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Text readability assessment is a challenging interdisciplinary endeavor with rich practical implications. It has long drawn the attention of researchers internationally, and the readability models since developed have been widely applied to various fields. Previous readability models have only made use of linguistic features employed for general text analysis and have not been sufficiently accurate when used to gauge domain-specific texts. In view of this, this study proposes a latent-semantic-analysis (LSA)-constructed hierarchical conceptual space that can be used to train a readability model to accurately assess domain-specific texts. Compared with a baseline reference using a traditional model, the new model improves by 13.88% to achieve 68.98% of accuracy when leveling social science texts, and by 24.61% to achieve 73.96% of accuracy when assessing natural science texts. We then combine the readability features developed for the current study with general linguistic features, and the accuracy of leveling social science texts improves by an even higher degree of 31.58% to achieve 86.68%, and that of natural science texts by 26.56% to achieve 75.91%. These results indicate that the readability features developed in this study can be used both to train a readability model for leveling domain-specific texts and also in combination with the more common linguistic features to enhance the efficacy of the model. Future research can expand the generalizability of the model by assessing texts from different fields and grade levels using the proposed method, thus enhancing the practical applications of this new method.
A neutron powder diffractometer at the University of Missouri Research Reactor (MURR) uses a linear position sensitive detector (PSD) which has increased both resolution and data acquisition rates. Rietveld analysis works as well with this system as with more conventional single and multi- Soller slit detector systems. This analysis has been successfully applied to problems involving more than 75 parameters and 1200 reflections and a future instrument upgrade should allow analyses which involve 100-150 parameters. A special advantage of the PSD instrument is that it needs only small (1-2 gm) samples to achieve high statistical accuracy.
Purpose: We identified key clinicopathologic features of brain metastasis (BM) patients who are long-term survivors (LTS). Methods: We screened a prospective database of 1892 patients (treated 2006-2017), identified 92 (5%) who lived > 3 years following BM diagnosis, and performed per patient analyses. Results: Median age at diagnosis of BM was 57 years (range 19-77), 77% were women. The most common tumors were lung (50%), breast (26%), thyroid (7%) and skin (5%). 42% had tumors with drug-targetable oncoproteins (e.g. EGFR mutant) and 15% expressed hormonal receptors. ECOG was <2 in 70%. 47% had stage IV disease at diagnosis (75% with brain as the first site). 55% had controlled extracranial disease at the time of BM diagnosis. Median BM diameter was 1.5 cm (range 0.2-7) and 62% had a single lesion. Treatment was with surgery, radiosurgery, whole brain radiation (WBRT), or systemic therapy alone in 38%, 62%, 52%, and 4%, respectively. 53% received targeted- or immuno-therapy. Median follow up was 63 months (range 36-113). 61% failed intracranially at a median 24 months (range 1-99). 5 and 10- year survival (from BM diagnosis) was 82%, and 34%, respectively. Neither upfront WBRT nor other variables tested correlated with improved survival. In patients who died, an MRI was available within 3 months from death in 57%; of those 55% had no active intracranial disease, suggesting that the majority of deaths were non-neurologic. Conclusion: In general, LTS of BM had a limited number of BM, inactive extracranial disease, and drug targetable mutations.
Background: Brain tumors present unique challenges to patient and family quality of life (QOL). Cognitive dysfunction is common and functionally limiting, with no established treatments. These studies evaluate feasibility and preliminary efficacy of behavioral interventions developed for neuro-oncology patients. Study 1: A randomized controlled trial (N=25 primary brain tumor patients) compared an adapted version of Goal Management Training (GMT, a neuroscience-based integration of mindfulness and strategy training) and a newly-designed supportive psychoeducational intervention (Brain Health Program, BHP) to standard of care. Each intervention comprised 8 individual sessions and at-home practice between sessions. GMT patients’ executive functions improved immediately (p=.077, d=1.13), with maintenance at 4-month follow-up (p=.046, d=1.09). Both intervention groups reported improvements in everyday cognitive functioning immediately (p=.049; d’s GMT=0.43, BHP=0.79) and at follow-up (p=.001; d’s GMT=0.22, BHP=1.01). BHP patients also reported improved mood (p’s=.026 & .012, d’s=0.61 & 0.62). Study 2: Following a needs assessment about cognitive concerns and QOL in brain metastases patients (N=109) and caregivers (N=31), we developed a novel, brief (3 sessions + homework) Cognitive Support Program to provide education and strategy-training in key areas of concern: executive functions, memory, and communication. Options include caregiver co-training, and in-person or web-based delivery. Preliminary data from a pilot trial in progress demonstrate objective and subjective improvements. Conclusions: Cognitive rehabilitation may be a feasible and effective option for primary or metastatic brain tumor patients, addressing a need that is largely unmet in standard cancer care. Further development and larger trials appear warranted, with capacity for remote delivery recommended.
Background: Glioblastoma is the most common adult malignant glioma, with poor prognosis and adverse neurological sequelae. Physical activity improves outcomes in patients with other cancers, but has not been evaluated in GBM. This prospective, single-arm intervention trial examines feasibility and preliminary efficacy of exercise on PFS, cognition and QOL in newly diagnosed GBM patients. Method: Participants are English-speaking GBM patients scheduled for concurrent chemoradiation at PMH, 18-65 years old, ECOG ≤ 2. The 3-month home-based exercise program includes aerobic and resistance training, tailored to prior fitness level, current physical status, and individual interests. Assessments of physical and neurocognitive functions, mood, fatigue, sleep, and QOL, occur within 2 weeks of starting chemoradiation, and approximately 3, 6, 12, and 18 months later, or until tumor progression. Feasibility will be assessed by accrual, retention, and adherence rates. Outcomes include PFS (RANO criteria), change in cognition (reliable change index method), physical activity and sleep (actigraphy, self-report questionnaires). Time-to-event outcomes will be estimated (Kaplan-Meier), and mixed modelling will explore individual and disease variables that contribute to outcomes. Results: During the first five months of recruitment, 13 of 19 eligible patients consented. Nine completed the exercise program. One patient died after the intervention and none of the others progressed. No exercise-related serious adverse events occurred. Preliminary results will be presented at the meeting. Discussion: Exercise appears feasible for GBM patients. Effects on survival, performance status, cognition, sleep, mood, and QOL are ongoing. Results may guide physical activity recommendations in GBM and generate avenues for translational research.
To examine the impact of a simulation training in raising a group of young students’ personal and situational awareness in disasters and emergencies.
In total, 25 young students participated in two simulation scenarios representing two actual events, fire, and shooting, using a combination of two validated simulation training (Emergency Management and Preparedness Training for Youth [EMPTY]). The changes in their knowledge and awareness were evaluated by using questionnaires and the whole simulation was evaluated by three independent observers and a reference group.
New concepts of emergency management, for example, evacuation, and barricading, could be trained in a safe environment. There was a significant increase in students’ personal and situational awareness and their active engagement in the management of emergencies.
EMPTY could raise the youth basic knowledge and ability to understand the concept of preparedness by being mentally prepared, available for collaboration, gaining a higher confidence, understanding the physical and psychological consequences of a major incident and the importance of their own safety. (Disaster Med Public Health Preparedness. 2018;12:685-688)
MERCOSUR’s success as an economic bloc suggests that it could serve as a stimulus or even a model for security integration. Improved military ties among the MERCOSUR nations have grown out of a sequence of developments, from political rapprochement to economic convergence and improved civilian state control. Yet increased cooperation has not led to a regional defense system. Case studies reveal that national considerations have inhibited most MERCOSUR members from accepting the idea of a regional security alliance.
The Subject of military rule in Latin America has been a familiar topic of inquiry for many years, but its treatment has been quite selective. While there is voluminous literature on the causes of military coups, very little has been written on military withdrawal from power. Both the example of Brazil's “apertura” (political opening) and the Argentine case under review here are still too recent to expect to find a large quantity of critiques. Even historical experiences of military defeat have gotten poor coverage, such as the fall of the Peruvian regime from 1975-1980. This study will analyze causes of the breakdown of military rule in Argentina, concentrating on the two year period of 1980-1982.
Over time, the Organization of American States has become institutionally and normatively more capable of defending democracy in the region. Yet the OAS is as selective in its interventions on behalf of democratic promotion today as it was in the early 1990s. To explain this puzzle, this study disaggregates democratic dilemmas according to issue areas, threats, and contingencies. It finds that the OAS responds more forcefully when the problem presents a clear and present danger both to the offending state and to other members. As threats become weaker or more ambiguous, the OAS tends to act more timidly, unless domestic constituencies cry out for its assistance or the United States puts its full weight behind the effort. Case study capsules provide empirical evidence to illustrate these arguments.
Objectives: Glioblastoma is a lethal disease in the elderly population. We aimed to evaluate disease and treatment outcomes in the oldest-old patients. Methods: Patients >80 years old with histologically confirmed glioblastoma treated between 2004 and 2009 were identified. We included patients managed with best supportive care (BSC), temozolomide (TMZ) alone, radiotherapy (RT) alone, or concomitantly with TMZ (CRT). Survival outcomes were analyzed using the Kaplan–Meier method. Results: Ultimately, 48 patients were analyzed. Median age and Eastern Cooperative Oncology Group (ECOG) Performance Status were 82 years and 2, respectively. The median Age-Adjusted Charlson Index (AAC) was 6. Gross total and subtotal resections were performed in 16.7% and 18.8% of patients, respectively. Biopsy followed by RT alone was the treatment modality for 23/48 (47.9%), while 17/48 (35.4%) received surgery followed by RT alone or CRT. A total of 8 (16.7%) were managed with BSC after biopsy. Median overall survival (OS) and progression-free survival (PFS) were 4.1 (95% confidence interval [95% CI] 3.3-4.9) and 2.7 (95% CI 1.5-3.9) months, respectively. Improved median OS was observed in those treated with surgical resection followed by RT alone or CRT (7.1 months), compared to biopsy followed by RT alone (4.2 months) or BSC (2.0 months; p=0.002). Surgical resection, age≤85, and AAC<6 were associated with better OS (p=0.032, p=0.031, and p=0.02, respectively). Cause of death was neurological progression in 56% of cases. RT was well-tolerated. Conclusions: PFS and OS outcomes remain poor in the oldest-old patients (>80 years old). Younger age, lower AAC, surgical resection, and adjuvant treatment were associated with improved OS.
While many scholars have studied “urban bias” in public policy, the potential for bias in the private provision of public goods has received little attention. Private certification is a mechanism encouraging private provision of environmental public goods. We show that within countries, there are often wide disparities in certification rates between firms located in urban and non-urban areas. However, these disparities can be mitigated if there is a countervailing force: scrutiny of firms' practices by key stakeholders. We suggest that the presence of strong civil society, independent media, a functioning state regulatory apparatus, and multinational owners can ameliorate the urban bias in certification uptakes. We test this argument with global, firm-level data covering over 40,000 firms in ninety-three countries. Our analyses suggest that an urban bias is mitigated when stakeholders—both public and private—have the freedom and capacity to scrutinize firms' activities.