Diverse we stand: Horizontal inequality and ethno-communal conflict in Indonesia

This paper aims to shed some light on the drivers of (relatively) small-scale ethno-communal violence within an ethnically diverse state, by quantitatively examining the relationship between horizontal inequalities and ethno-communal violence. Specifically it addresses the complexity in assessing the effect of Horizontal Inequality on ethno-communal conflict in Indonesia. The paper examines the case of Indonesia around the time of the downfall of the New Order regime and the first years of the reformasi (roughly 1997-2003). Different HI indicators are constructed and a pooled time series cross-sectional probit regression is utilised, using deadly ethno-communal violence as a binary (dummy) dependent variable. The research measures HI indicators across five dimensions (health, employment, education, housing and network connectivity), which are further subdivided into access and achievement variables. Results show that while horizontal inequalities can be considered a determinant for ethno-communal conflict, there are marked differences in the society for different groups, in this case linguistic versus religious groups. Preliminary results show that a common basis is formed by horizontal inequalities in malnutrition and water source. A main driver of the ethno-religious estimations has been adult educational attainment, pointing out to a narrative where schooling - and the career chances that come with it - is something for the privileged groups, leading to frustration among the disadvantaged. This study adds to the existing literature on horizontal inequalities and conflict by building on previous studies and looking further at a broad range of horizontal inequality indicators within the diverse context of Indonesia. We reflect on the notion that there is not a single dimension with a clearly stronger explanatory strength than another. Rather, it is the combination of different facets of horizontal inequality that enables us to uncover the variation in the data

Modeling PM 2.5

Outdoor air pollution costs millions of premature deaths annually, mostly due to anthropogenic fine particulate matter (or PM2.5). Quito, the capital city of Ecuador, is no exception in exceeding the healthy levels of pollution. In addition to the impact of urbanization, motorization, and rapid population growth, particulate pollution is modulated by meteorological factors and geophysical characteristics, which complicate the implementation of the most advanced models of weather forecast. Thus, this paper proposes a machine learning approach based on six years of meteorological and pollution data analyses to predict the concentrations of PM2.5 from wind (speed and direction) and precipitation levels. The results of the classification model show a high reliability in the classification of low (25 µg/m3) and low (<10 µg/m3) versus moderate (10–25 µg/m3) concentrations of PM2.5. A regression analysis suggests a better prediction of PM2.5 when the climatic conditions are getting more extreme (strong winds or high levels of precipitation). The high correlation between estimated and real data for a time series analysis during the wet season confirms this finding. The study demonstrates that the use of statistical models based on machine learning is relevant to predict PM2.5 concentrations from meteorological data

Telerehabilitation platform for hip surgery recovery

CEPRA XI-2017-15.The enhancement of ubiquitous and pervasive computing brings new perspectives in terms of medical rehabilitations. In that sense, the present study proposes a Web-based platform to promote the reeducation of patients after hip replacement surgery. This project focuses on two fundamental aspects in the development of a suitable telerehabilitation application, which are: (i) being based on an affordable technology and (ii) providing the patients with a real-time assessment of the correctness of their movements. A comparative test shows that the movement's evaluation carried out by therapists is consistent with the output of the automatic assessment module. Improvements of the algorithm are discussed, in order to increase the accuracy and depth of the analysis.authorsversionpublishe

On the use of natural user interfaces in physical rehabilitation: a web-based application for patients with hip prosthesis

This study aims to develop a telemedicine platform for self-motor rehabilitation and remote monitoring by health professionals, in order to enhance recovery in patients after hip replacement. The implementation of such a technology is justified by medical (improvement of the recovery process by the possibility to perform rehabilitation exercises more frequently), economic (reduction of the number of medical appointments and the time patients spend at the hospital), mobility (diminution of the transportation to and from the hospital) and ethics (healthcare democratization and increased empowerment of the patient) purposes. The Kinect camera is used as a Natural User Interface to capture the physical exercises performed at home by the patients. The quality of the movement is evaluated in real-time by an assessment module implemented according to a Hidden-Markov Model approach. The results show a high accuracy in the evaluation of the movements (92% of correct classification). Finally, the usability of the platform is tested through the System Usability Scale (SUS). The overall SUS score is 81 out of 100, which suggests a good usability of the Web application. Further work will focus on the development of additional functionalities and an evaluation of the impact of the platform on the recovery process

Continued Benefits of Methylphenidate in ADHD After 2 Years in Clinical Practice:A Randomized Placebo-Controlled Discontinuation Study

Objective: The benefits of long-term use of methylphenidate treatment in children and adolescents with attention deficit hyperactivity disorder (ADHD), as frequently prescribed in clinical practice, are unclear. The authors investigated whether methylphenidate remains beneficial after 2 years of use. Methods: Ninety-four children and adolescents (ages 8-18 years) who had been treated in regular care with methylphenidate for more than 2 years were randomly assigned to double-blind continuation of treatment for 7 weeks (36 or 54 mg/day of extended-release methylphenidate) or gradual withdrawal over 3 weeks, to 4 weeks of placebo. The primary outcome measure was the investigator-rated ADHD Rating Scale (ADHD-RS); secondary outcome measures were the investigator-rated Clinical Global Impressions improvement scale (CGI-I) and the Conners' Teacher Rating Scale-Revised: Short Form (CTRS-R:S). Continuous ratings were analyzed with mixed model for repeated measures analyses, and the CGI-I with a chi-square test. Results: The mean ADHD-RS scores at baseline for the continuation and discontinuation groups, respectively, were 21.4 (SD=9.7) and 19.6 (SD=8.9); after 7 weeks, the mean scores were 21.9 (SD=10.8) and 24.7 (SD=11.4), with a significant between-group difference in change over time of 24.6 (95% CI=28.7, 20.56) in favor of the group that continued methylphenidate treatment. The ADHD-RS inattention subscale and the CTRS-R: S ADHD index and hyperactivity subscale also deteriorated significantly more in the discontinuation group. The CGI-I indicated worsening in 40.4% of the discontinuation group, compared with 15.9% of the continuation group. Conclusions: Continued treatment with methylphenidate remains effective after long-term use. Some individual patients may, however, be withdrawn from methylphenidate without deterioration. This finding supports guideline recommendations that patients be assessed periodically to determine whether there is a continued need for methylphenidate treatment

Polygenic risk scores for antisocial behavior in relation to amygdala morphology across an attention deficit hyperactivity disorder case-control sample with and without disruptive behavior

Antisocial and aggressive behaviors show considerable heritability and are central to disruptive behavior disorders (DBDs), but are also frequently observed in attention deficit hyperactivity disorder (ADHD). While the amygdala is implicated as a key neural structure, it remains unclear whether common genetic variants underlie this brain-behavior association. We hypothesized that polygenic (risk) scores for antisocial and aggressive behaviors (ASB-PRS) would be related to amygdala morphology. Using the Broad Antisocial Behavior Consortium genome-wide association study (GWAS; mostly population based cohorts), we calculated ASB-PRS in the NeuroIMAGE I ADHD case-control sample with varying levels of DBD symptomatology (n=679 from 379 families, aged 7 - 29). We first investigated associations of several ASB-PRS p value thresholds with the presence of DBD symptoms and self-reported antisocial behavior (ASB) to determine the threshold for further analyses. This PRS was then related to amygdala volume and shape using regression and vertex-wise analyses. Our results showed associations of ASB-PRS with the presence of DBD symptoms, self-reported ASB, and left basolateral amygdala shape, independent of ADHD symptom severity and ADHD-PRS, with a relative outward displacement of the vertices. No associations of ASB-PRS, DBD symptoms or self-reported ASB with amygdala volume were found. Our results indicate that genetic risk for antisocial and aggressive behaviors is related to amygdala shape alterations, and point to genetic sharing across different DBD and ASB and aggression-related phenotypes as a spectrum of genetically related quantitative traits. Additionally, our findings support the utility of vertex-based shape analyses in genetic studies of ASB, aggression, and DBDs

Effects of Discontinuing Methylphenidate on Strengths and Difficulties, Quality of Life and Parenting Stress

Objectives: To study the effects of discontinuation of long-term methylphenidate use on secondary outcome measures of strengths and difficulties, quality of life (QoL), and parenting stress. Methods: Ninety-four children and adolescents aged 8 to 18 years who had used methylphenidate for over 2 years were randomly assigned to double-blind continuation of treatment for 7 weeks (36 or 54 mg extended release methylphenidate) or to gradual withdrawal over 3 to 4 weeks placebo. We used mixed models for repeated measures to investigate effects on parent, teacher, and child ratings of hyperactivity/inattention and comorbid symptoms with the Strengths and Difficulties Questionnaire (SDQ), investigator- and teacher-rated oppositional symptoms (Conners Teacher Rating Scale-Revised: short form [CTRS-R:S]), and parent-rated aggression with the Retrospective Modified Overt Aggression Scale. QoL was assessed with the Revised Questionnaire for Children and Adolescents to record health-related quality of life and parenting stress with the Nijmegen Parental Stress Index. Results: Hyperactivity/inattention scores from the parent- and teacher-rated SDQ (difference in mean change over time of respectively: -1.1 [95% confidence interval, CI, -2.0 to -0.3]; p = 0.01; -2.9 [95% CI -2.9 to -0.7; p = 0.01]) and oppositional scores of the teacher-rated CTRS-R:S (difference in mean change -1.9 95% CI [-3.1 to -0.6; p <0.01]) deteriorated to a significantly larger extent in the discontinuation group than in the continuation group. We did not find effects on other symptom domains, aggression, QoL, and parenting stress after discontinuation of methylphenidate. Conclusion: Our study suggests beneficial effects of long-term methylphenidate use beyond 2 years for oppositional behaviors in the school environment. Similarly, beneficial effects were found on hyperactivity-inattention symptoms as rated by parent and teacher scales, confirming our primary study on investigator ratings of attention-deficit/hyperactivity disorder. However, discontinuation of methylphenidate did not appear to have impact on other comorbid problems or aspects of the child's or parental functioning

Emotion recognition profiles in clusters of youth based on levels of callous-unemotional traits and reactive and proactive aggression

Youth with disruptive behavior showing high callous-unemotional (CU) traits and proactive aggression are often assumed to exhibit distinct impairments in emotion recognition from those showing mainly reactive aggression. Yet, reactive and proactive aggression and CU traits may co-occur to varying degrees across individuals. We aimed to investigate emotion recognition in more homogeneous clusters based on these three dimensions. In a sample of 243 youth (149 with disruptive behavior problems and 94 controls) aged 8-18 years, we used model-based clustering on self-report measures of CU traits and reactive and proactive aggression and compared the resulting clusters on emotion recognition (accuracy and response bias) and working memory. In addition to a Low and Low-Moderate symptom cluster, we identified two high CU clusters. The CU-Reactive cluster showed high reactive and low-to-medium proactive aggression; the CU-Mixed cluster showed high reactive and proactive aggression. Both CU clusters showed impaired fear recognition and working memory, whereas the CU-Reactive cluster also showed impaired recognition of disgust and sadness, partly explained by poor working memory, as well as a response bias for anger and happiness. Our results confirm the importance of CU traits as a core dimension along which youth with disruptive behavior may be characterized, yet challenge the view that high CU traits are closely linked to high proactive aggression per se. Notably, distinct neurocognitive processes may play a role in youth with high CU traits and reactive aggression with lower versus higher proactive aggression. Keywords: Callous-unemotional traits; Disruptive behavior problems; Emotion recognition; Proactive aggression; Reactive aggressio

Executive functioning and emotion recognition in youth with oppositional defiant disorder and/or conduct disorder

Objectives: Executive functioning and emotion recognition may be impaired in disruptive youth, yet findings in oppositional defiant disorder (ODD) and conduct disorder (CD) are inconsistent. We examined these functions related to ODD and CD, accounting for comorbid attention-deficit/hyperactivity disorder (ADHD) and internalising symptoms.Methods: We compared executive functioning (visual working memory, visual attention, inhibitory control) and emotion recognition between youth (8-18 years old, 123 boys, 55 girls) with ODD (n = 44) or CD (with/without ODD, n = 48), and healthy controls (n = 86). We also related ODD, CD, and ADHD symptom counts and internalising symptomatology to all outcome measures, as well as executive functioning to emotion recognition.Results: Visual working memory and inhibitory control were impaired in the ODD and CD groups versus healthy controls. Anger, disgust, fear, happiness, and sadness recognition were impaired in the CD group; only anger recognition was impaired in the ODD group. Deficits were not explained by comorbid ADHD or internalising symptoms. Visual working memory was associated with recognition of all basic emotions.Conclusions: Our findings challenge the view that neuropsychological impairments in youth with ODD/CD are driven by comorbid ADHD and suggest possible distinct neurocognitive mechanisms in CD versus ODD