26 research outputs found

    Normative resistance to responsibility to protect in times of emerging multipolarity: the cases of Brazil and Russia

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    This article assesses the normative resistance to Responsibility to Protect adopted by Brazil and Russia against the backdrop of their international identities and self-assigned roles in a changing global order. Drawing upon the framework of Bloomsfield's norm dynamics role spectrum, it argues that while the ambiguous Russian role regarding this principle represents an example of 'norm antipreneurship', particularities of Brazil's resistance are better grasped by a new category left unaccounted for by this model, which this study portrays as 'contesting entrepreneur'.- (undefined

    Disrupted Functional Brain Connectivity in Partial Epilepsy: A Resting-State fMRI Study

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    Examining the spontaneous activity to understand the neural mechanism of brain disorder is a focus in recent resting-state fMRI. In the current study, to investigate the alteration of brain functional connectivity in partial epilepsy in a systematical way, two levels of analyses (functional connectivity analysis within resting state networks (RSNs) and functional network connectivity (FNC) analysis) were carried out on resting-state fMRI data acquired from the 30 participants including 14 healthy controls(HC) and 16 partial epilepsy patients. According to the etiology, all patients are subdivided into temporal lobe epilepsy group (TLE, included 7 patients) and mixed partial epilepsy group (MPE, 9 patients). Using group independent component analysis, eight RSNs were identified, and selected to evaluate functional connectivity and FNC between groups. Compared with the controls, decreased functional connectivity within all RSNs was found in both TLE and MPE. However, dissociating patterns were observed within the 8 RSNs between two patient groups, i.e, compared with TLE, we found decreased functional connectivity in 5 RSNs increased functional connectivity in 1 RSN, and no difference in the other 2 RSNs in MPE. Furthermore, the hierarchical disconnections of FNC was found in two patient groups, in which the intra-system connections were preserved for all three subsystems while the lost connections were confined to intersystem connections in patients with partial epilepsy. These findings may suggest that decreased resting state functional connectivity and disconnection of FNC are two remarkable characteristics of partial epilepsy. The selective impairment of FNC implicated that it is unsuitable to understand the partial epilepsy only from global or local perspective. We presumed that studying epilepsy in the multi-perspective based on RSNs may be a valuable means to assess the functional changes corresponding to specific RSN and may contribute to the understanding of the neuro-pathophysiological mechanism of epilepsy

    Liver cell therapy: is this the end of the beginning?

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    The prevalence of liver diseases is increasing globally. Orthotopic liver transplantation is widely used to treat liver disease upon organ failure. The complexity of this procedure and finite numbers of healthy organ donors have prompted research into alternative therapeutic options to treat liver disease. This includes the transplantation of liver cells to promote regeneration. While successful, the routine supply of good quality human liver cells is limited. Therefore, renewable and scalable sources of these cells are sought. Liver progenitor and pluripotent stem cells offer potential cell sources that could be used clinically. This review discusses recent approaches in liver cell transplantation and requirements to improve the process, with the ultimate goal being efficient organ regeneration. We also discuss the potential off-target effects of cell-based therapies, and the advantages and drawbacks of current pre-clinical animal models used to study organ senescence, repopulation and regeneration

    Clinical investigation of dynamic and enduring aspects of global cognition in aged population

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    Background: A major issue in evaluating the cognitive status of ageing populations is a clear distinction between enduring and dynamic aspects of global cognition necessary for evaluating risks of dementia and effectiveness of preventive interventions. Materials and methods: Generalizability Theory was applied to investigate dynamic and enduring aspects of global cognition using longitudinal data over 10 years of follow-up. Measures included the Mini-Mental Status Examination (MMSE) and the Telephone Interview for Cognitive Status-modified (TICS-M). The sample (N = 238) included 154 females, mean age = 76.54 years, SD = 3.94 from the Sydney Memory and Ageing Study. Results: The MMSE measured dynamic and enduring aspects of cognition to a comparable degree with 56% of variance explained by enduring aspects and 44% by dynamic aspects and showed low sensitivity/high specificity in detecting dementia. A shortened version of the MMSE (MMSE-D8) better captured dynamic aspects of cognition after removing three items less sensitive to change. The TICS-M predominantly measured enduring aspects of cognition (72%) with the remaining 28% due to dynamic aspects and displayed high sensitivity/high specificity for dementia screening. Conclusions: The MMSE measures both dynamic and enduring cognitive aspects and is suitable for general clinical assessments, while the MMSE-D8 can be used to monitor transitory changes of global cognition over time. The TICS-M is more useful for measuring enduring features of cognition and screening for dementia. Our findings highlight the value of generalizability theory to distinguish dynamic and enduring features of cognition, which may contribute to preventive interventions and monitoring cognitive ability over time

    Enhancing precision of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) using Rasch methodology

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    Objective: This study aimed to investigate psychometric properties and enhance precision of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) up to interval-level scale using Rasch methodology. Design: Partial Credit Rasch model was applied to the IQCODE-16 scores using longitudinal data spanning 10 years of biennial follow-up. Setting: Community-dwelling older adults aged 70-90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study (MAS). Participants: The sample included 400 participants of the MAS aged 70 years and older, 109 out of those were diagnosed with dementia 10 years after the baseline assessment. Measurements: The IQCODE-16. Results: Initial analysis indicated excellent reliability of the IQCODE-16, Person Separation Index (PSI) = 0.92, but there were four misfitting items and local dependency issues. Combining locally dependent items into four super-items resulted in the best Rasch model fit with no misfitting or locally dependent items, strict unidimensionality, strong reliability, and invariance across person factors such as participants' diagnosis and relationship to their informants, as well as informants' age and sex. This permitted the generation of conversion algorithms to transform ordinal scores into interval data to enhance precision of measurement. Conclusions: The IQCODE-16 demonstrated strong reliability and satisfied expectations of the unidimensional Rasch model after minor modifications. Ordinal-to-interval transformation tables published here can be used to increase accuracy of the IQCODE-16 without altering its current format. These findings could contribute to enhancement of precision in assessing clinical conditions such as cognitive decline in older people

    New Avenue for the Geriatric Depression Scale: Rasch Transformation Enhances Reliability of Assessment

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    Background Depression is a common problem in older adults. The 15-item Geriatric Depression Scale (GDS-15) is a widely used psychometric tool for measuring depression in the elderly, but its psychometric properties have not been yet rigorously investigated. The aim was to evaluate psychometric properties of the GDS-15 and improve precision of the instrument by applying Rasch analysis and deriving conversion tables for transformation of raw scores into interval level data. Methods The data was extracted from the prospective cohort Sydney Memory and Ageing Study of initially not demented individuals aged 70 years and older. The GDS-15 items scores of 212 participants (47.2% males) were analysed using the dichotomous Rasch model. Results Initially poor reliability of the GDS-15, Person Separation Index (PSI)=0.68, was improved by combining locally dependent items into seven super-items. These modifications improved reliability of the GDS-15 (PSI=0.78) and resulted in the best Rasch model fit (χ2(28)=37.72, p=0.104), strict unidimensionality and scale invariance across personal factors such as gender, diagnostic and language background. Limitations Presence of participants with cognitive impairment may be a potential limitation. Conclusions Reliability and psychometric characteristics of the GDS-15 were improved by minor modifications and now satisfy expectations of the unidimensional Rasch model. By using Rasch transformation tables published here psychiatrists, psychologists and researchers can transform GDS raw scores into interval-level data, which improves reliability of the GDS-15 without the need to modify its original response format. These findings increase accuracy of clinical psychometric assessments, leading to more precise diagnosis of depression in the elderly
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