bluuebunny/crossref_metadata_2025 huggingface dataset:
Anaplasma phagocytophilum presenting with orchitis in a renal transplant recipient
Authors: Khatri Akshay , Lloji Amanda , Doobay Richard , Wang Guiqing , Knoll Bettina , Dhand Abhay , Nog Rajat
Published: June 2019

Human granulocytic anaplasmosis (HGA), caused by Anaplasma phagocytophilum, is an emerging tick‐borne disease. It is spread by the black‐legged deer tick Ixodes scapularis that serves as the vector for six human pathogens. HGA is still rarely reported in solid organ transplant recipients. In solid organ transplant recipients, orchitis has been reported secondary to chickenpox, tuberculosis and infections due to Listeria monocytogenes and Nocardia asteroides. Orchitis as a presenting feature of HGA infection has only been reported in animals. We present a unique case of a renal transplant recipient with HGA that presented as orchitis. We also compare the clinical presentation and laboratory findings of our patient with other cases of HGA in transplant recipients. To the best of our knowledge, our patient is one of the first cases of A phagocytophilum mono‐infection causing a classical presentation of orchitis in a transplant patient.
Clinical trials in low‐resource settings: the perspectives of caregivers of paediatric participants from Uganda, Tanzania and Kenya
Authors: van den Berg Machteld , Ogutu Bernhards , Sewankambo Nelson K. , Merten Sonja , Biller‐Andorno Nikola , Tanner Marcel
Published: June 2019

Objectives

Vaccine clinical trials in low‐resource settings have unique challenges due to structural and financial inequities. Specifically, protecting participant and caregiver autonomy to participate in the research study can be a major challenge, so understanding the setting and contextual factors which influence the decision process is necessary. This study investigates the experience of caregivers consenting on behalf of paediatric participants in a malaria vaccine clinical trial where participation enables access to free, high‐quality medical care.

Methods

We interviewed a total of 78 caregivers of paediatric participants previously enrolled in a phase II or III malaria vaccine clinical trial in Uganda, Tanzania and Kenya. Interviews were qualitative and analysed using a thematic framework analysis focusing on the embodied caregiver in the political, economic and social reality.

Results

Caregivers of participants in this study made the decision to enrol their child based on economic, social and political factors that extended beyond the trial into the community and the home. The provision of health care was the dominant reason for participation. Respondents reported how social networks, rumours, hierarchal structures, financial constraints and family dynamics affected their experience with research.

Conclusions

The provision of medical care was a powerful motivator for participation. Caregiver choice was limited by structural constraints and scarce financial resources. The decision to participate in research extended beyond individual consent and was embedded in community and domestic hierarchies. Future research should assess other contexts to determine how the choice to participate in research is affected when free medical care is offered.
Two‐step d‐ononitol epimerization pathway in Medicago truncatula
Authors: Pupel Piotr , Szablińska‐Piernik Joanna , Lahuta Lesław B.
Published: June 2019

Methylated inositol, d‐pinitol (3‐O‐methyl‐d‐chiro‐inositol), is a common constituent in legumes. It is synthesized from myo‐inositol in two reactions: the first reaction, catalyzed by myo‐inositol‐O‐methyltransferase (IMT), consists of a transfer of a methyl group from S‐adenosylmethionine to myo‐inositol with the formation of d‐ononitol, while the second reaction, catalyzed by d‐ononitol epimerase (OEP), involves epimerization of d‐ononitol to d‐pinitol. To identify the genes involved in d‐pinitol biosynthesis in a model legume Medicago truncatula, we conducted a BLAST search on its genome using soybean IMT cDNA as a query and found putative IMT (MtIMT) gene. Subsequent co‐expression analysis performed on publicly available microarray data revealed two potential OEP genes: MtOEPA, encoding an aldo‐keto reductase and MtOEPB, encoding a short‐chain dehydrogenase. cDNAs of all three genes were cloned and expressed as recombinant proteins in E. coli. In vitro assays confirmed that putative MtIMT enzyme catalyzes methylation of myo‐inositol to d‐ononitol and showed that MtOEPA enzyme has NAD+‐dependent d‐ononitol dehydrogenase activity, while MtOEPB enzyme has NADP+‐dependent d‐pinitol dehydrogenase activity. Both enzymes are required for epimerization of d‐ononitol to d‐pinitol, which occurs in the presence of NAD+ and NADPH. Introduction of MtIMT, MtOEPA, and MtOEPB genes into tobacco plants resulted in production of d‐ononitol and d‐pinitol in transformants. As this two‐step pathway of d‐ononitol epimerization is coupled with a transfer of reducing equivalents from NADPH to NAD+, we speculate that one of the functions of this pathway might be regeneration of NADP+ during drought stress.
Comparison of Some Coordinative Abilities in Terms of Team and Individual Sports
Authors: Peker Alper Tunga , Vural Mustafa
Published: June 2019

The purpose of this research is to compare some coordinative abilities in terms of team and individual sports. A total of 112 athletes were included in the research, of which 60 athletes were from individual sports (Athletics=20, Archery=20, Karate=20) with mean age of 15.02±0.813 years, mean body height of 1.64±0.88 meters and mean body weight of 54.80±11.196 kilograms and 52 athletes were from team sports (Football Player=32, Basketball Player=20) with mean age of 14.98±0.727 years, mean body height of 1.67±0.90 meters and mean body weight of 58.10±9.770 kilograms. Numbered medicine ball run test, backward medicine ball throw test and sprint at the given rhythm test were used to evaluate performances related to coordinative abilities. When our results are examined, it is seen that averages of the participants in team sports category in terms of rhythm, orientation and differentiation abilities are at better level than averages of the participants in individual sports category. It has been seen that individuals in team sports category have significantly better performance than athletes in individual sports in terms of their orientation and differentiation abilities. On the other hand, no significant difference was found for rhythm ability. Consequently, results of the study confirm our pre-research expectations. On the other hand, when literature is examined, it is significant that results obtained from other studies examining coordinative abilities of the athletes in individual sports and team sports categories are similar to our results. It has been seen in the studies in the literature that some results are not similar. It can be thought that different results are caused by age differences and differences in types and branches of sports in which athletes participate.
Enhancing Diesel Engine Performance and Reducing Emissions Using Binary Biodiesel Fuel Blend
Authors: Singh Paramvir , Chauhan S. R. , Goel Varun , Gupta Ashwani K.
Published: June 2019

Fossil fuel consumption provides a negative impact on the human health and environment in parallel with the decreased availability of this valuable natural resource for the future generations to use as a source of chemical energy for all applications in energy, power, and propulsion. The diesel fuel consumption in the transport sector is higher than the gasoline in most developing countries for reasons of cost and economy. Biodiesel fuel offers a good replacement for diesel fuel in compression ignition (CI) diesel engines. Earlier investigations by the authors revealed that a blend of 70% amla seed oil biodiesel and 30% eucalyptus oil (AB70EU30) is the favorable alternative renewable fuel blend that can be used as a fuel in diesel engines. With any fuel, air/fuel mixing and mixture preparation impact efficiency, emissions, and performance in CI engines. Minor adjustments in engine parameters to improve air/fuel mixing and combustion are deployable approaches to achieve good performance with alternative fuel blends in CI engines. This paper provides the role of a minor modification to engine parameters (compression ratio, injection timing, and injection pressure) on improved performance using the above mixture of binary fuel blends (AB70EU30). The results showed that the use of AB70EU30 in modified engine resulted in higher brake thermal efficiency and lower brake specific fuel consumption compared to normal diesel for improved combustion that also resulted in very low tailpipe emissions.
The M Number: A Novel Parameter to Evaluate the Performance of Static Mixers
Authors: Medina Hector , Thomas Morgan , Eldredge Thomas , Adebanjo Ayomikun
Published: June 2019

Static mixers (SM) have become standard equipment in the process industries. They are widely used in applications that involve chemical reactions, heat transfer, blending of fluids, or a combination of these. Compared to mechanically agitated vessels, SMs consume less energy, require less maintenance, and can provide mixing with shorter residence time. Assessment of the performance of SM provides a means to categorize and rank the available devices and new designs, which in turn facilitates selection for specific applications. Applying the second law efficiency (SLE) principle, we derived and proposed a novel mixing parameter, the M number, which is a dimensionless ratio of mixing level to energy loss. The parameter is compared to an industry-standard method of mixing evaluation that relies on the coefficient of variation (CoV) change across the mixer. Both CoV and the M number are used to evaluate mixing performance from computational fluid dynamics (CFD) results for a static mixer for various inlet conditions. Unlike the CoV-based parameters considered, the M number offers the advantages of accounting for energy loss and the natural mixing effects of the system. In addition, an empirical relationship is obtained that relates the M number to the Reynolds number (Re). Potential applications for the M number are discussed and its limitations are noted. Work in progress includes investigation with other SM.
Four new species of eriophyoid mites (Acari: Trombidiformes: Eriophyoidea) on native vegetation from Pampa biome, in the state of Rio Grande do Sul (Brazil)
Authors: Toldi Maicon , Ferla Noeli Juarez , Ferla Júlia Jantsch , Freitas Elisete Maria de , De Lillo Enrico
Published: June 2019

Four new species of eriophyoid mites (Acari: Trombidiformes: Eriophyoidea) were collected from native plant species from Pampa biome, in the state of Rio Grande do Sul, Brazil, and are described and illustrated herein. They have been named: Aculus pampae sp. nov. on Elephantopus mollis Kunth (Asteraceae); Costarectus lanceatus sp. nov. on Sebastiania brasiliensis Spreng. (Euphorbiaceae); Dichopelmus sigfeminae sp. nov. and Rhynacus symflori sp. nov. both on Symplocos uniflora (Pohl) Benth. (Symplocaceae). All new species appeared to be vagrants and no apparent symptom was associated to them.
New Zealand Pyemotes (Trombidiformes: Pyemotidae)
Authors: Yu Lichen , Zhang Zhi-Qiang
Published: June 2019

Pyemotid mites are parasitoids of various insects and are of potential as biocontrol agents. Three New Zealand new species of the genus Pyemotes are described in this paper: Pyemotes cumberi sp. nov. parasitic on Procecidochares utilis (Diptera: Tephritidae) in Auckland, Pyemotes martini sp. nov. parasitic on eggs of Scolypopa (Hemiptera: Ricaniidae) in the Northland, and Pyemotes mayae sp. nov. parasitic on scolytid larvae (Coleoptera) in Auckland. Keys to both adult males and females of these three new species are provided.
Defaunation precipitates the extinction of evolutionarily distinct interactions in the Anthropocene
Authors: Emer Carine , Galetti Mauro , Pizo Marco A. , Jordano Pedro , Verdú Miguel
Published: June 2019

Defaunation erodes millions of years of evolutionary history of bird–seed dispersal interactions in human-modified landscapes.
Efficacy of Azithromycin in a Mouse Pneumonia Model against Hospital-Acquired Methicillin-Resistant Staphylococcus aureus
Authors: Yamashita Yu , Nagaoka Kentaro , Kimura Hiroki , Suzuki Masaru , Konno Satoshi , Fukumoto Tatsuya , Akizawa Koji , Kaku Norihito , Morinaga Yoshitomo , Yanagihara Katsunori
Published: June 2019

The use of macrolides against pneumonia has been reported to improve survival; however, little is known about their efficacy against methicillin-resistant
Staphylococcus aureus
(MRSA) pneumonia. In this study, we investigated the effect of azithromycin (AZM) and compared it with that of vancomycin (VCM) and daptomycin (DAP) in a murine model of MRSA pneumonia. Mice were infected with MRSA by intratracheal injection and then treated with AZM, VCM, or DAP.
Ceftolozane-Tazobactam in the Treatment of Experimental Pseudomonas aeruginosa Pneumonia in Persistently Neutropenic Rabbits: Impact on Strains with Genetically Defined Mechanisms of Resistance
Authors: Petraitis Vidmantas , Petraitiene Ruta , Naing Ethan , Aung Thein , Thi Wai Phyo , Kavaliauskas Povilas , Win Maung Bo Bo , Michel Adam O. , Ricart Arbona Rodolfo J. , DeRyke Andrew C. , Culshaw Darren L. , Nicolau David P. , Satlin Michael J. , Walsh Thomas J.
Published: June 2019

Ceftolozane-tazobactam (C/T) is a novel cephalosporin with
in vitro
activity against
Pseudomonas aeruginosa
that is resistant to extended-spectrum penicillins and antipseudomonal cephalosporins. In order to assess the antimicrobial effect of C/T in treatment of
Pseudomonas
pneumonia, we investigated the pharmacokinetics and efficacy of C/T in persistently neutropenic rabbits.
Pseudomonas
pneumonia was established by direct endotracheal inoculation.
Clinical and Microbiological Outcomes in Obese Patients Receiving Colistin for Carbapenem-Resistant Gram-Negative Bloodstream Infection
Authors: Lam Simon W. , Athans Vasilios
Published: June 2019

Carbapenem-resistant infections are associated with poor outcomes, and treatment options are limited. Colistin is one of few antibiotics which retain
in vitro
activity against carbapenem-resistant pathogens. However, despite the availability of international consensus guidelines for the dosing of polymyxins, there are limited data on the effects of dosing on clinical outcomes among obese patients with carbapenem-resistant Gram-negative bacteremia.
Elevated Prevalence of Azole-Resistant Aspergillus fumigatus in Urban versus Rural Environments in the United Kingdom
Authors: Sewell Thomas R. , Zhang Yuyi , Brackin Amelie P. , Shelton Jennifer M. G. , Rhodes Johanna , Fisher Matthew C.
Published: June 2019

Azole resistance in the opportunistic pathogen
Aspergillus fumigatus
is increasing, dominated primarily by the following two environmentally associated resistance alleles: TR
34
/L98H and TR
46
/Y121F/T289A. By sampling soils across the South of England, we assess the prevalence of azole-resistant
A. fumigatus
(AR
Af
) in samples collected in both urban and rural locations.
The Twin-Arginine Pathway for Protein Secretion
Authors: Frain Kelly M. , van Dijl Jan Maarten , Robinson Colin
Published: June 2019

The Tat pathway for protein translocation across bacterial membranes stands out for its selective handling of fully folded cargo proteins. In this review, we provide a comprehensive summary of our current understanding of the different known Tat components, their assembly into different complexes, and their specific roles in the protein translocation process. In particular, this overview focuses on the Gram-negative bacterium
Escherichia coli
and the Gram-positive bacterium
Bacillus subtilis
. Using these organisms as examples, we discuss structural features of Tat complexes alongside mechanistic models that allow for the Tat pathway’s unique protein proofreading and transport capabilities. Finally, we highlight recent advances in exploiting the Tat pathway for biotechnological benefit, the production of high-value pharmaceutical proteins.
Decreased Seroreactivity in Individuals Initiating Antiretroviral Therapy during Acute HIV Infection
Authors: Manak Mark M. , Jagodzinski Linda L. , Shutt Ashley , Malia Jennifer A. , Leos Mike , Ouellette Jason , Akapirat Siriwat , Colby Donn L. , Phanuphak Nittaya , Eller Leigh Anne , Robb Merlin L. , de Souza Mark , Ananworanich Jintanat , Peel Sheila A.
Published: June 2019

Antiretroviral therapy (ART) during acute HIV infection (AHI) interrupts viral dynamics and may delay the emergence of serological markers targeted by current HIV screening and confirmatory assays, thus creating challenges for correctly classifying HIV infection status.
The Two Distinct Types of SecA2-Dependent Export Systems
Authors: Braunstein Miriam , Bensing Barbara A. , Sullam Paul M.
Published: June 2019

In addition to SecA of the general Sec system, many Gram-positive bacteria, including mycobacteria, express SecA2, a second, transport-associated ATPase. SecA2s can be subdivided into two mechanistically distinct types: (i) SecA2s that are part of the accessory Sec (aSec) system, a specialized transporter mediating the export of a family of serine-rich repeat (SRR) glycoproteins that function as adhesins, and (ii) SecA2s that are part of multisubstrate systems, in which SecA2 interacts with components of the general Sec system, specifically the SecYEG channel, to export multiple types of substrates. Found mainly in streptococci and staphylococci, the aSec system also contains SecY2 and novel accessory Sec proteins (Asps) that are required for optimal export. Asp2 also acetylates glucosamine residues on the SRR domains of the substrate during transport. Targeting of the SRR substrate to SecA2 and the aSec translocon is mediated by a specialized signal peptide. Multisubstrate SecA2 systems are present in mycobacteria, corynebacteria, listeriae, clostridia, and some bacillus species. Although most substrates for this SecA2 have canonical signal peptides that are required for export, targeting to SecA2 appears to depend on structural features of the mature protein. The feature of the mature domains of these proteins that renders them dependent on SecA2 for export may be their potential to fold in the cytoplasm. The discovery of aSec and multisubstrate SecA2 systems expands our appreciation of the diversity of bacterial export pathways. Here we present our current understanding of the mechanisms of each of these SecA2 systems.
P003 Intermittent vancomycin in paediatrics: implementation and audit of a new guideline
Authors: Gray Jenny
Published: June 2019

Aim

A guideline for the use of intermittent intravenous vancomycin in children was designed and implemented in our Trust in 2016. This introduced the use of a loading dose, increased dosing and increased frequency compared to the BNFC recommendations. The changes were based on the outcomes of a national NPPG project and local focus groups. The aim of this audit was assess compliance with the guideline and to establish if the time taken to reach target vancomycin levels had been reduced as a result of using the new guidance.

Methods

30 paediatric patients (≥1 month old) prescribed intermittent intravenous infusions of vancomycin were identified by ward pharmacists over a 2 month data collection period. 4 patients required treatment with adult dosing due to their weight. 2 patients were switched onto continuous infusion following pharmacist intervention. The results of the remaining 24 patients were compiled into an excel spreadsheet for analysis.

Results

Audit pre-implementation of the guideline had highlighted the lack of a support for staff to use appropriate dosing and monitoring.1 Overall, usage of the new guideline was positive. The loading dose was used appropriately in 83% patients. Levels were taken at appropriate times in 90% patients. The percentage of levels in therapeutic range at 48 hours increased from 7% to 40%. 100% of patient had a review at this time. Half of the patients out of range at 48 hours had treatment stopped or changed to a more appropriate treatment, reducing the need for unnecessary complex dose adjustment/monitoring plans. At 48 hours, there remained 30% of the total patient group requiring dose adjustment in order continue vancomycin treatment. The main area of concern was that review of these out of range levels was only carried out in accordance with the guideline in 40% of cases. This was improved to 80% with pharmacist intervention. A limitation of this data was the small patient group size. One patient had the level taken at the wrong time so could not be interpreted properly.

Conclusion

Compliance with the new guideline was good overall. This audit has shown that the use of the new guideline improved the percentage of patients with vancomycin levels in range at 48 hours from 7 to 40%. The main theme from this audit was that pharmacist intervention was the key to directing the medical teams towards prescribing the most appropriate form of treatment. Education can only improve compliance to a certain degree and this drug is not used often enough to be familiar to the average junior doctor. The use of vancomycin in complex and requires an understanding of pharmacokinetics and drug handling unique to the pharmacist skill set. Our aim for the future is that as our pharmacist team acquires more independent prescribers, direct adjustment of treatment plans will become a pharmacist role within the Trust.

Reference

Haylor J. Vancomycin use in paediatrics - prescribing and monitoring. University Hospitals Bristol Foundation Trust Clinical Audit 2014.
P014 An audit assessing the prescribing of naloxone in paediatric patients
Authors: Ntanganika Esther , Patel Bhavee
Published: June 2019

Aim

To assess whether paediatric patients who were prescribed opioids, had also been prescribed naloxone.

Methods

The audit was registered with the Clinical Audit and Effectiveness Department and ethical approval was not required. Patients who were taking weak opioids were excluded from this audit. A data collection sheet was created and data collected prospectively, over a two-month period. Forty-one inpatient medication charts were reviewed, to identify whether naloxone had been prescribed on the PRN section of the chart for patients who had been prescribed opioids, also to see whether the standards set for this audit had been met. The data was analysed with Microsoft excel.

Results

There were 41 paediatric inpatient charts reviewed in total. Three standards were set for this audit which were derived from local ‘Multidisciplinary Guidelines for Acute Pain Management in Children and Young People’.1 The first standard was that ‘all paediatric patients who are prescribed opioids should have naloxone prescribed’ which was met by 17% (7/41) of the inpatient charts. The second standard was that ‘naloxone should be prescribed on the ‘when required’ PRN section of the drug chart’ which was met by 100% (7/7) of the inpatient charts. The last standard was that ‘the directions for naloxone should include instructions to call a medical practitioner and to immediately commence the administration, if respiratory depression is encountered’,1 2 which was met by 86% (6/7) of the inpatient charts.

Conclusion

There is significant lack of naloxone prescribing in paediatric patients who are on opioids. This is reflected from the results showing that only 17% (7/41) of patients on opioids had naloxone prescribed on the PRN section of the chart. The inpatient charts which had naloxone prescribed, did not all have the correct dose and instructions on how it should be administered, only 86% (6/7) did. The results suggest that there is a lack of understanding on the importance of naloxone and how it should be prescribed on inpatient charts. The findings of this audit will be presented at the Paediatric Audit meeting and the Surgical Paediatric meeting, to educate prescribers on the importance of prescribing naloxone in patients who are receiving opioids and to reduce adverse effects that could occur due to opioid toxicity.

References

Dunn G. Multidisciplinary Guidelines for Acute Pain management in children and young people, COIN, 2016, 55.

Committee JF. British National Formulary for Children, 2017–2018. London: BMJ Group and Pharmaceutical Press.
P032  The burden associated with medicines reconciliation in hospitalised children
Authors: Qureshi Tathier , Huynh Chi , Isaac Rhian
Published: June 2019

Aim

Medicines reconciliation in children is an important intervention which prevents unintended medication discrepancies and medication errors from occurring when a child moves from one setting to another, e.g. from home to hospital admission. A national study in England across multiple sites has shown that 1/3 of medication discrepancies are prevented from occurring,1 What has not been evaluated however, is the potential burden that medicines reconciliation would have on the resources, in particular on the pharmacy workforce. The overall aim of this project was to investigate the burden that is associated with admissions medicines reconciliation (AMR) in children.

Methods

Over a 10 day period spanning over 4 weeks, rotational pharmacists carrying out hospital admission medicines reconciliation at a paediatric hospital in Birmingham, West Midlands were directly observed by a researcher (pharmacy student). This process was timed, and the student recorded the following observations: -

The number of AMRs that were initiated within 24 hours of admission

The number of AMRs that there completed within 24 hours of admission

The number of completed and incomplete medicines reconciliations

The reasons for incompletion of medicines reconciliation during the observation period.
Case of summer-type hypersensitivity pneumonitis complicated with IgA nephropathy
Authors: Maetani Tomoki , Shima Hiroshi , Shiraishi Yusuke , Marumo Satoshi
Published: June 2019

Association between pulmonary disease and IgA nephropathy (IgAN) has been previously reported. However, no association has been reported between hypersensitivity pneumonitis (HP) and IgAN. Here, we report about a patient with no particular medical history, who experienced worsening dyspnoea in the course of 1 month, with ground-glass opacity on chest CT and no improvement after antibiotic therapy. The patient was diagnosed as having HP based on the history of antigen exposure, detection ofTrichosporon asahii-specific antibodies and bronchoscopy findings. Concomitantly, findings of renal biopsy revealed the IgAN diagnosis. The patient underwent corticosteroid therapy, with good outcomes for both HP and IgAN. This is the first report in the literature to describe summer-type HP complicated with IgAN.
Safety of azithromycin in paediatrics: a systematic review protocol
Authors: Xu Peipei , Zeng Linan , Xiong Tao , Choonara Imti , Qazi Shamim , Zhang Lingli
Published: June 2019

Introduction

Azithromycin is widely used in children not only in the treatment of individual children with infectious diseases, but also as mass drug administration (MDA) within a community to eradicate or control specific tropical diseases. MDA has also been reported to have a beneficial effect on child mortality and morbidity. However, concerns have been raised about the safety of azithromycin, especially in young children. The aim of this review is to systematically identify the safety of azithromycin in children of all ages.

Methods and analysis

MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, Embase, CINAHL, International Pharmaceutical Abstracts and adverse drug reaction (ADR) monitoring systems will be systematically searched for randomised controlled trials (RCTs), cohort studies, case–control studies, cross-sectional studies, case series and case reports evaluating the safety of azithromycin in children. The Cochrane risk of bias tool, Newcastle-Ottawa and quality assessment tools, and The Joanna Briggs Institute Critical Appraisal tools will be used for quality assessment. Meta-analyses will be conducted to the incidence of ADRs from RCTs if appropriate. Subgroup analyses will be performed in different age and azithromycin dosage groups.

Ethics and dissemination

Formal ethical approval is not required as no primary data are collected. This systematic review will be disseminated through a peer-reviewed publication.

PROSPERO registration number

CRD42018112629
How consultants determine diagnostic competence in histopathology trainees
Authors: Brierley Daniel J , Farthing Paula M , Zijlstra-Shaw Sandra
Published: June 2019

Aims

This is a qualitative study exploring how consultant histopathologists determine diagnostic competence in their trainees.

Methods

Semi-structured interviews were conducted with consultants and trainees and analysed using the Framework Method.

Results

Five major themes emerged from the data: process, person, stage of training, trust and time. Within these major themes, there were multiple subthemes which reflect the complex, longitudinal nature of the judgement, as well as the knowledge, skills and attitudes which are most relevant to diagnostic competence. A conceptual framework is proposed to illustrate the judgement ecology, which is supported by anonymised quotes from interview participants.

Conclusions

Our study is the first to explore in depth how consultant histopathologists determine diagnostic competence in their trainees. This is particularly important as histopathology is a unique medical specialty for which there is little evidence to support the current assessment strategies during training. The resulting conceptual model and findings from this study may help to form an evidence base to inform future assessment tools in histopathology.
ExtragenitalMycoplasma genitaliuminfections among men who have sex with men
Authors: Latimer Rosie Louise , Vodstrcil Lenka , De Petra Vesna , Fairley Christopher K , Read Tim RH , Williamson Deborah , Doyle Michelle , Chow Eric PF , Bradshaw Catriona
Published: June 2019

Objectives

There are limited data on the prevalence ofMycoplasma genitalium(Mgen) coinfection with rectal chlamydia (Chlamydia trachomatis(CT)) and rectal gonorrhoea (Neisseria gonorrhoeae(NG)) infections and few studies examining the prevalence of pharyngeal Mgen in men who have sex with men (MSM). Using transcription-mediated amplification assay, this study aimed to determine the proportion of rectal CT and rectal NG infections in MSM who are coinfected with rectal Mgen, and the proportion of MSM with Mgen detected in the pharynx in order to inform clinical practice.

Methods

This was a cross-sectional study conducted at Melbourne Sexual Health Centre in Australia. Consecutively collected rectal swabs from MSM that tested positive for CT (n=212) or NG (n=212), and consecutively collected pharyngeal samples (n=480) from MSM were tested for Mgen using the AptimaMycoplasma genitaliumAssay (Hologic, San Diego). Samples were linked to demographic data and symptom status.

Results

Rectal Mgen was codetected in 27 of 212 rectal CT (13%, 95% CI 9 to 18) and in 29 of 212 rectal NG (14%, 95% CI 9 to 19) samples, with no difference in the proportion positive for Mgen. MSM with rectal CT/Mgen coinfection had more sexual partners than those with rectal CT monoinfection (mean 6 vs 11, p=0.06). MSM with rectal NG/Mgen coinfection were more likely to be HIV-positive than those with rectal NG monoinfection (OR=2.96, 95% CI 1.21 to 7.26, p=0.023). MSM with rectal CT/Mgen coinfection were more likely to be using pre-exposure prophylaxis than MSM with rectal NG/Mgen coinfection (OR 0.25, 95% CI 0.10 to 0.65, p=0.002). Pharyngeal Mgen was uncommon and detected in 8 of 464 samples (2%, 95% CI 1% to 3%). Pharyngeal Mgen was associated with having a rectal STI (OR=10.61, 95% CI 2.30 to 48.87, p=0.002), and there was a borderline association with being HIV-positive (p=0.079).

Conclusion

These data indicate one in seven MSM treated for rectal CT or rectal NG will have undiagnosed Mgen that is potentially exposed to azithromycin during treatment of these STIs. Rectal Mgen coinfection was associated with specific risk factors which may inform testing practices. Pharyngeal Mgen was uncommon.
The effects of sample plot selection strategy and the number of sample plots on inoptimality losses in forest management planning based on airborne laser scanning data
Authors: Ruotsalainen Roope , Pukkala Timo , Kangas Annika , Vauhkonen Jari , Tuominen Sakari , Packalen Petteri
Published: June 2019

In forest management planning, errors in predicted stand attributes might lead to suboptimal decisions that result in decreased net present value (NPV). Forest inventory data will have higher value if the amount of suboptimal decisions can be decreased. Therefore, the value of information can be measured through the decrease in inoptimality losses, which are the NPV differences between the optimal and suboptimal decisions. In this study, four alternative sample plot selection strategies with different numbers of sample plots were compared in terms of expected mean inoptimality losses. Stand-level mean inoptimality losses varied between €41.1·ha–1 and €80.7·ha−1, depending on the sample plot selection strategy and the number of sample plots used as training data in the k-nearest neighbors imputation method. Mean inoptimality losses decreased substantially when the number of sample plots increased from 25 to 100, and the decreasing trend continued until 500 sample plots. Total inoptimality losses can decrease by approximately €1 million in an inventory area of 100 000 ha when the number of sample plots is increased from 100 to 500. The measurement of more sample plots can be justified as long as the field measurement costs do not exceed the decrease in inoptimality losses.
Analysis of properties of metamaterial-based composite system
Authors: Abirami N. , Joseph Wilson K. S.
Published: June 2019

Magneto tunable left-handed material (LHM) which acts as a composite system has been theoretically demonstrated. The variation of the real and imaginary parts of the effective refractive index of the system is studied. The resonance that occurs in these studies are analyzed. The variation of impedance, reflectivity, absorptivity with frequency of the composite system was observed. The changes in resonance frequency with applied magnetic field are investigated. It is found that the resonance frequency increases with applied magnetic field.
Synchronization Adaptive Fuzzy Gain Scheduling PID Controller for a Class of MIMO Nonlinear Systems
Authors: Ghavidel Hesam Fallah , Kalat Ali Akbarzadeh
Published: June 2019

This paper presents a new Synchronization Adaptive Fuzzy Gain Scheduling PID controller (SAFGS-PIDc) for a class of Multiple-input multiple-output (MIMO) nonlinear systems with uncertainties. To achieve better adaptation properties, weighting factor is adapted to sum together the adaptive fuzzy control scheme and Fuzzy Gain Scheduler PID control (FGS-PIDc) method, such that both controllers can be incorporated at the same time. The FGS adjusts online the parameters of the conventional PID controller, and an Indirect Adaptive Fuzzy control (IAFc) scheme that uses feedback error function as inputs is constructed. In addition, each subsystem of MIMO system is able to adaptively compensate for uncertainties and external disturbance. Also, a robust control term is designed that aims to provide added robustness in the presence of uncertainties. The proposed scheme can overcome the controller singularity problem. While the proposed controller scheme requires the uncertainties to be bounded, it does not require this bound to be known. Thus, this control law can be used for the systems that the system’s models are quite unknown. The proposed method guarantees the stability of the closed-loop system based on Lyapunov theory. Finally, simulation studies demonstrate the usefulness and effectiveness of the proposed technique for controlling nonlinear.
A Data Assimilation Framework for Discrete Event Simulations
Authors: Hu Xiaolin , Wu Peisheng
Published: June 2019

Discrete event simulation (DES) is traditionally used as an offline tool to help users to carry out analysis for complex systems. As real-time sensor data become more and more available, there is increasing interest of assimilating real-time data into DES to achieve on-line simulation to support real-time decision making. This article presents a data assimilation framework that works with DES models. Solutions are proposed to address unique challenges associated with data assimilation for DES. A tutorial example of discrete event road traffic simulation is developed to demonstrate the data assimilation framework as well as principles of data assimilation in general. This article makes contributions to the DES community by presenting a data assimilation framework for DES and a concrete tutorial example that helps readers to grasp the details of data assimilation for DES.
Evaluation of Hardware Data Prefetchers on Server Processors
Authors: Bakhshalipour Mohammad , Tabaeiaghdaei Seyedali , Lotfi-Kamran Pejman , Sarbazi-Azad Hamid
Published: June 2019

Data prefetching, i.e., the act of predicting an application’s future memory accesses and fetching those that are not in the on-chip caches, is a well-known and widely used approach to hide the long latency of memory accesses. The fruitfulness of data prefetching is evident to both industry and academy: Nowadays, almost every high-performance processor incorporates a few data prefetchers for capturing various access patterns of applications; besides, there is a myriad of proposals for data prefetching in the research literature, where each proposal enhances the efficiency of prefetching in a specific way.

In this survey, we evaluate the effectiveness of data prefetching in the context of server applications and shed light on its design trade-offs. To do so, we choose a target architecture based on a contemporary server processor and stack various state-of-the-art data prefetchers on top of it. We analyze the prefetchers in terms of their ability to predict memory accesses and enhance overall system performance, as well as their imposed overheads. Finally, by comparing the state-of-the-art prefetchers with impractical ideal prefetchers, we motivate further work on improving data prefetching techniques.
Leveraging User-related Internet of Things for Continuous Authentication
Authors: Gonzalez-Manzano Lorena , Fuentes Jose M. De , Ribagorda Arturo
Published: June 2019

Among all Internet of Things (IoT) devices, a subset of them are related to users. Leveraging these user-related IoT elements, it is possible to ensure the identity of the user for a period of time, thus avoiding impersonation. This need is known as Continuous Authentication (CA). Since 2009, a plethora of IoT-based CA academic research and industrial contributions have been proposed. We offer a comprehensive overview of 58 research papers regarding the main components of such a CA system. The status of the industry is studied as well, covering 32 market contributions, research projects, and related standards. Lessons learned, challenges, and open issues to foster further research in this area are finally presented.
A Survey of Group Key Agreement Protocols with Constant Rounds
Authors: Xiong Hu , Wu Yan , Lu Zhenyu
Published: June 2019

Group key agreement (shorten as GKA) protocol enables a group of users to negotiate a one-time session key and protect the thereafter group-oriented communication with this session key across an unreliable network. The number of communication rounds is one of the main concern for practical applications where the cardinality of group participants involved is considerable. It is critical to have fixed constant rounds in GKA protocols to secure these applications. In light of overwhelming variety and multitude of constant-round GKA protocols, this article surveys these protocols from a series of perspectives to supply better comprehension for researchers and scholars. Concretely, this article captures the state of the art of constant-round GKA protocols by analyzing the design rationale, examining the framework and security model, and evaluating all discussed protocols in terms of efficiency and security properties. In addition, this article discusses the extension of constant-round GKA protocols including dynamic membership updating, password-based, affiliation-hiding, and fault-tolerance. In conclusion, this article also points out a number of interesting future directions.
Mulsemedia DIY: A Survey of Devices and a Tutorial for Building Your Own Mulsemedia Environment
Authors: Saleme Estêvão B. , Covaci Alexandra , Mesfin Gebremariam , Santos Celso A. S. , Ghinea Gheorghita
Published: June 2019

Multisensory experiences have been increasingly applied in Human-Computer Interaction (HCI). In recent years, it is commonplace to notice the development of haptic, olfactory, and even gustatory displays to create more immersive experiences. Companies are proposing new additions to the multisensory world and are unveiling new products that promise to offer amazing experiences exploiting mulsemedia—multiple sensorial media—where users can perceive odors, tastes, and the sensation of wind blowing against their face. Whilst researchers, practitioners and users alike are faced with a wide range of such new devices, relatively little work has been undertaken to summarize efforts and initiatives in this area. The current article addresses this shortcoming in two ways: first, by presenting a survey of devices targeting senses beyond that of sight and hearing and, second, by describing an approach to guide newcomers and experienced practitioners alike to build their own mulsemedia environment, both in a desktop setting and in an immersive 360° environment.
Bipartite Consensus of High‐Order Edge Dynamics on Coopetition Multiagent Systems
Authors: Yang Yilong , Ji Zhijian , Tian Lei , Ma Huizi , Qi Qingyuan
Published: June 2019

The bipartite consensus of high‐order edge dynamics is investigated for coopetition multiagent systems, in which the cooperative and competitive relationships among agents are characterized by positive weight and negative weight, respectively. By mapping the initial graph to a line graph, the distributed control protocol is proposed for the strongly connected, digon sign‐symmetric structurally balanced line graph; and then we give sufficient conditions for the third‐order multi‐gent system to achieve both the bipartite consensus of edge dynamics and the final value of bipartite consensus. By transforming the coefficients of characteristic polynomial from complex domain to real number domain, the sufficient conditions for the bipartite consensus of high‐order edge dynamics are also proposed, and the final values of the high‐order edge dynamics on multiagent systems are obtained.
Application of Layered Coding Genetic Algorithm in Optimization of Unequal Area Production Facilities Layout
Authors: Hou Shiwang , Wen Haijun , Feng Shunxiao , Wang Hui , Li Zhibin
Published: June 2019

Unequal area facilities layout problem (UA-FLP) is an inevitable problem in the process of new construction, reconstruction, and expansion of enterprises. The rationality of the facilities layout has a great influence on the operation performance of the production system. Finding the optimal solution of UA-FLP according to the requirement of production process is the main content of the plant design. The facilities were constrained by given areas and aspect ratio, respectively. By adopting the method of slicing tree, the layout space was divided into multiple regions for each facility. The genetic algorithm was developed by using layered coding to show the slicing process. Considering the production logistics cost as well as the adjacency relations between the facilities, the goal function was established and the optimal solution was obtained by running the proposed algorithm. Finally, the feasibility of the proposed approach was validated by a set of known problems. The comparison results show that it can provide decision support for rapid optimal layout of multifacilities.
A Multistep Method for Automatic Determination and Optimization of Microseismic P‐Phase Arrival Times in a Coal Mine
Authors: Zhu Quanjie , Liu Xiaohui , Liu Xiaoyun , Chai Haitao , Shi Jianjun
Published: June 2019

We present an algorithm for P‐phase arrival time automatic determination and optimization for microseismic events of a coal mine in steps. For P‐phase detection, we apply four modules: single denoising (band‐filter), fast searching (STA/LTA and peak value), accurately picking (AIC), and optimization selection (time difference of arrival time and envelope circle judgment). This method is applied for a precise determination of P‐phase arrival time; in addition, an automatic quality estimate is obtained to optimize and select the effective stations and used for source location. Through the analysis and validation of seismic data in a mine located in Hebei province, the result shows that this method can pick up the first arrival time of MS signal fast and accurately and automatically judge and remove the error station. Comparing automatic picks with the manual method in terms of speed and accuracy, computation cost (0.828 s) is far less than manual method (15 s per set), precision of manual and automatic represented by picking error is up to 71.7% (between −5 ms and 5 ms, 190 sets), 83.4% (between −10 ms and 10 ms, 221 sets), and 90.57% (between −20 ms and 20 ms, 240 sets). This study shows that the method presented in this paper is feasible to precise automatic P‐phase determination and is a basis on automatic and precision location.
Recognition of Ultrasound Artifact Mimicking Pulmonary Artery Dissection in Patients with Heart Disease
Authors: Wu Weichun , Zhang Na , Hsi David H. , Niu Lili , Jiang Yong , Wang Yang , Zhu Zhenhui , Wang Hao
Published: June 2019

Purpose. Imaging artifacts are frequently encountered when performing clinical echocardiography. Based on our review of the literature, two-dimensional linear artifacts are mainly reported in the ascending aorta in patients with suspected aortic dissections. However, pulmonary artery artifacts that mimic pulmonary artery dissection have not been discussed. We herein report our experience with children and adults with preexisting heart conditions and pulmonary artery imaging artifacts. Methods. The study population comprised 10 patients with heart disease who were treated at our hospital from March 2015 to September 2017. Nine patients were children with congenital heart disease, mainly patent ductus arteriosus (n = 8), and one patient was an adult with pulmonary artery hypertension. Transthoracic echocardiography was performed in all patients. Results. We confirmed the diagnosis in six patients during a surgical operation for other indications and in four patients by computed tomographic pulmonary angiography. The most common pulmonary imaging artifact was observed from the left high parasternal view (9/10, 90%). Most of the artifacts were diagonally oriented (8/10, 80%), and a few were horizontally oriented. Half of the artifacts were located in the main pulmonary arteries with mild pulmonary artery dilatation. Pulmonary hypertension was seen only in the adult patient. The thymus gland was clearly seen in young patients. Conclusion. Pulmonary artery imaging artifacts in patients with preexisting heart disease during echocardiographic examination can mimic pulmonary artery dissection. Understanding the types and origins of these ultrasound artifacts is important to avoid a false-positive diagnosis.