The Natural History and Clinical Syndromes of Degenerative Cervical Spondylosis

Cervical spondylosis is a broad term which describes the age related chronic disc degeneration, which can also affect the cervical vertebrae, the facet and other joints and their associated soft tissue supports. Evidence of spondylitic change is frequently found in many asymptomatic adults. Radiculopathy is a result of intervertebral foramina narrowing. Narrowing of the spinal canal can result in spinal cord compression, ultimately resulting in cervical spondylosis myelopathy. This review article examines the current literature in relation to the cervical spondylosis and describes the three clinical syndromes of axial neck pain, cervical radiculopathy and cervical myelopath

Measuring fidelity of delivery of the Community Occupational Therapy in Dementia-UK intervention

BACKGROUND: Interpreting data about intervention effectiveness requires an understanding of which intervention components were delivered and whether they were delivered as planned (fidelity of delivery). These studies aimed to develop a reliable measure for assessing fidelity of delivery of the Community Occupational Therapy in Dementia-UK intervention (COTiD-UK) (Study 1) and measure fidelity of delivery of COTiD-UK across sessions, sites and occupational therapists (Study 2). METHODS: The studies used a longitudinal observational design nested within a multi-site randomised controlled trial. Where practicable, all intervention sessions were audio-recorded. Fidelity checklists and coding guidelines were developed, piloted and refined until good agreement was achieved between two coders. Ten percent of sessions were purposively sampled from 12 sites and 31 occupational therapists. Transcripts were coded using checklists developed in Study 1; 10% of sets of intervention session transcripts were double coded to ensure that agreement was maintained. Percentages of components that were delivered were calculated for each session, site and occupational therapist. RESULTS: A reliable measure of fidelity of delivery for COTiD-UK was developed after several rounds of piloting and amendments. COTiD-UK was delivered with moderate fidelity across all six sessions (range: 52.4-75.5%). The mean range of fidelity varied across sites (26.7-91.2%) and occupational therapists (26.7-94.1%). CONCLUSIONS: A reliable, systematic method for measuring fidelity of delivery of COTiD-UK was developed and applied, and can be adapted for use in similar interventions. As COTiD-UK was delivered with moderate fidelity, there is a reasonable degree of confidence that intervention effects were attributable to COTiD-UK

Visual arguments in film

Nuestro objetivo es señalar algunas diferencias entre los argumentos verbales y visuales, y promover la perspectiva retórica de la argumentación, yendo más allá de la relevancia de la lógica y de la pragmática. En nuestra opinión, si ha de ser racional y aceptable como argumentación (visual), un film debe dirigirse a espectadores que tienen creencias informadas sobre el tema visto en la pantalla y sobre las limitaciones y las convenciones del medio. En nuestras reflexiones, aplicamos el análisis retórico al cine como un acto simbólico, humano y comunicativo que a veces puede entenderse como un argumento trazado visualmente. Como mezcla de estímulos visuales, auditivos y verbales, el film exige una interpretación y una (re)construcción activas y complejas. Nuestra sugerencia es concentrarse en cinco elementos diferentes, pero relacionados entre sí. La reconstrucción y la evaluación del argumento visual se basarán en esos elementos, y todo el proceso constituirá una argumentación visual.Our aim is to point out some differences between verbal and visual arguments, promoting the rhetorical perspective of argumentation beyond the relevance of logic and pragmatics. In our view, if it is to be rational and successful, film as (visual) argumentation must be addressed to spectators who hold informed beliefs about the theme watched on the screen and the medium’s constraints and conventions. In our reflections to follow, we apply rhetorical analysis to film as a symbolic, human, and communicative act that may sometimes be understood as a visually laid out argument. As a mixture of visual, auditory, and verbal stimuli, film demands active and complex interpretation and (re)construction. Our suggestion is to focus on five different but interrelated elements. The reconstruction and evaluation of the visual argument will be based on those elements, and the whole process will be one of visual argumentation

Predicting general and cancer-related distress in women with newly diagnosed breast cancer

Background: Psychological distress can impact medical outcomes such as recovery from surgery and experience of side effects during treatment. Identifying the factors that explain variability in distress would guide future interventions aimed at decreasing distress. Two factors that have been implicated in distress are illness perceptions and coping, and are part of the Self-Regulatory Model of Illness Behaviour (SRM). The model suggests that coping mediates the relationship between illness perceptions and distress. Despite this; very little research has assessed this relationship with cancer-related distress, and none have examined women with screen-detected breast cancer. This study is the first to examine the relative contribution of illness perceptions and coping on general and cancer-related distress in women with screen-detected breast cancer. Methods: Women recently diagnosed with breast cancer (N = 94) who had yet to receive treatment completed measures of illness perceptions (Revised Illness Perception Questionnaire), cancer-specific coping (Mental Adjustment to Cancer Scale), general anxiety and depression (Hospital Anxiety and Depression scale), and cancer-related distress. Results: Hierarchical regression analyses revealed that medical variables, illness perceptions and coping predicted 50% of the variance in depression, 42% in general anxiety, and 40% in cancer-related distress. Believing in more emotional causes to breast cancer (beta = .22, p = .021), more illness identity (beta = .25, p = .004), greater anxious preoccupation (beta = .23, p = .030), and less fighting spirit (beta = -.31, p = .001) predicted greater depression. Greater illness coherence predicted less cancer-related distress (beta = -.20, p = .043). Greater anxious preoccupation also led to greater general anxiety (beta = .44, p < .001) and cancer-related distress (beta = .37, p = .001). Mediation analyses revealed that holding greater beliefs in a chronic timeline, more severe consequences, greater illness identity and less illness coherence increases cancer-specific distress (ps < .001) only if women were also more anxiously preoccupied with their diagnosis. Conclusions: Screening women for anxious preoccupation may help identify women with screen-detected breast cancer at risk of experiencing high levels of cancer-related distress; whilst illness perceptions and coping could be targeted for use in future interventions to reduce distress

An Agenda for Best Practice Research on Group Singing, Health, and Well-Being

Research on choirs and other forms of group singing has been conducted for several decades and there has been a recent focus on the potential health and well-being benefits, particularly in amateur singers. Experimental, quantitative, and qualitative studies show evidence of a range of biopsychosocial and well-being benefits to singers; however, there are many challenges to rigor and replicability. To support the advances of research into group singing, the authors met and discussed theoretical and methodological issues to be addressed in future studies. The authors are from five countries and represent the following disciplinary perspectives: music psychology, music therapy, community music, clinical psychology, educational and developmental psychology, evolutionary psychology, health psychology, social psychology, and public health. This article summarizes our collective thoughts in relation to the priority questions for future group singing research, theoretical frameworks, potential solutions for design and ethical challenges, quantitative measures, qualitative methods, and whether there is scope for a benchmarking set of measures across singing projects. With eight key recommendations, the article sets an agenda for best practice research on group singing

(2R)-4-[(9H-Fluoren-9-ylmeth­oxy)carbon­yl]-2-methyl­piperazin-1-ium chloride

The synthesis of the title salt, C20H23N2O2 +·Cl−, was carried out with a precursor of known absolute configuration (R) and the X-ray analysis confirmed that the product retained the absolute configuration. In the crystal, the dominant packing motif is a chain running along [010] generated by N—H⋯Cl hydrogen bonding. C—H⋯O and C—H⋯Cl inter­actions are also observed

Applying Recent Argumentation Methods to Some Ancient Examples of Plausible Reasoning

Plausible (eikotic) reasoning known from ancient Greek (late Academic) skeptical philosophy is shown to be a clear notion that can be analyzed by argu- mentation methods, and that is important for argumentation studies. It is shown how there is a continuous thread running from the Sophists to the skeptical philosopher Carneades, through remarks of Locke and Bentham on the subject, to recent research in artificial intelligence. Eleven characteristics of plausible reasoning are specified by analyzing key examples of it recognized as important in ancient Greek skeptical philosophy using an artificial intelligence model called the Carneades Argumentation System (CAS). By applying CAS to ancient examples it is shown how plausible reasoning is especially useful for gaining a better understanding of evidential reasoning in law, and argued that it can also be applied to everyday argumentation. Our analysis of the snake and rope example of Carneades is also used to point out some ways CAS needs to be extended if it is to more fully model the views of this ancient philosopher on argumentation

Electrocardiographic features of immune checkpoint inhibitor associated myocarditis

Background Myocarditis is a highly morbid complication of immune checkpoint inhibitor (ICI) use that remains inadequately characterized. The QRS duration and the QTc interval are standardized electrocardiographic measures that are prolonged in other cardiac conditions; however, there are no data on their utility in ICI myocarditis. Methods From an international registry, ECG parameters were compared between 140 myocarditis cases and 179 controls across multiple time points (pre-ICI, on ICI prior to myocarditis, and at the time of myocarditis). The association between ECG values and major adverse cardiac events (MACE) was also tested. Results Both the QRS duration and QTc interval were similar between cases and controls prior to myocarditis. When compared with controls on an ICI (93±19 ms) or to baseline prior to myocarditis (97±19 ms), the QRS duration prolonged with myocarditis (110±22 ms, p<0.001 and p=0.009, respectively). In contrast, the QTc interval at the time of myocarditis (435±39 ms) was not increased compared with pre-myocarditis baseline (422±27 ms, p=0.42). A prolonged QRS duration conferred an increased risk of subsequent MACE (HR 3.28, 95% CI 1.98 to 5.62, p<0.001). After adjustment, each 10 ms increase in the QRS duration conferred a 1.3-fold increase in the odds of MACE (95% CI 1.07 to 1.61, p=0.011). Conversely, there was no association between the QTc interval and MACE among men (HR 1.33, 95% CI 0.70 to 2.53, p=0.38) or women (HR 1.48, 95% CI 0.61 to 3.58, p=0.39). Conclusions The QRS duration is increased in ICI myocarditis and is associated with increased MACE risk. Use of this widely available ECG parameter may aid in ICI myocarditis diagnosis and risk-stratification

Effect of powder metallurgy synthesis parameters for pure aluminium on resultant mechanical properties

In this work, pure aluminium powders of different average particle size were compacted, sintered into discs and tested for mechanical strength at different strain rates. The effects of average particle size (15, 19, and 35 μm), sintering rate (5 and 20 °C/min) and sample indentation test speed (0.5, 0.7, and 1.0 mm/min) were examined. A compaction pressure of 332 MPa with a holding time of six minutes was used to produce the green compacted discs. The consolidated green specimens were sintered with a holding time of 4 h, a temperature of 600 °C in an argon atmosphere. The resulting sintered samples contained higher than 85% density. The mechanical properties and microstructure were characterized using indentation strength measurement tests and SEM analysis respectively. After sintering, the aluminium grain structure was observed to be of uniform size within the fractured samples. The indentation test measurements showed that for the same sintering rate, the 35 μm powder particle size provided the highest radial and tangential strength while the 15 μm powder provided the lowest strengths. Another important finding from this work was the increase in sintered sample strength which was achieved using the lower sinter heating rate, 5 °C/min. This resulted in a tangential stress value of 365 MPa which was significantly higher than achieved, 244 MPa, using the faster sintering heating rate, 20 °C/min