Longitudinal grey and white matter changes in frontotemporal dementia and Alzheimer's disease

Behavioural variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) dementia are characterised by progressive brain atrophy. Longitudinal MRI volumetry may help to characterise ongoing structural degeneration and support the differential diagnosis of dementia subtypes. Automated, observer-independent atlas-based MRI volumetry was applied to analyse 102 MRI data sets from 15 bvFTD, 14 AD, and 10 healthy elderly control participants with consecutive scans over at least 12 months. Anatomically defined targets were chosen a priori as brain structures of interest. Groups were compared regarding volumes at clinic presentation and annual change rates. Baseline volumes, especially of grey matter compartments, were significantly reduced in bvFTD and AD patients. Grey matter volumes of the caudate and the gyrus rectus were significantly smaller in bvFTD than AD. The bvFTD group could be separated from AD on the basis of caudate volume with high accuracy (79% cases correct). Annual volume decline was markedly larger in bvFTD and AD than controls, predominantly in white matter of temporal structures. Decline in grey matter volume of the lateral orbitofrontal gyrus separated bvFTD from AD and controls. Automated longitudinal MRI volumetry discriminates bvFTD from AD. In particular, greater reduction of orbitofrontal grey matter and temporal white matter structures after 12 months is indicative of bvFTD

Cough and reflux esophagitis in children: their co-existence and airway cellularity

BACKGROUND: There are no prospective studies that have examined for chronic cough in children without lung disease but with gastroesophageal reflux (GER). In otherwise healthy children undergoing flexible upper gastrointestinal endoscopy (esophago-gastroscopy), the aims of the study were to (1) define the frequency of cough in relation to symptoms of GER, (2) examine if children with cough and reflux esophagitis (RE) have different airway cellularity and microbiology in bronchoalveolar lavage (BAL) when compared to those without. METHODS: Data specific for chronic cough (>4-weeks), symptoms of GER and cough severity were collected. Children aged <16-years (n = 150) were defined as 'coughers' (C+) if a history of cough in association with their GER symptoms was elicited before BAL were obtained during elective esophago-gastroscopy. Presence of esophagitis on esophageal biopsies was considered reflux esophagitis positive (E+). RESULTS: C+ (n = 69) were just as likely as C- (n = 81) to have esophagitis, odds ratio 0.87 (95%CI 0.46, 1.7). Median neutrophil percentage in BAL was significantly different between groups; highest in C+E- (7, IQR 28) and lowest in C-E+ (5, IQR 6). BAL positive bacterial culture occurred in 20.7% and were more likely present in current coughers (OR 3.37, 95%CI 1.39, 8.08). Airway neutrophilia (median 20%, IQR 34) was significantly higher in those with BAL positive bacterial cultures than those without (5%, 4; p = 0.0001). CONCLUSION: In children without lung disease, the common co-existence of cough with symptoms of GER is independent of the occurrence of esophagitis. Airway neutrophilia when present in these children is more likely to be related to airway bacterial infection and not to esophagitis

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Conventional approach to harmonious coordinated Cadastral Database weakness

The eKadaster system depended solely on the use of coordinated cadastral database known as the National Digital Cadastral Database (NDCDB) with an expected accuracy of ±10cm. Till date, there is an approximately of 7.8 million land parcels and 21.9 million boundary markers in the NDCDB that covers the total area of 132,183 km2. However, the NDCDB accuracy of ±10cm is still not at a satisfactory acceptance level and the adjustment keeps continuing without carrying out verification to the data sources weakness of varying accuracy and input errors. Thus, the foremost important corrective is to ensure the adjustment input files to have the exact value of the sources by further divided the existing adjustment blocks into smaller blocks to verify the input data line by line. A well distributed cadastral control points and latest NDCDB accessibility are also extensively needed to plan and to strengthen the adjustment network. The comparison result of the randomly picked ground truthing points in the field has shown a significant impact on the displacement accuracy that meet the expected tolerance of ±10cm or better after the data input file is cleaned without input error. And to further strengthen the adjustment network in order to make NDCDB accuracy better, the current cadastral control points shall need to tie to a highest accuracy fundamental network

Designing Playful Games and Applications to Support Science Centers Learning Activities

In recent years there has been a renewed interest on science, technology, engineering, and mathematics (STEM) education. Following this interest, science centers\u27 staff started providing technology enhanced informal STEM education experiences. The use of well-designed mobile and ubiquitous forms of technology to enrich informal STEM education activities is an essential success factor. The goal of our research is to investigate how technology applications can be better used and developed for taking full advantage of the opportunities and challenges they provide for students learning about STEM concepts. In our approach, we have conducted a series of interviews with experts from science center curating and outdoor learning activities development, with the final goal of exploring and improving current learning environments and practices. This paper presents the development of set of design considerations for the development of STEM games and applications of young students. An initial set of best practices was first developed through semi-structures interviews with experts; and afterwards, by employing content analysis, a revised set of considerations was obtained. These results are useful for STEM education teachers, curriculum designers, curators and developers for K-12 education environments

Stellate ganglion blockade under ultrasound-guidance and the physiological responses in the rat

Stellate ganglion blockade (SGB) is a practical approach to managing many clinical disorders. Ultrasound-guided SGB is currently adopted as a more effective and safer method in humans. Developing this technique in rats would facilitate further study of SGB application. The present study examined physiological responses following ultrasound-guided SGB in Sprague-Dawley rats. Under general anesthesia, lidocaine containing Chicago blue dye (1.0%-1.5% in 40-60&nbsp;µL) was injected into the unilateral stellate ganglion (SG). Ptosis was observed on the ipsilateral right (n = 8) or left (n = 7) side of lidocaine administration. No ptosis was noted in any controls by 0.9% normal saline injection into the right (n = 6) or left (n = 6) SG. Heart rate (HR) was significantly decreased after administration of lidocaine (344 ± 32 to 289 ± 47 bpm; p = 0.015, pre-vs. after-injection), but not after normal saline, into the right SG. HR was unaltered after injecting lidocaine or normal saline into the left SG. Heart rate variability analysis showed that SGB with lidocaine on the right or left side caused a decrease in the ratio of the power of low-frequency over high-frequency. Respiratory rate, body temperature, and general conditions were unchanged in all rats, regardless of left or right SGB. Chicago blue dye was confirmed to be distributed in the SG region. No bleeding or tissue damage was evident in the injected SG area. Our findings suggest that ultrasound-guided unilateral SGB effectively inhibits cervicothoracic sympathetic nerves in rats and enhances heart rate variability, and sympathetic nerves controlling HR are likely predominantly associated with the right SG in the rat

The empirical approach to strengthen coordinated cadastral database accuracy

The coordinated cadastral database in Malaysia is known as National Digital Cadastral Database (NDCDB) with an expected accuracy of ±10cm in rural and ±5cm in urban area. Till date, there are approximately 7.8 million land parcels and 22 million boundary markers in the NDCDB for the whole of Peninsular Malaysia and Federal Territory of Labuan covering total area of 132,183 km2. Since 2010, NDCDB block adjustment has been carried out continuously without giving prime concern to eliminate gross errors in the adjustment's input data. This approach aims to propose a methodology to improve the positional accuracy of the existing NDCDB through utilisation of the current eKadaster application. A comprehensive investigation in the office and field processes has been carried out to prove the efficiency of the methodology introduced. This investigation was focused on the East Coast Rail Link (ECRL) right of way (ROW) survey from Dungun to Besut where displacement of 1 to 6 meters relative to the NDCDB coordinates, as shown in the Land Acquisition (LA) Plan, have been identified. Areas involved are coded as Block T10701, T1100101 and T1100102 which are located in Lubuk Kawah and Pelagat Sub-districts, in the state of Terengganu. Positional accuracy of the NDCDB after adjustment was further verified by comparing the coordinates of randomly picked ground proofing points in the field using Real-Time Kinematic (RTK) observation. This will determine the Root Mean Square Error (RMSE) of the respective NDCDB Block based on actual observations and adjusted coordinate values. With that, it can be concluded that the proposed approach is reasonably practical and capable to improve and strengthen the positional accuracy of existing coordinated cadastral database used in Malaysia

Disrupting education using smart mobile pedagogies

© Springer Nature Switzerland AG 2019. As mobile technologies become more multifaceted and ubiquitous in society, educational researchers are investigating the use of these technologies in education. A growing body of evidence shows that traditional pedagogies still dominate the educational field and are misaligned with the diverse learning opportunities offered by the use of mobile technologies. There is an imperative to question those traditional notions of education, including how, where and when teaching and learning are enacted, and to explore the possible mediating roles of new mobile technologies. New smart pedagogies, which embrace the affordances offered by mobile technologies, have the potential to disrupt notions of schooling. In this chapter, we examine the nature of smart pedagogies and their intersection with mobile pedagogies. We unpack notions of innovation and disruption. We then discuss smart mobile learning activities for school students identified from a Systematic Literature Review, together with the pedagogical principles underpinning them. We argue to encourage smart pedagogies, teacher educators should support teachers to implement ‘feasible disruptions’. Consequently, implications for teacher education are explored

Unusual finding of endocervical-like mucinous epithelium in continuity with urothelium in endocervicosis of the urinary bladder

Endocervicosis in the urinary bladder is a rare benign condition. We present a case in a 37-year-old woman with classical clinical and pathological features of endocervicosis. The unusual observation of endocervical-like mucinous epithelium in continuity with the urothelium in addition to fully developed endocervicosis prompted immunohistochemical profiling of the case using antibodies to cytokeratins (AE1/AE3, CK19, CK7, CK5/6, CK20), HBME-1, estrogen receptor (ER) and progesterone receptor (PR) to assess the relationship of the surface mucinous and endocervicosis glandular epithelia. The surface mucinous epithelium, urothelium and endocervicosis glands were immunopositive for AE1/AE3, CK7 and CK19 while CK20 was only expressed by few urothelial umbrella cells. The surface mucinous epithelium was CK5/6 and HBME-1 immunonegative but showed presence of ER and PR. This was in contrast to the urothelium's expression of CK5/6 but not ER and PR. In comparison, endocervicosis glands expressed HBME-1, unlike the surface mucinous epithelium. The endocervicosis epithelium also demonstrated the expected presence of ER and PR and CK5/6 immunonegativity. The slightly differing immunohistochemical phenotypes of the surface mucinous and morphologically similar endocervicosis glandular epithelium is interesting and requires further clarification to its actual nature. The patient has remained well and without evidence of disease 18-months following transurethral resection of the lesion