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Long-term micro-structure and cerebral blood flow changes in patients recovered from COVID-19 without neurological manifestations
Get PDFThe coronavirus disease 2019 (COVID-19) rapidly progressed to a global pandemic. Although patients totally recover from COVID-19 pneumonia, long-term effects on the brain still need to be explored. Here, two subtypes (mild type-MG and severe type-SG) with no specific neurological manifestations at the acute stage and no obvious lesions on the conventional MRI three months after discharge were recruited. Changes in gray matter morphometry, cerebral blood flow (CBF) and white matter (WM) microstructure were investigated using MRI. The relationship between brain imaging measurements and inflammation markers were further analyzed. Compared with healthy controls, the decrease in cortical thickness/CBF, and the changes in WM microstructure were observed to be more severe in the SG than MG, especially in the frontal and limbic systems. Furthermore, changes in brain microstructure, CBF and tracts parameters were significantly correlated with inflammatory markers. The indirect injury related to inflammatory storm may damage the brain, that led to these interesting observations. There are also other likely potential causes, such as hypoxemia and dysfunction of vascular endothelium, et al. The abnormalities in these brain areas need to be monitored in the process of complete recovery, which could help clinicians to understand the potential neurological sequelae of COVID-19.
Key words: COVID-19; Brain MRI; Recovered patients; Inflammatory markers; Cortical thickness; Cerebral blood flow; microstructure; gray matter; white matter; subcortical nucle
Role of Bangabandhu in expanding higher education and Bangladesh today
Get PDFThe study attempts to evaluate the role of Bangabandu Sheikh Mujibur Rahman, the Founding Father of Bangladesh, in his initial plan on higher education and to produce adequate human resources to rebuild the country since independence. Secondary sources of information are used to evaluate his role in higher education expansion in Bangladesh. It has been revealed that the economic growth and development seen in Bangladesh today was largely impacted by his education plan
Cultural landscape changes in the built environment at World Heritage Sites: Lessons from Bukovina, Romania
Get PDFWorld Heritage Sites (WHSs) are among the most visited destinations due to their unique cultural and natural features. Their recognition by UNESCO as having ‘outstanding universal value’, while meant to help preserve their characteristics, also leads to increased visitation that may put them at risk. This study focuses on the changes in the cultural landscape as a result of tourism development at WHSs in the region of Bukovina, Romania. The paper offers a comprehensive picture by employing a mixed-method approach and analysing a wealth of data collected from key stakeholders involved in tourism development. The findings show that there is agreement among stakeholders with regard to the importance of preserving the cultural landscape of heritage destinations, with most believing that stricter measures should be put in place. However, the lack of cooperation between the key stakeholders in policy formulation and implementation could pose a threat for the sustainable development of tourism in the region. The study contributes to expanding our knowledge and understanding of the challenges faced by heritage destinations in developing countries in Eastern Europe, in particular their struggle to keep up with the modern life style while preserving their cultural features and thus the authenticity of the area
Teaching here and there, episode 2 with Peter Jamieson
No full textThis episode sees the team discuss hybrid teaching with international learning environment consultant, Professor Peter Jamieson. Peter Jamieson is an Educator with extensive experience across the School and Higher Education sectors working in classrooms and also distance education. He has led the design of innovative learning environments for 25 years, working in more than a dozen countries including the U.K. Most recently he led the design of a major learning facility at Australia’s leading agricultural college and the creation of a new P-12 school in Costa Rica. He is currently involved in multiple projects with a network of schools in Spain.
Peter talked passionately about how important it is to bring the students into the hybrid teaching session, so that their voice can be heard and that they are seen as a vital part of the learning experience. In a hybrid context academics need to think how to gain the benefit of having students in a class that may be being conducted in such a way by other students. Student engagement is key so they need to see the value of their participation in this class
Clinical and cost-effectiveness of a New psychosocial intervention to support Independence in Dementia (NIDUS-family) for family carers and people living with dementia in their own homes: a randomised controlled trial
Get PDFBackground: Most people living with dementia want to remain living in their own homes and are supported to do so by family carers. No interventions have consistently demonstrated improvements to people with dementia’s life quality, functioning, or other indices of living as well as possible with dementia. We have co-produced, with health and social care professionals and family carers of people with dementia, a new intervention (NIDUS-family). To our knowledge, NIDUS-family is the first manualised intervention that can be tailored to personal goals of people living with dementia and their families and is delivered by facilitators without clinical training. The intervention utilizes components of behavioural management, carer support, psychoeducation, communication and coping skills training, enablement, and environmental adaptations, with modules selected to address dyads’ selected goals. We will evaluate the effect of NIDUS-family and usual care on goal attainment, as measured by Goal Attainment Scaling (GAS) rated by family carers, compared to usual care alone at 12-month follow-up. We will also determine whether NIDUS-family and usual care is more cost-effective than usual care alone over 12 months.
Methods: A randomised, two-arm, single-masked, multi-site clinical trial involving 297 people living with dementia- family carer dyads. Dyads will be randomised 2:1 to receive the NIDUS-family intervention with usual care (n = 199) or usual care alone (n = 98). The intervention group will be offered, over 1 year, via 6–8 video call or telephone sessions (or face to face if COVID-19 restrictions allow in the recruitment period) in the initial 6 months, followed by telephone follow-ups every 1–2 months to support implementation, with a trained facilitator.
Discussion: Increasing the time lived at home by people living with dementia is likely to benefit lives now and in the future. Our intervention, which we adapted to include remote delivery prior to trial commencement due to the COVID-19 pandemic, aims to address barriers to living as well and as independently as possible that distress people living with dementia, exacerbate family carer(s) stress, negatively affect relationships, lead to safety risks, and frequently precipitate avoidable moves to a care home.
Trial registration: International Standard Randomised Controlled Trials Number ISRCTN11425138. Registered on 7 October 201
Impact of gender on the lipid profile of patients with coronary artery disease: a Bayesian analytical approach
Get PDFBackground: The variation of the lipid profile by sex in patients with coronary artery disease (CAD) is well known. However, when the sample size is small, it is difficult to establish this association.
Objectives: The present study uses the Bayesian paradigm to understand the association between sex and lipid profile in patients with coronary artery disease and compares the results with classical approaches.
Methods: The study is based on a secondary analysis of CAD patients’ data (n = 1045) from NHANES (2015-2016), older than 50 years for which lipid profile measurements were available. The clinical diagnosis of CAD was positive in 91 individuals and negative in 945. The comparison of differences in lipid profiles by sex was performed under the classical paradigm (independent sample t-test and Wilcoxon Rank Sum Test) and Bayesian.
Results: CAD-positive men were younger (54-80 years) than women (57-80 years). Lipid parameters (total cholesterol, LDL, direct HDL, non-HDL) differed significantly according to sex, under both classical and Bayesian paradigms; except triglycerides and two proportions (TC: HDL, LDL: HDL). However, the Bayesian paradigm has suggested differences even for triglycerides and two sex ratios.
Conclusions: The present study demonstrates the application of Bayesian t test in the case of a small sample size. This clearly suggests that even when the sample size is small, the Bayesian paradigm closely approximates our prior knowledge of the lipid profile as a risk factor for the development of CAD. The Bayesian paradigm revealed the importance of clinical parameters (triglycerides, TC: HDL and LDL: HDL), which remained hidden under the classical t-test and the non-parametric Wilcoxon Rank Sum Test
Effect of concentrated butt-joints on flexural properties of laminated bamboo-timber flitch beams
Get PDFThis paper presents the experimental and analytical studies to investigate the effect of concentrated butt-joints on the flexural properties of laminated bamboo-timber flitch beam (BTFB, or bio-flitch beam). The experimental results reveal that the concentrated butt-joints significantly reduce the flexural strength of the BTFB. They also suggest that the failure mechanism of the BTFB with or without concentrated butt-joints are completely different but less evidence shows an obvious effect of the butt-joints on the modulus of elasticity in bending. In addition, laminated bamboo lumber with concentrated butt-joints is found to be unsuitable for structural applications. The analytical predictions are in close agreement with the experimental results that demonstrate the potentials of the proposed analytical model as a forensic investigation instrument to estimate the strength reduction of the structure, if the butt-jointed laminated bamboo was, unfortunately, used in construction
The Copla musical: escapist songs for marginal collectives from the Spain of Franco to the rest of the world
No full textMultibeat echocardiographic phase detection using deep neural networks
Get PDFBackground
Accurate identification of end-diastolic and end-systolic frames in echocardiographic cine loops is important, yet challenging, for human experts. Manual frame selection is subject to uncertainty, affecting crucial clinical measurements, such as myocardial strain. Therefore, the ability to automatically detect frames of interest is highly desirable.
Methods
We have developed deep neural networks, trained and tested on multi-centre patient data, for the accurate identification of end-diastolic and end-systolic frames in apical four-chamber 2D multibeat cine loop recordings of arbitrary length. Seven experienced cardiologist experts independently labelled the frames of interest, thereby providing infallible annotations, allowing for observer variability measurements.
Results
When compared with the ground-truth, our model shows an average frame difference of −0.09 ± 1.10 and 0.11 ± 1.29 frames for end-diastolic and end-systolic frames, respectively. When applied to patient datasets from a different clinical site, to which the model was blind during its development, average frame differences of −1.34 ± 3.27 and −0.31 ± 3.37 frames were obtained for both frames of interest. All detection errors fall within the range of inter-observer variability: [-0.87, −5.51]±[2.29, 4.26] and [-0.97, −3.46]±[3.67, 4.68] for ED and ES events, respectively.
Conclusions
The proposed automated model can identify multiple end-systolic and end-diastolic frames in echocardiographic videos of arbitrary length with performance indistinguishable from that of human experts, but with significantly shorter processing time