Test Execution Research Articles

The Influence of Classroom Size and Window View on Young Children's Executive Functions and Physiological Responses, Based on VR Technology.

Despite the increasing enrollment of young children in childcare institutes, there have been few empirical studies on the effects of spatial elements on their development. This study explored the impact of preschool classroom size (large vs. small) and window view (natural vs. built environment) on young children's executive functions and physiological stress responses, using cortisol and heart rate variability (HRV) as indicators and employing virtual reality (VR) technology. Out of 144 participants aged 61-85 months, three were excluded due to missing values and outliers. Executive function tests were administered, and saliva samples were collected before and after VR exposure; HRV data were gathered during the experience. ANCOVA results indicated significant improvements in cognitive flexibility, as measured based on the Dimensional Change Card Sorting task, in the large classroom condition, and a marginally significant decrease in visuo-spatial working memory, as measured with the Corsi block task, in the small classroom condition. The classroom size conditions did not significantly differ in cortisol response, but the large classroom condition showed marginally significant HRV indices, suggesting increased relaxation. No significant effects on executive functions or physiological responses were found in either window view condition. Overall, the findings suggest that classroom size may influence young children's cognitive flexibility.

MRI white matter hyperintensities and neuropsychological performance in a clinical sample

Objective White-matter hyperintensities (WMH) are commonly observed on MRI of non-demented patients. Findings are mixed regarding their association with neuropsychological test performance. The purpose of this study is to investigate the association of white-matter hyperintensities on routine clinical MRI and neuropsychological test performance in non-demented outpatients. Method Two groups were selected based on MRI results: (1) normal (n = 62, M age = 50.21, M edu = 14.89) and (2) WMH without other MRI abnormality (n = 56, M age = 55.43, M edu = 14.04). Neuropsychological tests assessed five cognitive domains for which index scores were calculated and categorized in the following clinical ranges: well below average, below average, low average, average, and above average. Results Likelihood ratios comparing base rates for the WMH and normal groups across these clinical ranges revealed significant base rate differences only for attention/processing speed (Lχ2 = 16.47, df = 4, p < .01), with more WMH patients in the below average range and fewer above average. Odds ratios were calculated using two z-score cutoffs: −1.67 and −1.00. While patients with WMH were significantly more likely to have an index z-score ≤ −1.00 on attention/processing speed tests (OR = 3.62, 95% CI: 1.08–12.19) and an executive function test of reasoning (OR = 4.63, 95% CI: 1.18–18.19), there was no difference in the likelihood the groups would have a z-score ≤ −1.67 in any cognitive domain. Conclusions Taken together, these findings indicate that among referred outpatients without dementia, WMH on routine clinical MRI are associated with relatively mild decreased attention and processing speed.

Feasibility, safety and prognostic relevance of acetylcholine provocative testing in patients with myocardial bridge: a prespecified analysis of the RIALTO Registry

Abstract Introduction Myocardial bridge (MB) is the most frequent inborn coronary artery variant. Although MB has long been considered a benign entity, a growing body of evidence has suggested its association with angina and adverse cardiac events. However, to date, no data on long-term prognosis are available, nor on therapies improving cardiovascular outcomes. We are currently conducting an ambispective, observational, multicentre, study in which we enroll patients with a clinical indication to undergo coronary angiography (CA) and evidence of MB, aiming to describe the incidence of symptoms and cardiovascular events at baseline and at long-term follow-up (FUP). The role of invasive full-physiology assessment in modifying the discharge therapy and eventually the perceived quality of life and the incidence of major cardiovascular events will be analysed. Herein, we assessed the safety, feasibility, and the prognostic role of invasiveacetylcholine (Ach) testing in unmasking coronary artery spasm in patients with MB. Materials and Methods A total of 444 patients with MB were consecutively enrolled in the RIALTO registry. 73 underwent intracoronary Ach testing. Both patients with acute and chronic presentations were included. The decision to perform the provocative testing was left to the operator's judgment and performed according to a standardized protocol. The incidence of major and minor complications during Ach testing was recorded. Furthermore, the incidence of major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction, and cardiac hospitalization, and the rate of patients with a Seattle Angina Questionnaire (SAQ) Angina Summary Score &amp;lt;70 were compared between patients with and withoutcoronary artery spasm. Results Epicardial spasm was diagnosed in 58.9% of MB patients, whereas microvascular spasm in 6.9% according to COVADIS criteria. The most frequent location of coronary artery spasm (CAS) was the intramural segment. Regarding safety, no fatal or major non-fatal events occurred. The rate of minor side effects was low (12.3%) and comparable between acute and chronic patients. MACE occurred in 12 (18.8%) patients, without significant differences in the rate of MACE between the study groups (18.2% in patients with a positive Ach testing vs. 20% in patients with a negative Ach testing; log-rank = 0.88). However, the rate of significant angina (SAQ &amp;lt; 70) was higher in the Ach+ group compared with the Ach- group (47.7% vs. 25%; log-rank = 0.04). Conclusions CAS often coexists with MB. The execution of Ach testing in this cohort proved to be safe and feasible, identifying a subgroup of patients with a higher angina burden and poor quality of life, although with a comparable rate of MACE at 2 years. In our study, invasive provocative test improved the ability to unmask vasomotor disorders associated with MB and to prescribe a tailored therapy with calcium antagonists, which improved symptoms.

Design and development of an experimental bench concept for testing of fuselage stiffened panels, using a virtual testing methodology

PurposeFuselage structures are subjected to combinations of axial, bending, shear and differential pressure loads. The validation of advanced metallic and composite fuselage designs against such loads is based on the full-scale testing of the fuselage barrel, which, however, is highly demanding from a time and cost viewpoint. This paper aims to assist in scaling-down the experimentation to the stiffened panel level which presents the opportunity to validate state-of-the-art designs at higher rates than previously attainable.Design/methodology/approachDevelopment of a methodology to successfully design tests at the stiffened panel level and realize them using advanced, complex and adaptable test-rigs that are capable of introducing independently a set of distinct load types (e.g. internal overpressure, tension, shear) while applying appropriate boundary conditions at the edges of the stiffened panel.FindingsA baseline test-rig configuration was developed after extensive parametric modelling studies at the stiffened panel level. The realization of the loading and boundary conditions on the test-rig was facilitated through innovative supporting and loading system set-ups.Originality/valueThe proposed test bench is novel and compared to the conventional counterparts more viable from an economic and manufacturing point of view. It leads to panel responses, which are as close as possible to those of the fuselage barrel in-flight and can be used for the execution of static or fatigue tests on metallic and thermoplastic curved integrally stiffened full-scale panels, representative of a business jet fuselage.

Cognitive impairment in Chinese adult patients with type III spinal muscular atrophy without disease-modifying treatment.

Spinal muscular atrophy (SMA) is a neurodegenerative disorder characterized by the degeneration of motor neurons in the spinal cord. It remains uncertain whether the cognitive performance of adult patients with SMA is impaired. The objective of this study was to assess the cognitive profile of adult Chinese patients with SMA and the association between clinical features and cognitive ability, particularly executive function. This cross-sectional study included 22 untreated adult patients with type III SMA and 20 healthy subjects. The following variables were assessed: general intelligence, memory, attention, language, executive function, depression, anxiety, and other demographic and clinical parameters. In addition, physical function was evaluated using the Hammersmith Functional Motor Scale Expanded (HFMSE), the Revised Upper Limb Module (RULM), and the 6-Minute Walk Test (6MWT). SMA patients had lower scores than healthy subjects in the Verbal Fluency Test, Stroop effect, Total Errors, Perseverative Responses, Perseverative Errors, and Non-perseverative Errors in the Wisconsin Card Sorting Test, showing impaired abilities of SMA patients in executive function. In the Attention Network Test (ANT), the results indicated that the SMA patients also had selective deficits in their executive control networks. Ambulant patients had better executive function test performance than non-ambulant ones. Compromised executive abilities in patients with SMA were correlated with a younger age at onset, poorer motor function, and higher levels of anxiety and depression. Our study presented the distribution of cognitive impairment in a Chinese cohort with SMA. Patients with type III SMA showed selective deficits in executive function, which may be associated with disease severity, physical impairment, depression and anxiety. Future cognitive studies, accounting for motor and emotional impairment, are needed to evaluate if executive impairment is driven by specific brain changes or by those confounding factors.

Delayed recovery from ataxic dementia following liposuction

ABSTRACT A 19-year-old student developed hypoventilation and cyanosis at the end of a cosmetic liposuction procedure. She was awake, but severely abulic, disoriented, and unable to stand and walk due to severe locomotor ataxia. Neuropsychological evaluation showed psychomotor slowness, and deficits in memory encoding and retrieval, and on executive, and visuospatial and visuoperceptual tests; oral comprehension and constructional praxis were spared. ¹H-MRS showed a reduction of NAA. A year later, her cognitive and neurological exam, and NAA returned to normal, and she resumed her normal life. The severity of the acute manifestations of hypoxic encephalopathy not always entail a poor prognosis.

50 Remote Assessment has Minimal Effect on Test-Retest Reliability Among Older Adults with Essential Tremor

Objective:The COVID-19 pandemic increased utilization of remote assessment to allow clinicians and researchers to continue valuable work while maintaining quarantine guidelines. With guidelines relaxing, researchers have returned to in-person assessment. Information is needed regarding the effect of remote assessments on test-retest reliability. COGNET, a longitudinal study of cognition in participants with essential tremor, transitioned from in-person to remote assessments during the pandemic, and has now returned to in-person assessment. The current study investigates the extent to which remote assessment affected test-retest reliability across a range of neuropsychological assessments administered in COGNET.Participants and Methods:Participants included 27 older adults enrolled in COGNET (mean age=75.0 (9.1), education=16.2 (2.6), 67% female, and 100% white). Memory tests included: California Verbal Learning Test II, Logical Memory subtest of the Wechsler Memory Scales - Revised, and Verbal Paired? Associates. Executive function tests included: Digit Span Backwards and the Delis-Kaplan Executive Function System subtests of Verbal Fluency, Sorting, and Color-Word. Attention tests included Oral Symbol Digit Modalities Test and Digit Span Forward. Language was assessed with the Boston Naming Test. Intraclass correlation coefficients (ICCs) were calculated to examine test-retest reliability of InPerson to In-Person visits (P-P), and combination visits (e.g., In-Person to Remote (PR), and Remote to In-Person (R-P)). Following Koo &amp; Li (2016), ICCs were interpreted as: &gt;.90 excellent, .75-.90 good, .50-.74 moderate, and &lt;.50 poor reliability. The Feldt approach was used to compare ICCs from P-P visits against ICCs calculated for combination visits (P-R or R-P), with the test statistic compared to an F distribution.Results:ICCs for person-to-person assessment ranged from .51 to .89. Memory test ICCs ranged from moderate to good (.51 to .80). Executive function test ICCs ranged from moderate to good (.55 to .89). The attention domain had moderate ICCs (.67 - .68). Language ICC was moderate (.70). ICCs for person-to-remote assessment ranged from .42 to .89. Memory tests ranged from moderate to good ICCs (.59 to .83). Executive function tests ranged from poor to good ICCs (.42 to .89). Attention ICCs were moderate to good (.55 to .79). The Language ICC was moderate (.72). ICCs for remote-to-person ranged from .48 to 86. Memory ICCs ranged from moderate to good (.59 to .86). Executive function ICCs ranged from poor to good (.48 to .83). Attention ICCs were moderate to good (.56 to .79). The Language ICC was good (.78). The only test for which an ICC from a combination visit was significantly lower than a person to person visit was Digit Span Backwards.Conclusions:Test-retest reliability was moderate or better for all P-P assessments, consistent with the known psychometrics of these tests. Only one test of executive function showed lower reliability when remote assessment was introduced. From a broad standpoint, current results suggest that remote administration of neuropsychological tests can be used as a reliable substitute for in-person assessment for many measures, and suggest that caution be used when interpreting any change in Digit Span Backwards across person and remote assessments.

Pathological Lung Ultrasound May Take Time to Resolve Despite Respiratory Symptoms Improvement: A Pediatric Case Series Followed for Long COVID

Background: Long COVID affects 8 to 10 % of children. Currently, the COVID-19 fo-llow-up protocols in children include chest auscultation, collection of growth parameters, including weight, height and body mass index, execution of the six-minute walking test, basal spirometry, and afterwards, bronchodilation test and lung ultrasound. Case Presentation: In this paper, the authors describe a case series of long COVID followed up for 9 months at the Department of Pediatrics of the University Luigi Vanvitelli. The review of the lite-rature was performed on PubMed using the keywords COVID-19, follow-up, children, and lung ul-trasound. The aim of this article was to highlight the need to create custom follow-up programs for long Covid in children through the description of a case followed up at our Pediatric Department and a review of the current literature Discussion: The reversal of pathological lung ultrasound signs occurred in six or nine months des-pite the early improvement of respiratory symptoms and pulmonary function. There are limited stu-dies on the ultrasonography follow-up of kids with COVID-19 in the literature, and there are still no follow-up COVID-19 guidelines for paediatric population. Conclusion: Pathological lung ultrasound in children recovered from COVID-19, may take time to resolve; therefore, evaluating patients with lung ultrasound in the following months could be a ra-diation-saving approach useful for children who have fully recovered and have no warning signs.

5 Vascular Depression in Older Black Adults: White Matter Hyperintensities, Cognition, and Gait Speed

Objective:brain white matter integrity as a result of vascular burden is associated with a form of late-life depression, known as vascular depression (VaDep). Black older adults may be particularly vulnerable to developing VaDep due to a higher prevalence of vascular conditions compared to White older adults. The current study examined whether clinical and imaging markers of vascular burden predicted depressive symptoms in an older Black sample. Based on the literature in primarily White samples, we expected greater clinical vascular burden and white matter hyperintensity (WMH) volume to predict greater depressive symptoms both cross-sectionally and over 4-year follow-up. We additionally hypothesized that participants with operationally-defined VaDep would have worse cognitive performance and slower gait speed compared to those without VaDep. Exploratory analyses examined race (Black vs. White) as an additional predictor.Participants and Methods:This study used publicly available data from 113 Black older adults who were followed for four years in the Healthy Brain Project (a substudy of the Health, Aging, and Body Composition Study). Clinical vascular burden was defined as the number of vascular conditions (e.g., hypertension, diabetes, stroke); total WMH volume and WMH volume in the uncinate fasciculus, superior longitudinal fasciculus, and cingulum were considered imaging markers of vascular burden. Clinical and imaging-defined vascular burden were used to predict baseline depressive symptoms and average depressive symptoms over follow-up as measured by the Center for Epidemiologic Studies Depression Scale (CES-D). We then formed groups based on cutoffs for vascular burden (two or more conditions) and depressive symptoms (upper tertile of CES-D scores) to compare cognitive (Digit Symbol Substitution Test and 15-Item Executive Interview) and gait speed performance at baseline and changes over four years in VaDep, non-vascular depression, vascular only, and healthy groups. Exploratory analyses included 179 White older adults from the Healthy Brain Project dataset to examine race differences.Results:Total WMH volume and WMH volume in the uncinate fasciculus predicted higher depressive symptoms both cross-sectionally and longitudinally. However, no similar pattern emerged when using clinically-defined vascular burden as the predictor. The VaDep group had the slowest processing speed but the trajectory of decline over time did not differ between groups. The non-vascular depression group’s executive performance improved over time while performance by the other groups remained stable. Both VaDep and non-vascular depression groups’ gait speed declined over time. There was a stronger association between depression and uncinate fasciculus WMH in Black compared to White individuals, and the Black VaDep group had the slowest baseline processing speed of all groups.Conclusions:This research supports the validity of the VaDep framework in Black older adults by showing the impact of WMH, particularly in the uncinate fasciculus, on depressive symptoms and identifying cognitive risks associated with VaDep in this population. Moreover, results suggest WMH may confer a greater risk for depression in Black compared to White older adults, and that VaDep disproportionately impacts processing speed in Black older adults. This work addresses an important gap in the VaDep literature by examining a group that has historically been underserved.

35 Pairwise Concurrence Rates Between Standalone and Embedded Performance Validity Tests

Objective:Determine the classification concordance between a standalone performance validity test (PVT) and embedded PVTs from multiple cognitive domains.Participants and Methods:Participants were 106 patients (49.1% female; 69% white) that underwent neuropsychological evaluation at an outpatient university doctoral clinical psychology training and research clinic (M/SD: age = 32.38/11.95; education = 13.7/2.75). A comprehensive neuropsychological battery included the Medical Symptom Validity Test (MSVT) and embedded PVTs from different cognitive domains: attention - Wechsler Adult Intelligence Scale - Fourth Edition Reliable Digit Span and Digit Span age-corrected scaled score (DS ACSS); memory - California Verbal Learning Test, 3rd Edition (CVLT-3) Forced-Choice Recognition (FCR), executive functions -Wisconsin Card Sorting Test (WCST) Failure to Maintain Set (FMS); visual-spatial/construction -Rey Complex Figure Test (RCFT) Copy raw score; language - Boston Diagnostic Aphasia Examination Complex Ideation Material (CIM); and motor functions - Finger Tapping Test (FTT). All participants were administered the MSVT but not all participants were administered all seven embedded PVTs. Credible/noncredible classification concordance rates and kappa correlations (i.e., percentage of agreement) were computed for each pairwise PVT combination.Results:Twenty-two percent (n = 23) of the sample failed at least one PVT, with 17.0% (n = 18) failing at least two. DS ACSS was the embedded PVT with the highest MSVT concordance rate at 92.4% and a fair kappa coefficient of .39; WCST FMS had the lowest concordance with MSVT at 82.9% and a slight kappa coefficient of .19. The highest concordance among embedded PVTs from different cognitive domains was CVLT-3 FCR and RCFT Copy raw score at 89.7% with a fair kappa coefficient of .35; the lowest agreement among embedded PVTs was WCST FMS and FTT at 74.0% with a kappa coefficient of -.02. More conservative kappa coefficients among all pair-wise embedded PVT combinations from different cognitive domains ranged from -.02 to .36. For all standalone and embedded PVT pairwise concordance rates, only two fell below the recommended minimum agreement of 80%: FCR vs. FMS = 79.3% and FMS vs. FTT = 74.0%.Conclusions:Embedded PVTs across various cognitive domains have high agreement with a standalone PVT to aid in classifying noncredible performance, in the 83-92% range. Embedded PVTs from different cognitive domains also have mostly high agreement classification rates amongst themselves in aiding to determine noncredible performance, in the 74-90% range, with the lowest agreement rate between executive function and motor tests at 74%. More conservative kappa-based agreements between PVT pair-wise combinations were fairly consistent with other studies, with most being in the fair range. Finally, these findings indicate about a 17% base rate of noncredible cognitive performance in an outpatient university-based clinic.

68 Preliminary Evidence of a Therapeutic Effect of Electrical Neuromodulation on Cognitive Deficits in Patients with Mild Cognitive Impairment

Objective:Episodic memory functioning is distributed across two brain circuits, one of which courses through the dorsal anterior cingulate cortex (dACC). Thus, delivering non-invasive neuromodulation technology to the dACC may improve episodic memory functioning in patients with memory problems such as in amnestic mild cognitive impairment (aMCI). This preliminary study is a randomized, double-blinded, sham-controlled clinical trial to examine if high definition transcranial direct current stimulation (HD-tDCS) can be a viable treatment in aMCI.Participants and Methods:Eleven aMCI participants, of whom 9 had multidomain deficits, were randomized to receive 1 mA HD-tDCS (N=7) or sham (N=4) stimulation. HD-tDCS was applied over ten 20-minute sessions targeting the dACC. Neuropsychological measures of episodic memory, verbal fluency, and executive function were completed at baseline and after the last HD-tDCS session. Changes in composite scores for memory and language/executive function tests were compared between groups (one-tailed t-tests with a = 0.10 for significance). Clinically significant change, defined as &gt; 1 SD improvement on at least one test in the memory and non-memory domains, was compared between active and sham stimulation based on the frequency of participants in each.Results:No statistical or clinically significant change (N-1 X2; p = 0.62) was seen in episodic memory for the active HD-tDCS (MDiff = 4.4; SD = 17.1) or sham groups (MDiff = -0.5; SD = 9.7). However, the language and executive function composite showed statistically significant improvement (p = 0.04; MDiff = -15.3; SD = 18.4) for the active HD-tDCS group only (Sham MDiff = -5.8; SD = 10.7). Multiple participants (N=4) in the active group had clinically significant enhancement in language and executive functioning tests, while nobody in the sham group did (p = 0.04).Conclusions:HD-tDCS targeting the dACC had no direct benefit for episodic memory deficits in aMCI based on preliminary findings for this ongoing clinical trial. However, significant improvement in language and executive function skills occurred in response to HD-tDCS, suggesting HD-tDCS in this configuration has promising potential as an intervention for language and executive function deficits in MCI.

CORRELATION BETWEEN SUBTHALAMIC ALPHA RHYTHMIC ACTIVITY AND MOTOR CONTROL IMPAIRMENT IN PARKINSONIAN PATIENTS

Increased oscillatory beta activity in basal ganglia is one of the main electrophysiological biomarkers of impaired motor control in Parkinson’s disease. However, the functional role of dynamical rhythmic processes during movements is still not investigated in detail. We used microelectrode recordings to investigate the subthalamic nucleus neuronal activity in 9 patients with Parkinson’s disease during deep brain stimulation surgery. We have shown that the amplitude of the subthalamic nucleus alpha (7–12 Hz) and low-beta (12–20 Hz) activity correlated with motor impairment indices in patients with Parkinson’s disease. Also, we have shown that, in contrast to beta rhythmic activity, the magnitude of alpha activity decreased significantly during motor tests execution. Moreover, the degree of rhythmic activity suppression in the alpha band correlated with the severity of bradykinesia. These results allow us to suppose that, along with beta activities, subthalamic nucleus neuronal alpha activity also participate in motor control of Parkinson’s disease patients.

Modified hybrid damage criterion for the cross wedge rolling process

This paper considers the problem of material fracture in the cross wedge rolling (CWR) process. A modification of the hybrid damage criterion dedicated to crack prediction in CWR was proposed. The aim of the modification was to make the limits of the new criterion independent of the implementation temperature of the calibration tests. A rotary compression test was carried out to obtain specimens in which cracking is initiated. Based on the analysis of the FE results of the rotary compression test simulation, the final version of the modified hybrid damage criterion (MHDC) was presented. Using the results of experimental tests and FE simulations, the MHDC limit values were determined. The MHDC limits for the three different temperatures were obtained at similar levels, indicating that the MHDC limits can be made independent of the rotary compression test execution temperature. The MHDC was verified on the example of the cross wedge rolling of a railway axle forging. The verification carried out confirmed the possibility of predicting cracks in CWR-rolled forgings using MHDC. The research results obtained are of an applied nature. In particular, the criterion developed can be helpful in the design of cross wedge rolling technology.

74 The Impact of Motoric Dysfunction on Neuropsychological Test Performance Within an Electrical Injury Sample

Objective:Victims of electrical injury (EI) often experience injuries to the peripheral nervous system and neuromuscular damage that may diminish motor function, such as flexibility/dexterity. These difficulties may continue after rehabilitation due to the reorganization of muscle afferent projections during peripheral nerve regeneration. Therefore, understanding how patients with a history of thermal burn injuries perform on motoric measures is necessary to explain the impact neuromuscular damage has on both motor and non-motor tests of cognition. However, no studies have examined the impact of motor functioning on cognition in patients who experienced thermal and electrical injuries compared to an electrical shock injury. This study explored the impact of motor dysfunction and psychiatric distress measured by depression severity on psychomotor speed and executive test performances among EI patients with and without thermal burn injuries.Participants and Methods:This cross-sectional study consisted of EI patients undergoing an outpatient neuropsychological evaluation, including tests of motor dexterity (Grooved Pegboard [GP]), psychomotor speed (Wechsler Adult Intelligence Scale-IV Coding, Trail Making Test [TMT] Part A), and executive functioning (Stroop Color and Word Test [SCWT] Color-Word trial, TMT Part B). The sample was 83% male and 17% female, 88% White, 3% Black, 5% Hispanic, and 2% other race/ethnicity, with a mean age of 43.9 years (SD=11.36), mean education of 12.9 years (SD=2.05), and mean depression severity of 20.05 (SD=12.59) on the Beck Depression Inventory-II (BDI-II). Exclusion criteria were: 1) injury history of moderate-to-severe head trauma, 2) &gt;2 performance validity test failures, and 3) any amputation of the upper extremity. Regression analyses included GP T-Scores for dominant hand and BDI-II total score as independent variables and neuropsychological normative test data as dependent variables.Results:Among validly performing patients with EI (n=86), regression analyses revealed GP performance accounted for significant variance (R2 =.153-.169) on all neuropsychological measures. Among EI patients with burn injuries (n=50), regression analyses revealed GP performance accounted for significant variance (R2 =.197-.266) on all neuropsychological measures. Among EI patients without burn injuries (n=36), analyses revealed that neither GP performance nor BDI-II severity accounted for significant variance across the neurocognitive tests (R2=.056-.142). Furthermore, among EI patients with burn injuries and the total sample, regression analyses revealed depression severity negatively predicted GP performance (R2 =.099-.13), however, in patients without burn injuries, depression did not predict GP performance (R2 =.052).Conclusions:Overall, results showed that GP performance is a significant predictor of neurocognitive performance on both motor and non-motor measures in EI patients with burn injuries. Therefore, among EI patients with burn injuries, GP performance may have potential utility as an early indicator of injury severity, considering that it predicts neuropsychological test performance on measures of psychomotor speed and executive functioning. Lastly, depression predicted GP performance within the burn injury sample illustrating that psychological distress may negatively impact motor functionality.

DTester: Diversity-Driven Test Case Generation for Web Applications

Search-based Test Case Generation (TCG) for web applications suffers from unstable performance and suboptimal test suite problems due to diversity loss. However, previous diversity metrics mainly only focus on client-side models or server-side code, which are prone to low robustness and poor generalization in practical applications. We propose a diversity-driven TCG method DTester, which can maximize behavior exploration and minimize the test suite size while covering more server-side vulnerable paths. Three diversity metrics (i.e. phenotypic coupling, intent coupling and competitiveness) are proposed to measure the underlying relationship between test cases from user behavior, code logic and test execution history. Moreover, a 3-dimensional weight graph is designed to model association among metrics, which provides fine-grained guidance for the genetic algorithm to generate diverse test cases from the client-side behavior model. Our empirical evaluation on five web applications shows that DTester can efficiently and robustly generate better test suites than the state-of-the-art TCG method. The maximum improvement is [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text] in efficiency, test suite size, diversity and robustness.

Flexural behavior of composite ribbed slabs employing cold-formed steel lipped channels

By means of a series of full-scale laboratory tests, this research studied the flexural behavior of a composite ribbed slab employing cold-formed steel profiles as formwork before and after concrete casting. An experimental program was devised and separated in two sets of tests. The first set consisted of the execution of four-point bending tests on eight specimens to represent the system during construction, featuring three specimen types; isolated profile, profile with plastic spacers along the channel and a full assembly including the profile, the plastic spacers and a rebar truss. Displacement and strain as a function of load were measured and the data was used to analyze the influence of the different components on the flexural strength and stiffness of the system. On the second set of tests, three ribbed composite slab specimens featuring steel profiles were subjected to four-point bending. Displacement was registered along with strain on the concrete layer. A formulation to determine the flexural strength of the slabs based on Eurocode is presented and compared to experimental observations. The first phase indicates significant increases of flexural strength and stiffness by coupling a truss to the profile and varying the height of the former, namely a maximum increase of 708% in stiffness and 357% in strength. Isolated profiles and profiles with plastic spacers all failed by distortional buckling, while the full assembly specimens failed by instability of the top chord on the trusses. Second phase results show that the analytical prediction is adequate to determine the flexural strength of the prototype slabs, with approximately 95% accuracy for this sample size. All slab specimens failed by plastic hinge formation within the pure moment span. Furthermore, strain measurements on the concrete indicate that the formulae chosen to determine the effective width of the concrete “tee” section is also adequate.

The executive functions among patients with an initial Glasgow coma scale score of 15

Executive functions (EF) were the critical neuropsychological functions linked to long-term adaptation. Given the heterogeneous prognosis trajectories of mild traumatic brain jury (mTBI), the mildest TBI may not always be benign in the chronic stage. The present study explored the long-term EF in patients with chronic complicated mTBI and a Glasgow Coma Scale (GCS) score of 15. Fifty patients with complicated mTBI and GCS scores of 15 and 35 control participants were recruited in this study. Medical records were retrospectively analyzed, and neuropsychological assessments and subjective measures examined the neuropsychological functions. Compared with healthy controls, complicated mTBI patients with a GCS score of 15 performed significantly worse on most EF assessments, including longer reaction time (RT) and poor cognitive flexibility and abstract reasoning performances. Patients also reported more EF problems and lower quality of life (QoL) than healthy controls. Females and those with subdural hematoma (SDH) had significantly longer reaction times (RT) on executive attention tests. This study found that complicated mTBI with a GCS score of 15 had incomplete recovery of EF, even in the chronic stage. We suggest that early neuropsychological assessment and rehabilitation should be arranged for such patients.

Executive functions and daily functioning in myotonic dystrophy type 1 ecological assessment with virtual reality

Central nervous system dysfunction is characteristic of patients with myotonic dystrophy type 1 (DM1). Although no consensus exists regarding the exact cognitive profile of these patients, executive dysfunction has been suggested to play a role. Due to the impact of executive functions on daily performance, this study aimed to describe executive functioning in an ecological manner and to analyze its impact — and that of other clinical variables — on the functional performance of DM1 patients. A Virtual Reality executive functioning test (Nesplora Ice Cream), the Wechsler Adult Intelligence Scale-Fourth Edition, and self-report questionnaires (AES, FSS, ESS and LIFE-H) were administered to 20 patients. Statistical analyses included correlation and multiple regression analyses to analyze the best predictors of daily performance. DM1 patients did not show major difficulties in the executive functioning tasks or in their overall performance on daily habits. However, both cold and hot executive functions still seem necessary for the correct accomplishment of life habits, since planning and level of apathy explained 47.6% of the total variance of daily functioning. This was the first study to assess executive functions in DM1 using Virtual Reality, and our findings open a debate about their actual impairment in this population.

Mutation testing optimisations using the Clang front‐end

AbstractMutation testing is the state‐of‐the‐art technique for assessing the fault detection capacity of a test suite. Unfortunately, a full mutation analysis is often prohibitively expensive. The CppCheck project for instance, demands a build time of 5.8 min and a test execution time of 17 s on our desktop computer. An unoptimised mutation analysis, for 55,000 generated mutants took 11.8 days in total, of which 4.3 days is spent on (re)compiling the project. In this paper, we present a feasibility study, investigating how a number of optimisation strategies can be implemented based on the Clang front‐end. These optimisation strategies allow to eliminate the compilation and execution overhead in order to support efficient mutation testing for the C language family. We provide a proof‐of‐concept tool that achieves a speedup of between 2 and 30 . We make a detailed analysis of the speedup induced by the optimisations, elaborate on the lessons learned and point out avenues for further improvements.

Assessing the impact of age on everyday cognitive function with a virtual environment task: The EcoKitchen

More realistic assessment tools are imperative for a better understanding of the impact of age-related cognitive deficits on functional status. With this in mind, we probed the ability of the EcoKitchen, a non-immersive virtual environment task with increasing executively demanding kitchen chores, to detect the effects of aging on the simulated everyday functioning of healthy adults. Fifty-three adults (age between 23 and 77 years) were assessed with the EcoKitchen and a set of conventional paper-and-pencil neuropsychological tests. The associations between the baseline features of study participants and each of the two different assessment methods were examined. The associations between the EcoKitchen variables and an executive composite score were also explored. Our results showed that older individuals present deficits in the performance of both the EcoKitchen task and standard assessment methods. Notably, we found that, unlike conventional tests, accuracy in the EcoKitchen task was not related to the education level and IQ score of participants. Moreover, the EcoKitchen performance time was significantly correlated with executive tests. We have demonstrated that the EcoKitchen task, an ecologically relevant computerized neuropsychological assessment tool, might be more suitable than classic paper-and-pencil tests to capture the impact of aging on everyday cognitive function, as it proved to be less prone to the influence of confounding factors. Additionally, we have shown that executive function plays an important role in the timely performance of cognitively challenging virtual environment tasks.