bluuebunny/crossref_metadata_2025 huggingface dataset:
Computationally-Efficient Fuel-Economic High-Level Controller Design for a Group of Connected Vehicles in Urban Roads
Authors: Canosa Alejandro Fernandez , HomChaudhuri Baisravan
Published: November 2018

This paper presents a computationally-efficient fuel-economic control strategy for a group of connected vehicles in urban roads. We assume the availability of vehicle-to-vehicle (V2V) and vehicle-to-infrastructure (V2I) communication. Apart from fuel economy, the proposed higher-level controller also focuses on reducing red light idling, which improves traffic mobility and in turn improves vehicle emissions. The red light idling avoidance problem is formulated as a two-point boundary value problem and sampling-based approach is employed to evaluate a feasible solution in real-time. This leads to control solutions that can ensure avoidance of red light idling despite the number of vehicles in front of it. We have shown that sampling from a Gaussian distribution whose mean depends on the target velocity can improve fuel economy to a good extent. This higher-level control solution provides a good initial solution for any deterministic lower-level controller. Simulation results show the efficacy of the proposed method in terms of fuel economy and computational efficiency.
A Dynamic-System-Based Approach to Modeling Driver Movements Across General-Purpose/Managed Lane Interfaces
Authors: Wright Matthew A. , Horowitz Roberto , Kurzhanskiy Alex A.
Published: November 2018

To help mitigate road congestion caused by the unrelenting growth of traffic demand, many transportation authorities have implemented managed lane policies, which restrict certain freeway lanes to certain types of vehicles. It was originally thought that managed lanes would improve the use of existing infrastructure through demand-management behaviors like carpooling, but implementations have often been characterized by unpredicted phenomena that are sometimes detrimental to system performance. The development of traffic models that can capture these sorts of behaviors is a key step for helping managed lanes deliver on their promised gains. Towards this goal, this paper presents an approach for solving for driver behavior of entering and exiting managed lanes at the macroscopic (i.e., fluid approximation of traffic) scale. Our method is inspired by recent work in extending a dynamic-system-based modeling framework from traffic behaviors on individual roads, to models at junctions, and can be considered a further extension of this dynamic-system paradigm to the route/lane choice problem. Unlike traditional route choice models that are often based on discrete-choice methods and often rely on computing and comparing drivers’ estimated travel times from taking different routes, our method is agnostic to the particular choice of physical traffic model and is suited specifically towards making decisions at these interfaces using only local information. These features make it a natural drop-in component to extend existing dynamic traffic modeling methods.
Improved Cross-Coupled Iterative Learning Control for Contouring NURBS Curves
Authors: Armstrong Ashley , Johnson Amy Wagoner , Alleyne Andrew
Published: November 2018

Additive manufacturing (AM) uses computer-aided design to construct parts layer by layer. Relative to traditional manufacturing processes, AM provides a time-efficient and cost-effective way to produce low-volume, customized parts with complex geometries. This work presents an improved Cross-Coupled iterative learning control (CCILC) scheme to overcome current limitations in contour following for complex, free-form curves in AM. The approach involves modifying the definition of the error vector used in the individual axis iterative learning controllers and defining time varying weightings based on the curvature of the reference trajectory to couple tracking and contour errors. In this paper, the design for the improved CCILC system is presented, and the performance of this system is compared to the performance of existing ILC control schemes via simulations. In comparison to the current control methods, the simulation results demonstrate significant performance improvements for contour tracking of a reference trajectory with high levels of curvature.
Capturability of Inverted Pendulum Gait Model Under Slip Conditions
Authors: Mihalec Marko , Yi Jingang
Published: November 2018

This paper presents a simple inverted pendulum gait model to study walking under slip conditions. The model allows for both the horizontal and vertical movements of the center of mass during normal walking and walking gaits with foot slip. Stability of the system is analyzed using the concept of capturability. Considering foot placement as a control input, we obtain the stable regions which lead to stable gait. The size of those stable regions is used to evaluate the effect of the coefficient of friction and the slip reaction time on capturability. We also analyze the feasibility of recovery from slip gait in relation to the coefficient of friction and the reaction time. The results confirm the effectiveness of the model and the capturability developement.
A Distributed-Parameter Control System Using Electromagnetic Images Stimulation for Human-Machine Perception Interface
Authors: Li Min , Lee Kok-Meng
Published: November 2018

This article develops a new human-machine perception interface method to convert visual patterns to accurate eddy-current stimulation using an electromagnet (EM) array. The eddy-current stimulation is formulated as a feedforward controller design. In this paper, a state-space model for the eddy-current stimulation is derived for design and analysis of the controller. Unlike traditional methods where the distributed parameter systems are often modeled using partial differential equations and solved numerically using numerical methods such as finite element analysis, the model presented here offers closed-form solutions in state-space representation. The novel approach enables the applications of the well-established control theory for analyzing the system controllability. The feasibility and accuracy of the feedforward control method are numerically illustrated and validated by generating the stimulation with two types of patterns, which provides an essential base for future research of human-machine perception interface.
Control and Experimental Validation of a Powered Knee and Ankle Prosthetic Device
Authors: Bhakta Krishan , Camargo Jonathan , Young Aaron J.
Published: November 2018

Developing active prostheses require robust design methodologies and smart controllers in order to appropriately provide net positive mechanical work to the user. Passive prostheses are limited in their ability to sustain walking for long periods of time as well as ambulating over different terrains/environmental conditions. In this paper we present a control architecture and validation results on three individuals with transfemoral amputation using our powered knee and ankle prosthetic device. A three stage controller structure is proposed: high-level control, mid-level control, and low-level control. The high-level controller is responsible for determining the locomotion mode. At the mid-level control, an impedance controller is paired with a state machine to coordinate the kinematics and kinetics of the device with the user during community ambulation tasks. At the low-level control, the device is paired in conjunction with a series elastic actuator (SEA) at each joint to enable closed-loop torque control (PID control). Our results indicate that our powered prosthetic device is capable of scaling to a range of speeds without having to tune many impedance parameters. Our approach shows that our device is a good platform for further testing robust controllers that can provide powered assistance to the user.
The pathogenicity of entomopathogenic fungus Acremonium hansfordii to two-spotted spider mite, Tetranychus urticae and predatory mite Neoseiulus barkeri
Authors: Shang Su-Qin , Chen Yao-Nian , Bai Ying-Lu
Published: November 2018

The two-spotted spider mite, Tetranychus urticae, is an important mite pest worldwide. It often leads to reduced crop yields or poor marketability of the produce and has already developed resistance to many acaricides. In this study, the pathogenicity of the entomopathogenic fungus (EPF), Acremonium hansfordii, to T. urticae and its side effects on the predatory mite Neoseiulus barkeri were compared. The toxicity of A. hansfordii was evaluated on T. urticae at 1.0×104, 1.0×106, 1.0×108 conidia/mL concentrations and predatory mite N. barkeri at 1.0×108 conidia/mL under experimental conditions at 25±1°C, 75±5% RH and 16L: 8D photoperiod. The effects of EPF on the development of the F0 and F1 generation of predatory mites were also assessed at 1.0×108 conidia/mL concentration. The results showed that the corrected mortality of T. urticae at three tested concentrations were 36.67%, 53.67% and 66.33% within 11d, and the median lethal time were 14.39 d, 9.84d and 7.99d, respectively. The corrected mortality of N. barkeri was only 3.9% after 11d at 1×108 conidia/mL concentration. Some hyphae of A. hansfordii were detected on the surface of treated T. urticae but not on N. barkeri body after 7d. After N. barkeri females were treated with 1.0×108 conidia/mL, the preoviposition period of the F0 generation was prolonged 1.56 times and the other life history parameters have no significant differences; similar patterns were also shown in the F1 generation. A. hansfordii showed strong pathogenicity against T. urticae but did not significantly adversely influence N. barkeri. Therefore, the combination of A. hansfordii and N. barkeri has the potential to be used for the control of T. urticae in the future.
Evaluation of a toolkit resource package to support positive workplace behaviours in relation to quality end-of-life care in Australian hospitals
Authors: Hutchinson Claire , Tieman Jennifer , Devery Kim
Published: November 2018

Background

The study aimed to determine the effectiveness of an action-orientated toolkit in supporting behaviour change in relation to quality end-of-life care in acute hospital settings. The toolkit was developed to complement a programme of online end-of-life care education.

Methods

A toolkit was developed from an international review of peer-reviewed literature on end of life. Toolkits were distributed (n=428) to Australian healthcare professionals over a 4-week period. An online survey was sent to all recipients; 65 responses were received (16% response rate, excluding emails returned as undeliverable). Semistructured interviews (n=10) were conducted using purposeful sampling to ensure a range of views were captured. The focus of the evaluation was on investigating (1) users’ responses to the toolkit and (2) individuals’ reported behaviour change.

Findings

The toolkit was well received by users who reported increased confidence in communication around end-of-life matters. 59.3% of users reported making a behaviour change over the previous 4 weeks; 70.8% of those who had not made a change reported they intended to in the near future. Against expectation, the toolkit’s appeal went beyond its intended audience in acute hospital settings, for example, personal care workers in aged care settings.

Conclusions

Despite study limitations (self-report of a small, self-selected sample), these early findings suggest that the toolkit has potential to positively impact on end-of-life care practices. However, additional evaluation is needed to determine whether such a toolkit can positively impact on practice and on patient experience at the end of life.
Childhood injuries in Oman: retrospective review of a multicentre trauma registry data
Authors: Mehmood Amber , Agrawal Priyanka , Allen Katharine A , Al-Kashmiri Ammar , Al-Busaidi Ali , Hyder Adnan Ali
Published: November 2018

Objectives

Injuries are among the top causes of hospital-based mortality for adults in Oman. However, little is known about the distribution and risk of injuries among children. This paper describes the epidemiology and risk factors for childhood injuries (0–15 years of age), in two hospitals of Oman.

Methods

Data were collected between November 2014 and April 2015 at Khoula and Nizwa Hospitals. All patients between 0 and 15 years with a diagnosis of injury/trauma admitted to the hospital, and those who had trauma team activation in the emergency department were included in the analysis. Descriptive and multivariable Poisson regression analyses were conducted to generate sociodemographic risk factor profiles associated with the need for surgical management of injuries.

Results

Out of 795 cases, 59% were under 5 years of age; 67% were males. Around 50% injuries were fall related, followed by exposure to inanimate mechanical forces and transport injuries. Burn injuries were more prevalent in females than males. Three-fourths of all injuries occurred in private residences. Almost 92% injuries were minor (Injury Severity Score <9). Of children with all types of injuries, 303 (40.9%) received surgical treatment. Patients suffering from head injuries (RR 8.8: 95% CI 4.9 to 15.3) or being involved in a burn injury (RR 1.5: 95% CI 0.3 to 7.5) were at increased risk of undergoing surgical treatment.

Conclusion

In this study, >30% of injury admissions were children 0–15 years of age. The high incidence of falls, home injuries and burns highlight the need for age-targeted interventions and injury control programmes. Although infrequent, transport injuries and head injuries put children in need of surgical management and prolonged hospital care.
Extubation from high-frequency oscillatory ventilation in extremely low birth weight infants: a prospective observational study
Authors: Tana Milena , Lio Alessandra , Tirone Chiara , Aurilia Claudia , Tiberi Eloisa , Serrao Francesca , Purcaro Velia , Corsello Mirta , Catenazzi Piero , D’Andrea Vito , Barone Giovanni , Ricci Cinzia , Pastorino Roberta , Vento Giovanni
Published: November 2018

Objective

To evaluate if weaning from high-frequency oscillatory ventilation (HFOV) directly to a non-invasive mode of respiratory support is feasible and results in successful extubation in extremely low birth weight (ELBW) infants.

Design

Prospective observational study.

Setting

Tertiary neonatal intensive care unit.

Patients

One hundred and eight ELBW infants of 26.2±1.4 weeks of gestational age (GA) directly extubated from HFOV.

Interventions

All infants were managed with elective HFOV and received surfactant after a recruitment HFOV manoeuvre. Extubation was attempted at mean airways pressure (MAP) ≤6 cm H2O with FiO2≤0.25. After extubation, all infants were supported by nasal continuous positive airway pressure (6–8 cm H2O).

Main outcome measures

Extubation failure (clinical deterioration requiring reintubation) was defined as shorter than 7 days.

Results

Ninety patients (83%) were successfully extubated and 18 (17%) required reintubation. No significant differences were found between the two groups in terms of birth weight, day of life and weight at the time of extubation. Multivariable analysis showed that GA (OR 1.71; 95% CI 1.04, 2.08) and higher MAP prior to surfactant (OR 1.51; 95% CI 1.06, 2.15) were associated with successful extubation.

Conclusions

In ELBW infants, direct extubation from HFOV at MAP ≤6 cm H2O with FiO2≤0.25 is feasible. Our extubation success rate (83%) is higher than conventional mechanical ventilation in this very vulnerable class of infants.
Ziprasidone, haloperidol and clonazepam intramuscular administration in the treatment of agitation symptoms in Chinese patients with schizophrenia: A network meta-analysis
Authors: Su Liang , Lu Zheng , Shi Shenxun , Xu Yifeng
Published: November 2018

Background

Agitation is very common in patients with acute stage schizophrenia, and injection of antipsychotics and clonazepam is widely used. Network meta-analysis of these comparisons among three injection treatments has been seldom reported.

Aim

To compare the efficacy and safety of various injections for agitation symptoms in Chinese patients with schizophrenia.

Methods

Searches were made in PubMed, Embase and Web of Knowledge, Cochrane Library, Wanfang data, CNKI, SinoMed and VIP databases up to 18 February 2018. Standard search strategies were performed by two reviewers according to the Cochrane Review Group. The Consolidated Standards of Reporting Trials statement was used to assess the methodological quality of the studies. STATA was used to perform meta-analysis. The Cochrane Grades of Recommendation, Assessment, Development and Evaluation (GRADE) was used to assess the strength of evidence.

Results

A total of 15 studies were included in the network meta-analysis. There were 11 studies comparing ziprasidone with haloperidol, and four studies comparing haloperidol with clonazepam. The results showed that ziprasidone is more effective than haloperidol and clonazepam (sucra: 77.2, 72.8 and 0) in the treatment of agitation symptoms. There was the effect size (standardised mean difference (SMD)) in the three groups: haloperidol: SMD=2.278, 95% CI 1.836 to 2.719; ziprasidone: SMD=2.536, 95% CI 2.082 to 2.990; and clonazepam: SMD=1.360, 95% CI 0.127 to 2.593. The acceptability was assessed by the incidence of excessive sedation, which showed that ziprasidone and haloperidol were similar with both being superior to clonazepam (sucra: 0.3, 0.7 and 99.0). Ziprasidone had significantly less adverse effects than haloperidol in effects of extrapyramidal system (EPS) (z=5.01, p<0.001). There were no statistically significant differences between haloperidol and ziprasidone in tachycardia and abnormal ECG (z=1.69, p=0.091; z=0.87, p=0.386; respectively). Based on GRADE, the strength of the evidence for primary outcome was ‘medium’.

Conclusion

Our results suggested that ziprasidone was more suitable than haloperidol and clonazepam in the treatment of agitation symptoms in Chinese patients with schizophrenia, according to the efficacy and acceptability of these three intramuscular injection medications.
Stromal protein βig-h3 reprogrammes tumour microenvironment in pancreatic cancer
Authors: Goehrig Delphine , Nigri Jérémy , Samain Rémi , Wu Zhichong , Cappello Paola , Gabiane Gaëlle , Zhang Xinyi , Zhao Yajie , Kim In-San , Chanal Marie , Curto Roberta , Hervieu Valerie , de La Fouchardière Christelle , Novelli Francesco , Milani Pascale , Tomasini Richard , Bousquet Corinne , Bertolino Philippe , Hennino Ana
Published: November 2018

Objective

Pancreatic cancer is associated with an abundant stromal reaction leading to immune escape and tumour growth. This massive stroma drives the immune escape in the tumour. We aimed to study the impact of βig-h3 stromal protein in the modulation of the antitumoural immune response in pancreatic cancer.

Design

We performed studies withp48-Cre;KrasG12D,pdx1-Cre;KrasG12D;Ink4a/Arffl/fl,pdx1-Cre;KrasG12D; p53R172Hmice and tumour tissues from patients with pancreatic ductal adenocarcinoma (PDA). Some transgenic mice were given injections of anti-βig-h3, anti-CD8, anti-PD1 depleting antibodies. Tumour growth as well as modifications in the activation of local immune cells were analysed by flow cytometry, immunohistochemistry and immunofluorescence. Tissue stiffness was measured by atomic force microscopy.

Results

We identified βig-h3 stromal-derived protein as a key actor of the immune paracrine interaction mechanism that drives pancreatic cancer. We found that βig-h3 is highly produced by cancer-associated fibroblasts in the stroma of human and mouse. This protein acts directly on tumour-specific CD8+T cells and F4/80 macrophages. Depleting βig-h3in vivoreduced tumour growth by enhancing the number of activated CD8+T cell within the tumour and subsequent apoptotic tumour cells. Furthermore, we found that targeting βig-h3 in established lesions released the tissue tension and functionally reprogrammed F4/80 macrophages in the tumour microenvironment.

Conclusions

Our data indicate that targeting stromal extracellular matrix protein βig-h3 improves the antitumoural response and consequently reduces tumour weight. Our findings present βig-h3 as a novel immunological target in pancreatic cancer.
Reclassification of BRCA1 and BRCA2 variants of uncertain significance: a multifactorial analysis of multicentre prospective cohort
Authors: Lee Jee-Soo , Oh Sohee , Park Sue Kyung , Lee Min-Hyuk , Lee Jong Won , Kim Sung-Won , Son Byung Ho , Noh Dong-Young , Lee Jeong Eon , Park Hai-Lin , Kim Man Jin , Cho Sung Im , Lee Young Kyung , Park Sung Sup , Seong Moon-Woo
Published: November 2018

Background

BRCA1 and BRCA2 (BRCA1/2) variants classified ambiguously as variants of uncertain significance (VUS) are a major challenge for clinical genetic testing in breast cancer; their relevance to the cancer risk is unclear and the association with the response to specific BRCA1/2-targeted agents is uncertain. To minimise the proportion of VUS in BRCA1/2, we performed the multifactorial likelihood analysis and validated this method using an independent cohort of patients with breast cancer.

Methods

We used a data set of 2115 patients with breast cancer from the nationwide multicentre prospective Korean Hereditary Breast Cancer study. In total, 83 BRCA1/2 VUSs (BRCA1, n=26; BRCA2, n=57) were analysed. The multifactorial probability was estimated by combining the prior probability with the overall likelihood ratio derived from co-occurrence of each VUS with pathogenic variants, personal and family history, and tumour characteristics. The classification was compared with the interpretation according to the American College of Medical Genetics and Genomics–Association for Molecular Pathology (ACMG/AMP) guidelines. An external validation was conducted using independent data set of 810 patients.

Results

We were able to redefine 38 VUSs (BRCA1, n=10; BRCA2, n=28). The revised classification was highly correlated with the ACMG/AMP guideline-based interpretation (BRCA1, p for trend=0.015; BRCA2, p=0.001). Our approach reduced the proportion of VUS from 19% (154/810) to 8.9% (72/810) in the retrospective validation data set.

Conclusion

The classification in this study would minimise the ‘uncertainty’ in clinical interpretation, and this validated multifactorial model can be used for the reliable annotation of BRCA1/2 VUSs.
Development of alcohol treatment for UK military personnel
Authors: Rushton Ruth , Lynch K
Published: November 2018

The consumption of alcohol in the UK Armed Forces (AF) as ‘an agent to assist cohesion and informal operational debriefing’ is a social and psychological conceptualisation that has some empirical support. Indisputable data exist to suggest that high levels of alcohol misuse and related problems are prevalent among UK AF. Recent research indicates that the overall level of hazardous alcohol consumption remains high in the UK military, with little evidence of reduced consumption over time. Meanwhile, risky drinking in the general population appears to be decreasing. This paper describes work to develop a key aspect of an integrated care pathway for UK military personnel at all levels of alcohol risk. The project focuses on the development of an evidence-based treatment response across primary care and mental health services that will link with preventative initiatives. Specialist (ie, substance misuse) input from the Defence Clinical Psychology Service across and within Departments of Community Mental Health lends an overarching perspective to a major healthcare and organisational concern for the UK AF. Work towards a consistent treatment pathway for alcohol misuse is also benefiting from collaboration between the Ministry of Defence and Public Health England.
Adopting a multidisciplinary approach to maximising performance during military visual search tasks
Authors: Cornes Katherine R , Boardman M , Ford C , Smith S
Published: November 2018

During the conflicts in Afghanistan and Iraq, many UK military personnel were killed or injured by improvised explosive devices (IEDs). Insurgents sought to develop new ways of concealing and detonating IEDs, and UK forces invested significantly in finding increasingly effective methods of detecting and avoiding them. Between 2010 and 2014 the UK’s Defence Science and Technology Laboratory’s Human and Social Sciences Group (HSSG) was asked to investigate the factors that might affect the performance of specialist search teams in the identification of IEDs. They sought to ascertain ways to improve effectiveness and maximise safety through training, human factors advice on equipment design, and recommendations on changes to tactics techniques and procedures. This paper provides a short summary of some of the research conducted that underpinned the advice and recommendations that were provided. The research conducted by HSSG, in collaboration with industry and academia, helped ensure that search teams had the best possible training, advice and equipment.
Defence Anaesthesia transition from the Tri-Service Anaesthetic Apparatus to the Diamedica Portable Anaesthesia Machine 02
Authors: Pearson Jonathan David , Maund A , Jones CP , Coley E , Frazer S , Connor D
Published: November 2018

Defence Anaesthesia is changing its draw-over anaesthetic capability from the Tri-Service Anaesthetic Apparatus (TSAA) to the Diamedica Portable Anaesthesia Machine 02 (DPA02). The DPA02 will provide a portable, robust, lightweight and simple method for delivering draw-over volatile anaesthesia with the option of positive pressure ventilation through manual or mechanical operation for paediatric and adult patients. The UK Defence Medical Services uses a modified configuration of the DPA02; this paper seeks to explain the rationale for the differing configurations and illustrates alternative assemblies to support integration with other Defence Anaesthesia equipment. High-fidelity simulation training using the DPA02 will continue to be delivered on the Defence Anaesthesia Simulation Course (DASC). Conformité Européenne accreditation of DPA02 supports future UK live patient training in centres of excellence supervised by subject matter experts; this was not possible with the TSAA. This article is intended to be a key reference for all members of the Defence Anaesthesia team. Alongside other resources, it will be given as precourse learning prior to attending the DASC and the Military Operational Surgical Training. This article will also be issued with all Defence DPA02 units, supporting ease of access for review during future clinical exercises (including validation), prior to supervised live training and on operational deployments.
A systematic review and meta-analysis of observational evidence for the use of bailout self-expandable stents following failed anterior circulation stroke thrombectomy
Authors: Wareham James , Flood Richard , Phan Kevin , Crossley Robert , Mortimer Alex
Published: November 2018

Background

The crucial role of thrombectomy in the management of emergent large vessel occlusive stroke is not disputed but there is a technical failure rate in a significant minority of patients whose outcomes are often poor. Our objective was to perform a systematic review and meta-analysis to assess the safety and efficacy of permanent self-expandable stent deployment as a bailout procedure in cases of failed anterior circulation thrombectomy.

Methods

Two independent reviewers searched the Pubmed (Medline) database for studies reporting outcomes following failed endovascular thrombectomy with subsequent rescue therapy employing self-expandable stents.

Results

Eight studies (one prospective, seven retrospective) originating from Europe, Asia, and America comprising 160 patients met the inclusion criteria. Estimated baseline National Institutes of Health Stroke Scale score was 17.1 (95% CI 15.7 to 18.4). Following failed thrombetcomy and stent deployment, the rate of favorable outcome (modified Rankin Scale score 0–2) was 43% (95% CI 34% to 53%). Pooled mortality was 21% (95% CI 13% to 33%). Successful recanalization (Thrombolysis in Cerebral Infarction (TICI) 2b–3 or Thrombolysis in Myocardial Infarction (TIMI) 2–3) was 71% (95% CI 63% to 77%). Symptomatic intracerebral hemorrhage was seen in 12% (95% CI 7% to 18%). The Solitaire stent (Medtronic) was the most commonly deployed stent following failed thrombectomy attempts (66%; 95% CI 31% to 89%). Pre- or post-stent angioplasty was performed in 39%of patients (95% CI 29% to 48%). Glycoprotein IIb/IIIa inhibitors were used in 89% (95% CI 71% to 97%). 95% of patients received postprocedural antiplatelet therapy.

Conclusion

A rescue stent procedure seems reasonable as a last resort following failed thrombectomy but currently the level of evidence is limited. Prospective registries may aid in guiding future recommendations.
Real-world presentation with heart failure in primary care: do patients selected to follow diagnostic and management guidelines have better outcomes?
Authors: Bottle Alex , Kim Dani , Aylin Paul P , Majeed F Azeem , Cowie Martin R , Hayhoe Benedict
Published: November 2018

Objective

To describe associations between initial management of people presenting with heart failure (HF) symptoms in primary care, including compliance with the recommendations of the National Institute for Health and Care Excellence (NICE), and subsequent unplanned hospitalisation for HF and death.

Methods

This is a retrospective cohort study using data from general practices submitting records to the Clinical Practice Research Datalink. The cohort comprised patients diagnosed with HF during 2010–2013 and presenting to their general practitioners with breathlessness, fatigue or ankle swelling.

Results

13 897 patients were included in the study. Within the first 6 months, only 7% had completed the NICE-recommended pathway; another 18.6% had followed part of it (B-type natriuretic peptide testing and/or echocardiography, or specialist referral). Significant differences in hazards were seen in unadjusted analysis in favour of full or partial completion of the NICE-recommended pathway. Covariate adjustment attenuated the relations with death much more than those for HF admission. Compared with patients placed on the NICE pathway, treatment with HF medications had an HR of 1.16 (95% CI 1.05 to 1.28, p=0.003) for HF admission and 1.03 (95% CI 0.90 to 1.17, p= 0.674) for death. Patients who partially followed the NICE pathway had similar hazards to those who completed it. Patients on no pathway had the highest hazard for HF admission at 1.30 (95% 1.18 to 1.43, p<0.001) but similar hazard for death.

Conclusions

Patients not put on at least some elements of the NICE-recommended pathway had significantly higher risk of HF admission but non-significant higher risk of death than other patients had.
EXACT SOLUTION AND CONSERVATION LAWS OF FRACTIONAL COUPLED WAVE INTERACTION EQUATION
Authors: MANDAL HEMANTA , BIRA B.
Published: November 2018

In this paper, we consider a time-fractional coupled KdV equations describing the interaction of equatorial and midlatitude Rossby waves. From the application of Lie group analysis, the governing system of fractional partial differential equations (FPDEs) is reduced to a system of fractional ordinary differential equations (FODEs). Further, we construct the group-invariant solution as well as the power series solution for the given coupled equations. Next, the evolutionary behavior of the waves under the influence of the fractional order derivative [Formula: see text] is studied graphically through the group-invariant solution. Finally, the conservation laws for the given system of FPDEs are obtained.
The qq-bit (III): Symmetric q-Jordan–Wigner embeddings
Authors: Accardi Luigi , Lu Yun-Gang
Published: November 2018

We prove that, replacing the left Jordan–Wigner [Formula: see text]-embedding by the symmetric [Formula: see text]-embedding described in Sec. 2, the result of the corresponding central limit theorem changes drastically with respect to those obtained in Ref. 5. In fact, in the former case, for any [Formula: see text], the limit space is precisely the [Formula: see text]-mode Interacting Fock Space (IFS) that realizes the canonical quantum decomposition of the limit classical random variable. In the latter case, this happens if and only if [Formula: see text]. Furthermore, as shown in Sec. 4, the limit classical random variable turns out to coincide with the [Formula: see text]-mode version of the [Formula: see text]-deformed quantum Brownian introduced by Parthasarathy[Formula: see text], and extended to the general context of bi-algebras by Schürman[Formula: see text]. The last section of the paper (Appendix) describes this continuous version in white noise language, leading to a simplification of the original proofs, based on quantum stochastic calculus.
ROS
Authors: Yan Wenrui , Yao Jie , Cao Qiang , Xie Changsheng , Jiang Hong
Published: November 2018

The combination of the explosive growth in digital data and the demand to preserve much of these data in the long term has made it imperative to find a more cost-effective way than HDD arrays and a more easily accessible way than tape libraries to store massive amounts of data. While modern optical discs are capable of guaranteeing more than 50-year data preservation without media replacement, individual optical discs’ lack of the performance and capacity relative to HDDs or tapes has significantly limited their use in datacenters. This article presents a Rack-scale Optical disc library System, or ROS in short, which provides a PB-level total capacity and inline accessibility on thousands of optical discs built within a 42U Rack. A rotatable roller and robotic arm separating and fetching discs are designed to improve disc placement density and simplify the mechanical structure. A hierarchical storage system based on SSDs, hard disks, and optical discs is proposed to effectively hide the delay of mechanical operation. However, an optical library file system (OLFS) based on FUSE is proposed to schedule mechanical operation and organize data on the tiered storage with a POSIX user interface to provide an illusion of inline data accessibility. We further optimize OLFS by reducing unnecessary user/kernel context switches inheriting from legacy FUSE framework. We evaluate ROS on a few key performance metrics, including operation delays of the mechanical structure and software overhead in a prototype PB-level ROS system. The results show that ROS stacked on Samba and FUSE as network-attached storage (NAS) mode almost saturates the throughput provided by underlying samba via 10GbE network for external users, as well as in this scenario provides about 53ms file write and 15ms read latency, exhibiting its inline accessibility. Besides, ROS is able to effectively hide and virtualize internal complex operational behaviors and be easily deployable in datacenters.
Arrhythmia Classification of ECG Signals Using Hybrid Features
Authors: Anwar Syed Muhammad , Gul Maheen , Majid Muhammad , Alnowami Majdi
Published: November 2018

Automatic detection and classification of life-threatening arrhythmia plays an important part in dealing with various cardiac conditions. In this paper, a novel method for classification of various types of arrhythmia using morphological and dynamic features is presented. Discrete wavelet transform (DWT) is applied on each heart beat to obtain the morphological features. It provides better time and frequency resolution of the electrocardiogram (ECG) signal, which helps in decoding important information of a quasiperiodic ECG using variable window sizes. RR interval information is used as a dynamic feature. The nonlinear dynamics of RR interval are captured using Teager energy operator, which improves the arrhythmia classification. Moreover, to remove redundancy, DWT subbands are subjected to dimensionality reduction using independent component analysis, and a total of twelve coefficients are selected as morphological features. These hybrid features are combined and fed to a neural network to classify arrhythmia. The proposed algorithm has been tested over MIT-BIH arrhythmia database using 13724 beats and MIT-BIH supraventricular arrhythmia database using 22151 beats. The proposed methodology resulted in an improved average accuracy of 99.75% and 99.84% for class- and subject-oriented scheme, respectively, using three-fold cross validation.
Pelargonium graveolensAqueous Decoction: A New Water-Soluble Polysaccharide and Antioxidant-Rich Extract
Authors: Ennaifer Malek , Bouzaiene Taroub , Chouaibi Moncef , Hamdi Moktar
Published: November 2018

Background. The decoction ofPelargonium graveolensyields an antioxidant-rich extract and a water-soluble polysaccharide. This study aims (1) to investigate the effect of process parameters (extraction time and temperature) on the antioxidant activity of the decoction and the extraction yield of CPGP by response methodology and (2) to study the chemical properties of the optimized decoction and rheological properties of the corresponding extracted polysaccharide.Results. The antioxidant-rich decoction contained about 19.76 ± 0.41 mg RE/g DM of flavonoids and 5.31 ± 0.56 mg CE/gDM of condensed tannins. The crudePelargonium graveolenspolysaccharide (CPGP) contained 87.27 % of sugar. Furthermore, the CPGP solutions (0.5%, 1%, and 2%) exhibited shear-thinning or pseudoplastic flow behavior. A central composite design (CDD) was applied to assess the effects of temperature and time on the antioxidant activity of the decoction, on the one hand, and on water-soluble polysaccharide yield, on the other. The decoction optimization ofPelargonium graveolensaimed to use less energy (93°C for 11 minutes) leading to the highest values of decoction phenolic content (33.01 ±0.49 mg GAE/gDM) and DPPH scavenging activity (136.10 ± 0.62 mg TXE/gDM) and the highest values of CPGP yield (6.97%).Conclusion. The obtained results suggest that the CPGP rheological characteristics are suitable for applications in many industries, especially food. The values of optimal conditions showed thatPelargonium graveolensdecoction operation could have multiple uses, especially for consuming less energy.
A Balanced Trust-Based Method to Counter Sybil and Spartacus Attacks in Chord
Authors: Pecori Riccardo , Veltri Luca
Published: November 2018

A Sybil attack is one of the main challenges to be addressed when securing peer-to-peer networks, especially those based on Distributed Hash Tables (DHTs). Tampering routing tables by means of multiple fake identities can make routing, storing, and retrieving operations significantly more difficult and time-consuming. Countermeasures based on trust and reputation have already proven to be effective in some contexts, but one variant of the Sybil attack, the Spartacus attack, is emerging as a new threat and its effects are even riskier and more difficult to stymie. In this paper, we first improve a well-known and deployed DHT (Chord) through a solution mixing trust with standard operations, for facing a Sybil attack affecting either routing or storage and retrieval operations. This is done by maintaining the least possible overhead for peers. Moreover, we extend the solution we propose in order for it to be resilient also against a Spartacus attack, both for an iterative and for a recursive lookup procedure. Finally, we validate our findings by showing that the proposed techniques outperform other trust-based solutions already known in the literature as well.
Occupational Therapy’s Unique Contribution to Chronic Pain Management: A Scoping Review
Authors: Lagueux Émilie , Dépelteau Andréa , Masse Julie
Published: November 2018

Occupational therapy (OT) makes a unique contribution to chronic pain (CP) management due to its overarching focus on occupation. The aim of this scoping review was to describe current knowledge about this contribution by documenting OT roles, models, assessments, and intervention methods used with adults living with CP. A systematic search exploring 10 databases and gray literature from 2006 to 2017 was conducted. Fifty-two sources were retained and analysed. Results bring forward the main role of OT being improving activities and participation (76.9 %), the Canadian Model of Occupational Performance (9.6 %), and the Canadian Occupational Performance Measure (21.2 %). Within the 30 reported interventions, 73.3% related directly to the person, 20% pertained to occupation (activities and participation), and 6.7% addressed environmental factors. The distinction and complementarity between the bottom-up and the top-down approaches to OT intervention were discussed. This review highlights OT specificity in adult CP management.
Cancer Risk from Exposure to Particulate Matter and Ozone According to Obesity and Health-Related Behaviors: A Nationwide Population-Based Cross-Sectional Study
Authors: Kim Kyoung Jin , Shin Jinyoung , Choi Jaekyung
Published: November 2018

Background:

There is little evidence of an association between cancer risk and long-term exposure to ambient particulate matter <10 μm (PM10) and ozone (O3), according to obesity and health-related behaviors.

Methods:

In the 2012 Korean Community Health Survey, survey data on socioeconomic characteristics, health-related behaviors, and previous cancer history were collected from 100,867 participants. Daily average concentrations of PM10 and O3 (2003–2012) were obtained from the Korean Air Pollutants Emission Service. The cancer risks for interquartile increases in PM10 and O3 were evaluated using multiple logistic regression and were stratified by age, sex, obesity, and health-related behaviors.

Results:

Increased cancer risk was found among obese subjects aged ≥50 years after adjusting for confounding factors [PM10: ≥60 years: OR 1.34, 95% confidence interval (CI) 1.03–1.74; 50–60 years: OR 1.40, CI 1.01–1.96; O3: ≥60 years: OR 1.12, CI 1.04–1.20; 50–60 years: OR 1.20, CI 1.08–1.33]. However, we did not observe similar trends in the nonobese subjects. Among obese subjects aged ≥50 who had been exposed to PM10, men, ever smokers, and inactive subjects were at increased cancer risk. Regarding O3, the cancer risk was significantly higher among obese adults >50 years old, regardless of sex or health-related behaviors.

Conclusions:

Long-term exposure to PM10 and O3 was found to increase cancer risk. In particular, the risk differed according to obesity status, age, sex, and health-related behaviors.

Impact:

The effect of air pollution on cancer risk was compounded by obesity, smoking, and physical inactivity among subjects over 50 years old.
Isoform-Dependent Changes in Cytochrome P450-Mediated Drug Metabolism after Portal Vein Ligation in the Rat
Authors: Kovács Tibor , Déri Máté , Fülöp András , Pálházy Tímea , Háfra Edit , Sirok Dávid , Kiss Ádám Ferenc , Lotz Gábor , Szijártó Attila , Monostory Katalin
Published: November 2018

Background: Surgical removal of complicated liver tumors may be realized in two stages via selective portal vein ligation, inducing the atrophy of portally ligated lobes and the compensatory hypertrophy of nonligated liver lobes. Unlike morphological changes, functional aspects such as hepatic cytochrome P450 (CYP)-mediated drug metabolism remain vaguely understood, despite its critical role in both drug biotransformation and hepatic functional analysis. Our goal was the multilevel characterization of hepatic CYP-mediated drug metabolism after portal vein ligation in the rat. Methods: Male Wistar rats (n = 24, 210–230 g) were analyzed either untreated (controls; n = 4) or 24/48/72/168/336 h (n = 4 each) following portal vein ligation affecting approximately 80% of the liver parenchyma. Besides the weights of ligated and nonligated lobes, pentobarbital (30 mg/kg)-induced sleeping time, CYP1A(2), CYP 2B(1/2), CYP2C(6/11/13), CYP3A(1) enzyme activities, and corresponding isoform mRNA expressions, as well as CYP3A1 protein expression were determined by in vivo sleeping test, CYP isoform-selective assays, polymerase chain reaction, and immunohistochemistry, respectively. Results: Portal vein ligation triggered atrophy in ligated lobes and hypertrophy nonligated lobes. Sleeping time was transiently elevated (p = 0.0451). After an initial rise, CYP1A, CYP2B, and CYP3A enzyme activities dropped until 72 h, followed by a potent increase only in the nonligated lobes, paralleled by an early (24–48 h) transcriptional activation only in nonligated lobes. CYP2C enzyme activities and mRNA levels were bilaterally rapidly decreased, showing a late reconvergence only in nonligated lobes. CYP3A1 immunohistochemistry indicated substantial differences in positivity in the early period. Conclusions: Beyond the atrophy-hypertrophy complex, portal vein ligation generated a transient suppression of global and regional drug metabolism, re-established by an adaptive, CYP isoform-dependent transcriptional response of the nonligated lobes.
Radiotherapy in Patients with Mycosis Fungoides and Central Nervous System Involvement
Authors: Jensen Garrett L. , Dabaja Bouthaina S. , Pinnix Chelsea C. , Gunther Jillian R. , Huen Auris , Duvic Madeleine , Oki Yasuhiro , Fanale Michelle , Hosing Chitra , Milgrom Sarah A.
Published: November 2018

Background: Involvement of the central nervous system (CNS) by mycosis fungoides (MF) is rare; however, it portends a poor prognosis. While aggressive multimodality therapy may improve outcomes, the role of radiation therapy (RT) is not well defined. Objectives: We sought to explore the efficacy of RT in the management of CNS involvement by MF. Method: We retrospectively identified five patients with MF and CNS involvement who received cranial or craniospinal RT at a single institution. Patient characteristics, disease features, radiographic findings, treatments delivered, and outcome data were extracted from the electronic medical record. Results: All 5 patients had neurologic deficits at RT initiation, and 4 experienced at least a partial improvement. Of 4 patients evaluated by MRI after RT completion, 3 had complete resolution of CNS disease within the irradiated field. At the time of last follow-up, all patients had died of MF. The median time to death was 7.4 months (range 1.0–21 months) from their diagnosis with CNS involvement and 1.2 months (range 0.4–7.1 months) from the end of RT treatment. Conclusions: We observed high rates of radiographic response and palliation of neurological symptoms. Nonetheless, all patients succumbed to their disease shortly after treatment, confirming the poor prognosis of this condition. Our findings suggest that RT may play a valuable palliative role for these patients.
A definição da vocação poética goethiana nos livros 13 a 16 de Dichtung und Wahrheit (uma investigação)
Authors: Clímaco Marco Antônio Araújo
Published: November 2018

Concebido para suprir as lacunas de uma existência que se tornara pública e notória com a publicação do Werther, o relato autobiográfico de Dichtung und Wahrheit dedicará boa parte das quase 300 páginas de seus sete últimos livros à narração das circunstâncias que teriam possibilitado a Goethe encontrar um campo de atuação e influência compatíveis com a estrondosa repercussão do Werther, mas ao mesmo tempo condizentes com uma vocação poética a que Goethe recusa qualquer interferência direta e ‘didática’ nos assuntos humanos, visto como passa a concebê-la ‘inteiramente como natureza’. O artigo se propõe passar em revista esse momento decisivo de elaboração da Bildung goethiana compreendido sobretudo nos livros 13 a 16, o qual coincide com a definição dos fundamentos da vocação poética que marcará a fisionomia espiritual da produção de Goethe vida afora. Para tanto, investigará a pertinência do conceito de teleologia como princípio explicativo oportuno à elucidação do referido momento, à luz da discussão proposta por Fotis Jannidis (1996); e analisará o papel das referências e influências que maior importância tiveram para Goethe nesse processo: Lavater, Basedow e Zimmermann, entre os convivas, Spinoza e Prometeu entre os luminares.