cutoff criterion 17° (P < 0.001). The FMA had an optimal diagnostic value that provided complementary evidence to investigate BI type B.

Integrated transcriptomics explored the cancer-promoting genes CDKN3 in esophageal squamous cell cancer

Background and objectivesEach individual studies is limited to multi-factors and potentially lead to a significant difference of results among them. The present study aim to explore the critical genes related to the development of Esophageal squamous cell carcinoma (ESCC) by integrated transcriptomics and to investigate the clinical significance by experimental validation.MethodsDatasets of protein-coding genes expression which involved in ESCC were downloaded from Gene Expression Omnibus (GEO) database. The “Robustrankaggreg” package in language was used for data integration, and the different expression genes (DEGs) were identified based the cut-off criteria as follows: adjust p-value < 0.05, |fold change (FC)| ≥ 1.5; The protein expression of seed gene in 184 cases of primary ESCC tissues and 50 tumor adjacent normal tissues (at least 5 cm away from the tumor, and defind as the controls) were detected by immunohistochemistry; The relationship between the expression level of seed genes and clinical parameter were analyze. Enumeration data were represented by frequency or percentage (%) and were tested by x2 test. The P value of less than 0.05 was considered statistically significant.ResultsA total of 244 DEGs were identified by comparing gene expression patterns between ESCC patients and the controls based on integrating dataset of GSE77861, GSE77861, GSE100942, GSE26886, GSE17351, GSE38129, GSE33426, GSE20347 and GSE23400; The Cyclin-dependent kinase inhibitor 3 (CDKN3) were identified the top 1 seed gene of top cluster by use of protein-protein Interaction network and plug-in Molecular Complex Detection; The level of CDKN3 mRNA was significantly increased in ESCC patients compared to controls; The positive expression rate of CDKN3 protein in ESCC tissue samples was 32 and 61.4% in control, respectively. The correlations between the expression level of CDKN3 and lymph node metastasis or clinical staging of ESCC patients are statistically significant.ConclusionIntegrated transcriptomics is an efficient approach to system biology. By this procedure, our study improved the understanding of the transcriptome status of ESCC.

Incremental Model Fit Assessment in the Case of Categorical Data: Tucker–Lewis Index for Item Response Theory Modeling

The Tucker–Lewis index (TLI; Tucker & Lewis, 1973), also known as the non-normed fit index (NNFI; Bentler & Bonett, 1980), is one of the numerous incremental fit indices widely used in linear mean and covariance structure modeling, particularly in exploratory factor analysis, tools popular in prevention research. It augments information provided by other indices such as the root-mean-square error of approximation (RMSEA). In this paper, we develop and examine an analogous index for categorical item level data modeled with item response theory (IRT). The proposed Tucker–Lewis index for IRT (TLIRT) is based on Maydeu-Olivares and Joe's (2005) M_2 family of limited-information overall model fit statistics. The limited-information fit statistics have significantly better Chi-square approximation and power than traditional full-information Pearson or likelihood ratio statistics under realistic situations. Building on the incremental fit assessment principle, the TLIRT compares the fit of model under consideration along a spectrum of worst to best possible model fit scenarios. We examine the performance of the new index using simulated and empirical data. Results from a simulation study suggest that the new index behaves as theoretically expected, and it can offer additional insights about model fit not available from other sources. In addition, a more stringent cutoff value is perhaps needed than Hu and Bentler's (1999) traditional cutoff criterion with continuous variables. In the empirical data analysis, we use a data set from a measurement development project in support of cigarette smoking cessation research to illustrate the usefulness of the TLIRT. We noticed that had we only utilized the RMSEA index, we could have arrived at qualitatively different conclusions about model fit, depending on the choice of test statistics, an issue to which the TLIRT is relatively more immune.

Cycle cut-off criterion effect on the performance of cascaded, sensible, combined sensible-latent heat storage tank for concentrating solar power plants

Thermocline thermal energy storage (TES) technology that uses the molten salt as heat transfer fluid is cheaper than a traditional two-tank structure, owing to its composite design and use of inexpensive filler materials. Nevertheless, this TES type suffers from the significant disadvantage of low capacity and utilization ratio when it is integrated with concentrating solar power plants due to moderate charge/discharge cut-off values. The primary purpose of the current research is to investigate and evaluate the impact of the change charge/discharge cut-off values on the thermal performance of six different TES tank configurations. First, the equations for the dispersion-concentric model were approached through the MATLAB program, and then the present research results are authenticated. The results show that the thermocline zones shrink when the charge cut-off value rises, and the discharge cut-off value reduces because a higher charge cut-off value and a smaller discharge cut-off value permit a longer charge/discharge time. Moreover, when the cut-off value of the charge/discharge changes simultaneously, the combined sensible-latent heat storage configuration has the highest capacity ratio, utilization ratio, recovered energy, and overall efficiency, which equals 90.55%, 83.3%, 147.2 MWh, 91.3%, respectively, at low charge cut-off value.

Apolipoprotein A2 in the Brain: Quantitative Proteomic Analysis of Brain Tissue Reveals Perturbed Mitochondrial Signaling in ApoA2‐Knockout Mice

Objectives Apolipoprotein A2 (ApoA2) gene expression is deterministic of apnea and have broad effects on breathing and fictive brainstem phrenic rhythm stability (Gillombardo et al, 2016 and 2017). ApoA2 is the second most abundant apolipoprotein in the circulation, however, there is a lack of fundamental information relevant to its presence and actions in the brain. Our previous data showed no ApoA2 protein in the KO mouse; and a lesser abundance of the protein in WT brain in comparison to either WT liver or plasma (P=0.0001). To gain a mechanistic understanding of the systems-level perturbations mediated by ApoA2 presence (ApoA2-wild type, WT) or absence (ApoA2 knockout, KO), we performed a quantitative proteomics and pathway analyses. Methods Brain tissue samples (WT, n= 8; KO, n=8) were lysed, FASPed, and trypsin digested (Azzam et al 2016 and 2017). Each sample was then analyzed by LC-MS/MS using LTQ Orbitrap Elite mass spectrometer (MS). Differential quantification of peptides was performed using Rosetta Elucidator quantitative software. Peptide and protein assignments were made using peptide and protein teller algorithm (FDR <2%). Analysis of variance (ANOVA) was performed to calculate the P-value Protein fold changes (FC) were determined by dividing the average protein intensity for each peptide in each group. Significant proteins (P-value ≤ 0.05 and FC with ≤-2 and ≥+2) were imported into Ingenuity Pathway Analysis (IPA) for network and pathway analyses. Protein expression of selected target proteins was validated using Selected Reaction Monitoring (SRM)-MS. Results A total of 6307 peptides were identified and quantified. Of those, 1150 peptides mapping to 298 unique proteins were differentially expressed across groups based on three cutoff criteria (P-value ≤0.05, two or more peptides per protein, and fold change of 2 or greater). IPA analysis identified mitochondrial function (oxidative phosphorylation, citric acid cycle and respiratory electron transport) as the top dysregulated canonical pathway. Furthermore, alteration of mitochondrial proteins including ATP-citrate synthase, V-type proton ATPase subunit C1, cytochrome c oxidase subunit 5A, and cytochrome b-c1 complex subunit 2 was confirmed by SRM analysis. This finding is consistent with our previous quantitative proteomic and pathway analyses of liver tissue that have indicated an effect of ApoA2 on mitochondrial electron transport chain. Conclusions Quantitative proteomics and pathway analyses identify perturbations in mitochondrial signaling as a consequence of ApoA2 loss with implication for energy homeostasis and cellular bioenergetics systems in the brain.

Performance of Korean-English bilinguals on an adaptation of the screening bilingual aphasia test.

The use of standardized tests specifically designed for and normed on bilingual groups is crucial for the accurate diagnosis and language profiling of bilingual speakers with aphasia. Currently, there is a dearth of norms and supporting psychometric data for the few available bilingual aphasia assessments. The only available aphasia test for Korean-English (KE) bilinguals is the Korean-English Bilingual Aphasia Test (KE-BAT). The absence of bilingual normative data for the KE-BAT limits its clinical and research utility. (1) To revise the original screening KE-BAT to clarify ambiguities in its instructions and stimuli; and (2) to examine subtest and item performance across the two languages for the revised screening KE-BAT with a local sample of highly proficient KE bilinguals. The original screening KE-BAT was first revised to replace unrecognizable drawings, address ambiguities in the instructions and stimuli, and increase the number of items on naming subtests. This revised test is henceforth referred to as the adapted screening KE-BAT (AS KE-BAT). A total of 21 neurologically healthy, highly proficient and college-educated KE bilinguals (19-34 years old) were recruited from a large city in the United States. Participants completed three measures of language proficiency and the AS KE-BAT including the KE translation test (Part C). Total and subtest scores were compared across the two languages, and individual item accuracy was calculated. Incorrect responses of low scoring items were examined. Performance was comparable across Korean and English for all subtests, except for the spontaneous speech subtest. The item accuracy of 17 items (7% of total items) in the AS KE-BAT fell to < 80%, and four items (1.6% of total items) had an accuracy < 60%. Incorrect responses of low scoring items were caused by phoneme misperception, lexical substitution and morphosyntactic L2 patterns. The results of the study highlight the importance of empirically examining the performance of neurotypical bilinguals on bilingual aphasia assessments to establish their psychometric properties. Based on the small-sized local bilingual normative sample obtained in this study, appropriate cut-off criteria, recommendations for clinical interpretation and further modifications of the AS KE-BAT are proposed. What is already known on the subject The pair of English and Korean aphasia assessments (e.g., Western Aphasia Battery-Revised; WAB-R) (Kertesz 2012) and Korean Western Aphasia Battery (Kim and Na 2001) cannot be used to assess language impairments in KE bilinguals with aphasia since these tests have not been designed for and normed on the bilingual group. Clinical utility of the Korean-English Bilingual Aphasia Test (KE-BAT), which is the only resource currently available to assess KE bilinguals with aphasia, is greatly compromised by the lack of KE bilingual normative data. What this study adds to existing knowledge This study provides cut-off scores, comparability of test performance and item difficulty metrics and it identifies additional ways in which items and spontaneous speech scoring of the adapted screening KE-BAT (AS KE-BAT) could be modified. Suggested guidelines allow improved interpretations of the linguistic performance of local KE bilinguals with aphasia who have a similar demographic and linguistic background. What are the potential or actual clinical implications of this work? The AS KE-BAT with cut-off criteria of 95% for Part B and 80% for Part C is suitable for the language assessment of highly proficient and young KE bilinguals with a high level of education and it yields comparable performance across the two languages. Clinicians may decide to adjust spontaneous speech scoring criteria if the client's language history is suggestive of code-switching and use the item difficulty data to guide test item selection for this group of bilinguals.

Exploration of the minimum visual disability criteria for Para nordic and Para alpine skiing using simulated vision impairments

ABSTRACT The International Paralympic Committee Classification Code requires sports to develop evidence-based, sports-specific classification systems. This project aimed to determine the minimum eligibility criteria for Para nordic and Para alpine skiing by simulating vision impairments and measuring the impact of the impairments on performance in twenty-two nordic (28.09 ± 9.68 years; 16 male) and eleven alpine (37.91 ± 18.9 years, 11 male) able-sighted skiers. Eight visual acuity (VA)/contrast sensitivity (CS) (Cambridge Simulation Glasses, University of Cambridge) and six visual field (VF) impairments (bespoke goggles; University of Waterloo) were simulated. VA, CS and VF were measured in each participant before they completed an on-snow session, skiing short competition-style courses with each of the 14 simulated impairments in a randomized order. Clear goggle (no impairment) trials were used as controls. Receiver Operating Characteristic (ROC) and decision tree analyses were conducted to determine the optimum VA, CS and VF cut-offs for classifying performance based on differences from baseline in real time. Moderate impairments in VA, CS and VF negatively affect skiing performance. The recommended cut-off criteria based on both analyses were VA ≥0.90 logMAR and ≤48% VF extent for nordic and VA of ≥0.60 logMAR and VF extent of ≤59.0% for alpine.

Depression as a Risk Factor for Alzheimer's Disease: A Systematic Review of Longitudinal Meta-Analyses.

Alzheimer’s disease (AD) is the most frequent cause of dementia, linked to morbidity and mortality among elderly patients. Recently, several clinical studies suggested that depression is a potential risk factor for cognitive decline and AD. A review of meta-analyses was performed, calculating pooled odds ratios to estimate the risk of AD in people with a prior diagnosis (or clinically significant symptoms) of depression. A total of six meta-analyses which represented 28 individual studies were analyzed. A significant association between depression and AD was found (OR = 1.54, 95% CI [1.02–2.31]; p = 0.038). The results showed that heterogeneity across studies was substantial. We found a significant positive effect size for clinical measures of depression, but not for symptomatic rating scales, in the association of depression with risk of AD. The type of rating scale used to assess depression and the cut-off criteria selected also moderated the relationship between depression and AD risk. We found that studies that used clinically significant criteria for diagnosis of depression had more consistent and significant results than studies that used symptomatic scales.

The Higher Prevalence of Learning Disabilities in Children With Idiopathic Epilepsy in China

Background: Although school-age children with epilepsy are at a high risk of developing comorbid learning disabilities, there is a lack of empirical research to confirm the prevalence of learning disabilities among children with idiopathic epilepsy in China. Further, previous research has not confirmed whether children with epilepsy have a higher prevalence rate of learning disabilities than other school-age children. Methods: The current study aims to examine the prevalence and gender ratios of dyscalculia, dyslexia, and comorbidity among children with idiopathic epilepsy and other school-age children in China. Specific screening tests in arithmetic fluency (dyscalculia), reading fluency (dyslexia), and their co-occurrence were administered in a large population-based sample of children with epilepsy (N = 2,282) and other school-age children (N = 2,371). The prevalence of dyscalculia, dyslexia and comorbidity were calculated based on three cutoff criteria. Findings: The results showed that children with idiopathic epilepsy, when compared to other school-age children, have significantly higher prevalence rate of dyscalculia (-1 SD cutoff: 7·6% vs. 3·8%, -1·5 SD cutoff: 4·1% vs. 2·4%), dyslexia (-1 SD cutoff: 9·0% vs. 3·7%, -1·5 SD cutoff: 3·9% vs. 2·0%) and comorbidity (-1 SD cutoff: 5·1% vs. 1·4%, -1·5 SD cutoff: 1·5% vs. 0·4%, -2 SD cutoff: 0·4% vs. 0·1%). Moreover, gender differences in the prevalence rate of dyslexia only appeared among other school-age children. Interpretation: The results suggest that children with idiopathic epilepsy are more vulnerable to dyscalculia and dyslexia compared to other school-age children. Risk factors in the idiopathic epilepsy population should be identified to formulate effective prevention strategies. Moreover, gender differences on the prevalence of dyscalculia, dyslexia and comorbidity only exist among typical school-age children, which might be explained by clinical factors related to idiopathic epilepsy, therefore, future studies could make further examination. Funding: Funding Natural Science Foundation of China (Grant No. 31700977, 31671151), Natural Science Foundation of Beijing (Grant No. 5212004), The 111 Project (Grant No. BP0719032), Advanced Innovation Center for Future Education (Grant No. 27900-110631111), Directional Guidance Fund for the Capital Institute of Pediatrics (Grant No. FX-2019-03). Declaration of Interest: We declare no competing interests. Ethical Approval: This study was approved by the Human Research Ethics Committee at the Capital Institute of Pediatrics (approval no.: SHERLL 2019001). We also obtained oral consent from participants and informed consent signed by their guardians.

Outlier Detection of Water Quality Data Using Ensemble Empirical Mode Decomposition

Objectives : This study was conducted to propose a new methodology for efficiently identifying and removing various outliers that occur in data collected through automated water quality monitoring systems. In the present study, water temperature data were collected from domestic G_water supply system, and the performance of the proposed methodology was tested for water temperature data collected from domestic G_water supply system.Methods : We applied the following analytical procedure to identify outliers in the water quality data: First, a normality test was performed on the collected data. If normality condition was satisfied, the Z-score was used. However, if the normality condition was not satisfied, outliers were identified using the quartile, and the limitations of the existing methodology were analyzed. Second, we decomposed the intrinsic mode function using empirical mode decomposition and ensemble empirical mode decomposition for the collected data, and then considered the occurrence of modal mixing. Finally, a group of intrinsic mode functions was selected using statistical characteristics to identify outliers. In addition, the performance of the method was verified after removing and interpolating outliers using regression analysis and Cook’s distance.Results and Discussion : In the case of water temperature data, as normality condition was not satisfied, outlier identification was carried out by applying the modified quartile method. It was confirmed that outliers distributed within the seasonal component could not be identified at all. In the case of empirical mode decomposition, modal mixing occurred because of the effect of outliers. However, in the case of the ensemble empirical mode decomposition, modal mixing was resolved and the distinct seasonal components were decomposed as intrinsic mode functions. The intrinsic mode functions were synthesized, which showed statistical correlation with the raw water temperature data. As a result of developing a regression model using the synthesized intrinsic mode functions and raw water temperature data and performing outlier search based on Cook’s distances, we concluded that various outliers distributed within the seasonal component could be effectively identified.Conclusions : Considering that satisfactory results could be derived from statistical analysis of the data collected from the automated water quality monitoring system, it can be concluded that outlier identification procedures are essential. However, in the case of the conventional univariate outlier search method, it is apparent that the outlier search performance is significantly poor for data with strong inherent variability, and the interpolation method for the searched outlier cannot be performed. Conversely, the outlier identification method based on ensemble empirical mode decomposition and regression analysis proposed in this study shows excellent discrimination performance for outliers distributed in data with strong inherent variability. Moreover, this method has the advantage of reducing the analyst’s dependence on subjective judgment by presenting statistical cutoff criteria. An additional advantage of the method is that data can be interpolated after removing outliers using intrinsic mode functions. Therefore, the outlier search and interpolation method proposed in this study is expected to have greater applicability as a more effective analysis tool compared to the existing univariate outlier search method.

A multi-surface interface model for sequentially linear methods to analyse masonry structures

In the finite element modelling of masonry structures, the micro-modelling technique of differentiating the continuum into a linear elastic bulk, and interfaces representing non-linear joints is common. However, this approach of simulating cracking-crushing-shearing failure possibilities in interfaces, typical of damage in masonry, also poses numerical stability issues due to the quasi-brittle nature of the failure. In this regard, the article proposes the use of numerically robust sequentially linear procedures and a suitable discretised tension-shear-compression failure model for interfaces. Sequentially linear solution procedures describe the nonlinear response of a specimen/structure through a sequence of scaled linear analyses, each of which represents locally applied damage increments, using secant-stiffness based discretised constitutive relations called saw-tooth laws. The constitutive formulation proposed herein includes a tension cut-off criterion combined with a uniaxial discretised softening law, a Coulomb friction criterion with a discretised cohesion softening law, and a compression cut-off criterion combined with a uniaxial discretised hardening–softening law. It is presented for both two-dimensional (2D) line interfaces and three-dimensional (3D) planar interfaces. The applicability of these formulations are illustrated using 2D and 3D models of a pushover analysis on a squat unreinforced masonry wall. The simulations are made using Sequentially Linear Analysis (SLA) and the Force-Release method, which are total (load-unload) and incremental sequentially linear methods respectively. The clear global softening in the force–displacement evolution and the localised brittle shear failure observed in the experiment are reproduced well and in a stable manner.

Mass-Like Fat at the Medial Midfoot: A Common Pseudolesion.

Background Fatty masses are common and may be encountered in the foot and ankle. In some cases, normal subcutaneous fat may be mistaken for a discrete mass. Aims The aim of this study was to evaluate the common finding of prominent subcutaneous fat at the medial midfoot resembling a lipoma and to determine the prevalence of this pseudolesion by applying a series of potential size cutoff criteria. Materials and Methods Three musculoskeletal radiologists retrospectively evaluated 91 sequentially performed magnetic resonance imaging examinations of the ankle to measure fat resembling a discrete lipoma at the medial midfoot. Each blinded reader measured the largest area of continuous subcutaneous fat in orthogonal axial, coronal craniocaudal, and coronal transverse dimensions. Patient age, sex, and study indications were also recorded. Statistical analysis was performed with R and SAS 9.4 software Results A discrete fatty pseudolesion as defined by measuring at least 1 cm in all planes by measurements of at least two of three readers was present in 87% of cases (79 of 91). When a size criterion of 1.5 cm was used, a pseudolesion was documented in 14% of cases (13 of 91). There was a significant correlation between larger pseudolesion size and female sex in the axial plane; however, there was no correlation in the coronal craniocaudal and coronal transverse dimensions. Conclusions Subcutaneous fat at the medial midfoot often has a mass-like appearance that could be mistaken for a lipoma. It is important to recognize this pseudolesion variant and not to confuse the imaging appearance for a discrete mass.

Assessment models and dynamic variables for dynamic life cycle assessment of buildings: a review.

Life cycle assessment (LCA) is widely used to quantify the environmental performance of buildings. Recently, the potential temporal variations in the lifetime of buildings and their influences on assessment results have attracted considerable attention. Dynamic LCA (DLCA) is an emerging research topic. This study provides an overview of the current scenario of DLCA studies in the building field. A literature survey was conducted by searching through scientific literature databases; 48 articles met the inclusion criteria. Eleven dynamic variables as well as their addressing approaches were summarized and analyzed. A few typical dynamic assessment models were synthesized and compared to present the methodology progress. Finally, considering the existing limitations, a few research directions were recommended: setting cutoff criteria for dynamic variables, developing a dynamic database, and considering the interactions between dynamic variables. The analyses in this study indicate that research on the DLCA of buildings needs interdisciplinary cooperation. This review promotes in-depth understanding about DLCA research of buildings and offers valuable implications for environmental practice. The highlighted future research directions facilitate further explorations in this research area.

A Systematic Review of Job Loss Prevention Interventions for Persons with Inflammatory Arthritis.

Purpose To present an overview of the evidence of the effect of job loss prevention interventions, aiming to improve work ability and decrease absenteeism and/or job loss in persons with inflammatory arthritis (IA). Method A systematic literature search in the databases PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Library was conducted. A search strategy used in a review from 2014 was copied and additional keywords were added with no time restriction. The Cochrane Risk of Bias Tool (RoB 1) was used for quality assessment and the overall quality of each study was determined using predetermined cut-off criteria, categorising studies to be of good-, acceptable- or low quality. Results were summarised narratively. Results Six randomised controlled trials (published in seven articles) were included, one of good quality and five of acceptable quality. One study identified significant improvements in work ability, while three found no significant difference between groups. One study identified significant difference in absenteeism, while two studies identified no difference between the intervention and control groups. Two studies identified significant reduction in job loss, while two studies identified no group difference. The inconsistent results may be due to heterogeneity in interventions and outcome measures used, and the results should therefore be interpreted with caution. Conclusion The results indicate that job loss prevention interventions may have an effect on work ability, absenteeism and in particular job loss among persons with IA. Further good-quality studies regarding job loss prevention interventions for people with IA are still recommended.

Typhoon eye effect versus ripple effect: the role of family size on mental health during the COVID-19 pandemic in Pakistan

BackgroundThe recent outbreak of COVID-19 has impacted adversely upon the mental health of millions of people worldwide. Impacts on the mental health conditions and the associated predictors relating to adults in Pakistan, the fifth most populous country in the world, during the COVID-19 remain understudied. Our aim was to investigate distress, anxiety, and overall mental health and their associated predictors among Pakistani adults in this pandemic. We specifically examine mental health issues based on the distance from the epicenter, (a predictor that has revealed opposing evidence in other countries) based on the theories of typhoon eye effect and ripple effect. The sample consisted of 601 adults who were surveyed online about 2.5 months into the outbreak across Pakistan with varying distances from the epicenter of COVID-19 of Karachi.ResultsThe results showed that 9.2 and 19.0% of the participants surpassed the cut-off criteria for distress and anxiety disorders, respectively. Overall, the distance from the epicenter positively predicted the mental health of adults in Pakistan, and family size negatively moderated this effect. The distance from the epicenter negatively predicted distress and anxiety disorders for adults in large families, which are quite common in Pakistan.ConclusionThe evidence of the study interestingly finds that the prediction of the mental health of people by their distance from the epicenter depends on family size. The evidence of this study can help to provide initial indicators for mental health care providers to screen vulnerable groups in Pakistan, a populous country that continues struggling to cope with the COVID-19 pandemic.

Analysis of the Characteristics of Environmental Impacts According to the Cut-Off Criteria Applicable to the Streamlined Life Cycle Assessment (S-LCA) of Apartment Buildings in South Korea

This study analyzed the characteristics of the environmental impacts of apartment buildings, a typical housing type in South Korea, as part of a research project supporting the streamlined life cycle assessment (S-LCA) of buildings within the G-SEED (Green Standard for Energy and Environmental Design) framework. Three recently built apartment building complexes were chosen as study objects for the quantitative evaluation of the buildings in terms of their embodied environmental impacts (global warming potential, acidification potential, eutrophication potential, ozone layer depletion potential, photochemical oxidant creation potential, and abiotic depletion potential), using the LCA approach. Additionally, we analyzed the emission trends according to the cut-off criteria of the six environmental impact categories by performing an S-LCA with cut-off criteria 90–99% of the cumulative weight percentile. Consequently, we were able to present the cut-off criterion best suited for S-LCA and analyze the effect of the cut-off criteria on the environmental impact analysis results. A comprehensive environmental impact analysis of the characteristics of the six environmental impact categories revealed that the error rate was below 5% when the cut-off criterion of 97.5% of the cumulative weight percentile was applied, thus verifying its validity as the optimal cut-off criterion for S-LCA.