bluuebunny/crossref_metadata_2025 huggingface dataset:
Behavioural effects of a community‐oriented setting‐based intervention for prevention of childhood obesity in eight European countries. Main results from the IDEFICS study
Authors: De Bourdeaudhuij I. , Verbestel V. , De Henauw S. , Maes L. , Huybrechts I. , Mårild S. , Eiben G. , Moreno L. A. , Barba G. , Kovács É. , Konstabel K. , Tornaritis M. , Gallois K. , Hebestreit A. , Pigeot I. ,   IDEFICS consortium
Published: December 2015

Objective

The objective of this paper is to evaluate the behavioural effects, as reported by the parents of the participating boys and girls, of the IDEFICS (Identification and prevention of Dietary‐ and lifestyle‐induced health EFfects In Children and infantS) intervention.

Methods

The effectiveness of the IDEFICS intervention was evaluated through a cluster‐controlled trial in eight European countries (control and intervention communities in each country) including more than 16,000 children. The 2‐ to 9.9‐year‐old children in the intervention group were exposed to a culturally adapted intervention that aimed to prevent childhood obesity through the community, schools/kindergartens and family. Parents completed questionnaires to measure water, soft drink and fruit juice intake; fruit and vegetable intake; daily TV viewing and other sedentary behaviours; daily physical activity levels and strengthening of the parent–child relationships at baseline and follow‐up (2 years later). Mixed models with an additional random effect for country were used to account for the clustered study design, and results were stratified by sex.

Results

The pan‐European analysis revealed no significant time by condition interaction effects, neither for boys nor girls, i.e. the analysis revealed no intervention effects on the behaviours of the IDEFICS children as reported by their parents (F = 0.0 to 3.3, all p > 0.05). Also very few significances were found in the country‐specific analyses. Positive intervention effects were only found for sport club participation in Swedish boys, for screen time in weekends for Spanish boys and for TV viewing in Belgian girls.

Conclusion

Although no expected intervention effects as reported by the parents on diet, physical activity and sedentary behaviours could be shown for the overall IDEFICS cohort, a few favourable intervention effects were found on specific behaviours in some individual countries. More in‐depth analyses of the process evaluation data are needed to obtain more insight into the relationship between the level of exposure to the intervention and its effect. © 2015 World Obesity
Effectiveness of the IDEFICS intervention on objectively measured physical activity and sedentary time in European children
Authors: Verbestel V. , De Henauw S. , Barba G. , Eiben G. , Gallois K. , Hadjigeorgiou C. , Konstabel K. , Maes L. , Mårild S. , Molnár D. , Moreno L. A. , Oja L. , Pitsiladis Y. , Ahrens W. , Pigeot I. , De Bourdeaudhuij I. ,   on behalf of the IDEFICS consortium
Published: December 2015

Background

This paper reports on the effectiveness of the prevention of dietary‐ and lifestyle‐induced health effects in children and infants (IDEFICS) intervention on objectively measured physical activity (PA) and sedentary time (ST) in 2‐ to 9.9‐year‐old European boys and girls.

Methods

The intervention was evaluated after 2 years through a non‐randomized cluster‐controlled trial in eight European countries (one control and one intervention community per country). All children in the intervention group received a culturally adapted childhood obesity prevention programme through the community, schools/kindergartens and family. A random sub‐sample of children participating in the IDEFICS study wore an accelerometer at baseline and follow‐up for at least 3 days (n = 9,184). Of this sample, 81% provided valid accelerometer data at baseline (n = 7,413; 51% boys; 6.21 ± 1.76 years; boys: 617 ± 170 cpm day−1; girls 556 ± 156 cpm day−1) and 3,010 children provided valid accelerometer data at baseline and during the follow‐up survey 2 years later.

Results

In boys and girls, no significant differences in PA and ST were found between intervention and control groups over 2 years. Strong temporal effects were found in the total sample of boys and girls: the percentage of time spent in light PA per day decreased by 4 percentage points in both boys and girls between baseline and follow‐up (both: p < 0.001), while time spent in ST per day increased by 4 percentage points in both sexes over time (both: p < 0.001). Percentage of time spent in moderate‐to‐vigorous PA per day remained stable over time in boys and girls.

Conclusion

Despite the socio‐ecological approach and implementation of a culturally adapted intervention in each country, no effects of the IDEFICS intervention were found on children's objectively measured PA and ST. Behavioural interventions for children may need to enhance specificity and intensity at the family level using other behaviour change techniques and more direct strategies to reach parents. © 2015 World Obesity
Adherence to combined lifestyle factors and their contribution to obesity in the IDEFICS study
Authors: Kovács E. , Hunsberger M. , Reisch L. , Gwozdz W. , Eiben G. , De Bourdeaudhuij I. , Russo P. , Veidebaum T. , Hadjigeorgiou C. , Sieri S. , Moreno L. A. , Pigeot I. , Ahrens W. , Pohlabeln H. , Molnár D. ,   on behalf of the IDEFICS consortium
Published: December 2015

Background

The Identification and prevention of Dietary‐ and lifestyle‐induced health EFfects In Children and infantS (IDEFICS) study investigated the aetiology of childhood obesity and developed a primary prevention programme.

Methods

Pre‐intervention adherence to key behaviours related to childhood obesity, namely water/sweetened drink, fruit/vegetable consumption, daily TV time, physical activity, family time and adequate sleep duration, was measured at baseline. Adherence to international recommendations was converted into a composite score ranging from 0 (none) to 6 (adhering to all). Data on adherence were available for 7,444 to 15,084 children aged 2–9.9 years, depending on the behaviour. By means of multi‐level logistic regression models adjusted for age, sex and country, we calculated odds ratios (OR) and 95% confidence intervals (CI) to estimate the relationship between adherence to these recommendations and the risk of being overweight/obese.

Results

Adherence ranged from 15.0% (physical activity) to 51.9% (TV time). As adherence increased, a lower chance of being overweight/obese was observed; adhering to only one key behaviour (score = 1) meant an OR = 0.81 (CI: 0.65–1.01) compared with non‐adherence (score = 0), while adhering to more than half of the key behaviours (score ≥ 4) halved the chance for overweight/obesity (OR = 0.54, CI: 0.37–0.80). Adherence to physical activity, TV and sleep recommendations was the main driver reducing the chance of being overweight. Overweight/obese children were more likely not to adhere to at least one of the recommended behaviours (19.8%) than normal‐weight/thin children (12.9%)

Conclusion

The selected key behaviours do not contribute equally to a reduced chance of being overweight. Future interventions may benefit most from moving more, reducing TV time and getting adequate sleep. © 2015 World Obesity
Process evaluation of the IDEFICS school intervention: putting the evaluation of the effect on children's objectively measured physical activity and sedentary time in context
Authors: Verloigne M. , Ahrens W. , De Henauw S. , Verbestel V. , Mårild S. , Pigeot I. , De Bourdeaudhuij I. ,   on behalf of the IDEFICS consortium
Published: December 2015

Objectives

The first aim was to describe the intervention implementation and reception with specific regard to physical activity (PA) within Belgian schools participating in the IDEFICS (Identification and prevention of Dietary‐ and lifestyle‐induced health EFfects In Children and infantS) intervention. Second, we examined if a higher intervention process score in schools showed more favourable effects on children's objectively measured PA and sedentary time (ST).

Methods

The IDEFICS intervention focused on improving children's health behaviour (including PA) at the community, school/kindergarten and family level. Five process evaluation questionnaires completed by school working groups, and (physical education) teachers were used for the process evaluation of four intervention modules (school working groups, healthy weeks, school environment, health‐related physical education and PA). Items were summed to calculate a total intervention process score per school. Schools were subdivided into three groups (low, medium and high score). Multilevel models were used to examine if changes in PA or ST differed between schools with a low, medium or high score. In total, 333 children (54.1% girls, mean age 6.0 ± 1.5 years) from 34 intervention schools (18 pre‐schools and 16 primary schools) in the town of Geraardsbergen, Belgium, provided valid accelerometer data for two weekdays and one weekend day.

Results

Mean intervention process score (maximum value = 44) was 20.9 ± 5.8 for schools. The breakdown per module showed which components were implemented and received well and which components could have been improved. After the intervention, the decrease in light PA and increase in ST was much higher in children from primary schools with a low intervention process score, whereas the behaviours remained relatively stable in children from primary schools with a medium or high score. The change in moderate to vigorous PA did not differ significantly between schools with a low, medium or high score.

Conclusion

The IDEFICS intervention was relatively able to prevent unfavourable changes in ST and light PA in schools with a medium and high intervention process score. Further process evaluation research is needed to obtain a more profound picture of the IDEFICS intervention process.
The IDEFICS intervention: what can we learn for public policy?
Authors: Williams G.
Published: December 2015

Introduction

As considered in the rest of this volume, the effects of the IDEFICS intervention on obesity rates were not encouraging. This paper considers how far findings from the IDEFICS study and similar intervention studies are relevant to the policy process and political decision‐making.

Methods

The paper offers theoretical and policy‐level arguments concerning the evaluation of evidence and its implications for policymaking. The paper is divided into three parts. The first considers problems in the nature and applicability of evidence gained from school‐ and community‐level obesity interventions. The second part considers whether such interventions present a model that policymakers could implement. The third part considers how we should think about policy measures given the limited evidence we can obtain and the many different goals that public policy must take account of.

Results

The paper argues that (1) there are clear reasons why we are not obtaining good evidence for effective school‐ and community‐level interventions; (2) public policy is not in a good position to mandate larger‐scale, long‐term versions of these interventions; and (3) there are serious problems in obtaining ‘evidence’ for most public policy options, but this should not deter us from pursuing options that tackle systemic problems and have a good likelihood of delivering benefits on several dimensions.

Conclusions

Research on school‐ and community‐level obesity interventions has not produced much evidence that is directly relevant to policymaking. Instead, it shows how difficult it is to affect obesity rates without changing wider social and economic factors. Public policy should focus on these.
Should the IDEFICS outcomes have been expected?
Authors: Baranowski T. , Lytle L.
Published: December 2015

The Identification and prevention of Dietary‐ and lifestyle‐induced health EFfects In Children and infantS (IDEFICS) study evaluated with a large sample a comprehensive carefully planned obesity prevention intervention targeting multiple levels of influence that were culturally adapted to the situations in eight European countries. Despite the great effort and attention to detail, the IDEFICS study did not achieve its targeted adiposity or behaviour change objectives. Should we be surprised that the IDEFICS trial did not have its intended effects? We think not, and would have been surprised if it did. Recent research has revealed the lack of consistent meaningful relationships between several apparently obesogenic behaviours and adiposity, weak or no relationships among behavioural change procedures, mediating variables and targeted behaviours and inadequate attention to moderating effects. Future obesity prevention interventions would benefit from a more thorough understanding of the complex relationships that have been hypothesized and the interrelationships with biological factors. While systems modelling has been proposed as providing the solution, important less complex identification of new constructs, new relationships and community interventions are still needed, both to find innovative solutions and to provide input into the systems models. We should question results from cross‐sectional studies and be satisfied only with longitudinal or experimental tests of relationships.
Impact of a community based health‐promotion programme in 2‐ to 9‐year‐old children in Europe on markers of the metabolic syndrome, the IDEFICS study
Authors: Mårild S. , Russo P. , Veidebaum T. , Tornaritis M. , De Henauw S. , De Bourdeaudhuij I. , Molnár D. , Moreno L. A. , Bramsved R. , Peplies J. , Ahrens W. ,   on behalf of the IDEFICS consortium
Published: December 2015

Introduction

One objective of ‘Identification and prevention of Dietary‐and lifestyle‐induced health EFfects In Children and infantS’, the IDEFICS study, was to implement a community‐oriented childhood obesity prevention intervention in eight European countries.

Objective

To assess the effect of an obesity primary prevention programme on metabolic markers.

Methods

The study had a non‐randomized cluster‐experimental design. In each country, children were recruited from distinct communities serving as intervention and control regions. Health examinations were done during 2007–2008 before the intervention (T0) and during 2009–2010 (T1). Children with results available from T0 and T1 on blood pressure, waist circumference and at least one blood‐marker (fasting glucose, insulin, HOMA‐IR, HbA1c, HDL‐ and LDL‐cholesterol, triglycerides, C‐reactive protein) were included. A metabolic syndrome (MetS) score was calculated.

Results

A total of 7,406 children (age 2–9.9 years) of the 16,228 participating at T0 provided the necessary data. No effect of the intervention was seen on insulin, HOMA‐IR, CRP or the MetS score. Overall fasting glucose increased less in the intervention than in the control region, a pattern driven by three of the eight countries and more pronounced in children of parents with low education. Overall, HbA1c and waist circumference increased more and blood pressure less in the intervention regions.

Conclusion

We observed no convincing effect of the intervention on markers of the metabolic syndrome. We identified diverse patterns of change for several markers of uncertain relation to the intervention. © 2015 World Obesity
Advances in the microbial etiology and pathogenesis of early childhood caries
Authors: Hajishengallis E. , Parsaei Y. , Klein M.I. , Koo H.
Published: December 2015

Early childhood caries (ECC) is one of the most prevalent infectious diseases affecting children worldwide. ECC is an aggressive form of dental caries, which, left untreated, can result in rapid and extensive cavitation in teeth (rampant caries) that is painful and costly to treat. Furthermore, it affects mostly children from impoverished backgrounds, and so constitutes a major challenge in public health. The disease is a prime example of the consequences arising from complex, dynamic interactions between microorganisms, host, and diet, leading to the establishment of highly pathogenic (cariogenic) biofilms. To date, there are no effective methods to identify those at risk of developing ECC or to control the disease in affected children. Recent advances in deep‐sequencing technologies, novel imaging methods, and (meta)proteomics–metabolomics approaches provide an unparalleled potential to reveal new insights to illuminate our current understanding about the etiology and pathogenesis of the disease. In this concise review, we provide a broader perspective about the etiology and pathogenesis of ECC based on previous and current knowledge on biofilm matrix, microbial diversity, and host–microbe interactions, which could have direct implications for developing new approaches for improved risk assessment and prevention of this devastating and costly childhood health condition.
NewB for newbies: a randomized control trial training housestaff to perform neonatal intubation with direct and videolaryngoscopy
Authors: Koele‐Schmidt Lindsey , Vasquez Margarita M.
Published: December 2015

Background

Competency rates in neonatal intubation among pediatric residents are low and currently not meeting ACGME/AAP standards.

Aims

The aim of this study was to compare standard bedside teaching of neonatal endotracheal intubation to a computer module, as well as introduce residents to the emerging technology of videolaryngoscopy.

Methods

The study population consisted of The University of Texas Health Science Center at San Antonio Pediatric interns/residents and PGY‐1 Anesthesia interns rotating through the NICU. Prior to participating in the study, the residents completed a survey addressing past experiences with intubation, comfort level, and prior use of direct and videolaryngoscopy. Participants then performed timed trials of both direct and videolaryngoscopy on the SimNewB®. They had up to three attempts to successfully intubate, with up to 30 s on each attempt. After randomization, participants received one of the following teaching interventions: standard, computer module, or both. This was followed by a second intubation trial and survey completion.

Results

Thirty residents were enrolled in the study. There was significant improvement in time to successful intubation in both methods after any teaching intervention (direct 22.0 ± 13.4 s vs 14.7 ± 5.9 s, P = 0.002 and videolaryngoscopy 42.2 ± 29.3 s vs 26.8 ± 18.6 s, P = 0.003). No differences were found between the types of teaching. Residents were faster at intubating with direct laryngoscopy compared to videolaryngoscopy before and after teaching. By the end of the study, only 33% of residents preferred using videolaryngoscopy over direct laryngoscopy, but 76% felt videolaryngoscopy was better to teach intubation.

Conclusions

Both standard teaching and computer module teaching of neonatal intubation on a mannequin model results in improved time to successful intubation and overall improved resident confidence with intubation equipment and technique. Although intubation times were lower with direct laryngoscopy compared to videolaryngoscopy, the participating residents felt that videolaryngoscopy is an important educational tool.
Morbidity in preterm infants with fetal inflammatory response syndrome
Authors: Ozalkaya Elif , Karatekin Güner , Topcuoğlu Sevilay , Gürsoy Tuğba , Ovalı Fahri
Published: December 2015

Background

The aim of this study was to evaluate the relationship between umbilical cord blood interleukin (IL)‐6 concentration and preterm morbidity and mortality in premature infants born with fetal inflammatory response syndrome (FIRS).

Methods

This prospective, observational study included 84 preterm infants with a gestational age of 24–36 weeks who had been admitted to the neonatal intensive care unit (NICU). FIRS was defined as umbilical cord blood IL‐6 > 11 pg/mL. In premature infants with FIRS, morbidities (multiple organ failure [MOF], respiratory distress syndrome [RDS], patent ductus arteriosus, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity) and death were evaluated. Critical umbilical cord blood IL‐6 concentrations for the development of RDS, death, and for MOF were determined in premature infants with FIRS.

Results

Fifty‐two infants with IL‐6 concentration > 11 pg/mL constituted the FIRS group. Thirty‐two infants without FIRS served as a control group. RDS, MOF, and mortality were significantly higher in the FIRS group (P = 0.001, P = 0.001, and P = 0.005, respectively). Umbilical cord blood IL‐6 concentration > 26.7 pg/mL in the FIRS group was found to be predictive of RDS, with 70% sensitivity and 85% specificity. Umbilical cord blood IL‐6 concentration > 37.7 pg/mL was found to be predictive of death, with 78.6% sensitivity and 60% specificity. The predictive value of IL‐6 for the development of MOF was 17.5 pg/mL, with 91% sensitivity and 66% specificity.

Conclusions

Umbilical cord blood IL‐6 concentration > 26.7, 37.7, and 17.5 pg/mL in premature infants with FIRS was found to be predictive for RDS, death, and MOF, respectively.
Intellectual maturity and physical fitness in preschool children
Authors: Latorre‐Román Pedro Á , Mora‐López David , García‐Pinillos Felipe
Published: December 2015

Background

There is an important connection between body growth, physical fitness and cognition. The association between physical fitness and cognitive function has been investigated in some studies, but little is known about the relationship between physical and motor performance and intellectual maturity in preschool children. The aim of this study was therefore to analyze the association between intellectual maturity and physical and motor fitness in preschool children.

Methods

A total of 1012 children aged 3–6 years participated voluntarily. A fitness test battery and the Goodenough–Harris drawing test (GHDT) were used.

Results

Boys did better in the standing broad jump and 20 m sprint (P < 0.001), and girls had a better crude GHDT score (P = 0.001). With regard to age group, there were significant differences (P < 0.01) between all groups in all fitness test variables and GHDT. Moreover, a significant correlation was found between crude GHDT score and the fitness test variables.

Conclusions

From an early age, physical–motor performance and intellectual maturity are linked. Fitness condition is able to predict intellectual maturity. Increasing the amount of time devoted to physical education can promote cognitive benefits in preschool children.
Women, mobile phones, and M16s: Contemporary New Guinea highlands warfare
Authors: Macdonald Fraser , Kirami Jonathan
Published: December 2015

This paper reports upon a series of recent developments in New Guinea highlands warfare. Building upon existing literature highlighting the deep influence of modernity within this context, we draw attention to two particular developments yet to be reported in the literature and which appear to be of special significance. Through an analysis of Aiya warfare, Southern Highlands Province, Papua New Guinea, we document the direct and increasing involvement of women within warfare, as well as the important role played by mobile phones used by warriors to communicate before and during fighting. These two developments are situated in relation to broader shifts currently reshaping Melanesian sociality, namely, the ambivalent and fraught position of women within an emergent PNG society, as well as the rapid diffusion of mobile phone technology throughout the region.
Boiling Visualization of Two Adjacent Impinging Jets on Hot Steel Plate
Authors: Lee Jungho , Sohn Sangho , Lee Sang Gun
Published: December 2015

The simultaneous measurement between the boiling visualization and the boiling heat transfer characteristics by two adjacent impinging jets on hot steel plate was made by the experimental technique that has a function of high-temperature flat-plate heat flux gauge. The 22 K-type thermocouples were installed at 1 mm below the surface of flat-plate heat flux gauge. The 2-D inverse heat conduction was formulated to solve the surface temperature and heat flux. The boiling visualization was synchronized with a 4K video camera which was meaningful to understand complex boiling heat transfer phenomena. The heat flux gauge was uniformly heated up to 900°C by induction heating. The successive boiling images show where the nucleate boiling starts to occur on hot surface and the film boiling turns to be collapsed. The measured surface temperature and heat flux distribution agrees well with the corresponding boiling visualization: While heat transfer at the stagnation point shows a maximum heat flux, the interaction between two adjacent impinging jets exhibits a relative high heat flux and a steep temperature gradient until the end of boiling heat transfer at which single-phase convection occurs near 200°C.
Unsteady Aerodynamic Interaction in a Closely Coupled Turbine Consistent With Contrarotation
Authors: Ooten Michael K. , Anthony Richard J. , Lethander Andrew T. , Clark John P.
Published: December 2015

The focus of the study presented here was to investigate the interaction between the blade and downstream vane of a stage-and-one-half transonic turbine via computation fluid dynamic (CFD) analysis and experimental data. A Reynolds-averaged Navier–Stokes (RANS) flow solver with the two-equation Wilcox 1998 k–ω turbulence model was used as the numerical analysis tool for comparison with all of the experiments conducted. The rigor and fidelity of both the experimental tests and numerical analysis methods were built through two- and three-dimensional steady-state comparisons, leading to three-dimensional time-accurate comparisons. This was accomplished by first testing the midspan and quarter-tip two-dimensional geometries of the blade in a linear transonic cascade. The effects of varying the incidence angle and pressure ratio on the pressure distribution were captured both numerically and experimentally. This was used during the stage-and-one-half post-test analysis to confirm that the target corrected speed and pressure ratio were achieved. Then, in a full annulus facility, the first vane itself was tested in order to characterize the flowfield exiting the vane that would be provided to the blade row during the rotating experiments. Finally, the full stage-and-one-half transonic turbine was tested in the full annulus cascade with a data resolution not seen in any studies to date. A rigorous convergence study was conducted in order to sufficiently model the flow physics of the transonic turbine. The surface pressure traces and the discrete Fourier transforms (DFT) thereof were compared to the numerical analysis. Shock trajectories were tracked through the use of two-point space–time correlation coefficients. Very good agreement was seen when comparing the numerical analysis to the experimental data. The unsteady interaction between the blade and downstream vane was well captured in the numerical analysis.
Turbine Tone Noise Prediction Using a Linearized Computational Fluid Dynamics Solver: Comparison With Measurements
Authors: González Adolfo Serrano , Aparicio José Ramón Fernández
Published: December 2015

The capability of a linearized computational fluid dynamics (CFD) method for predicting turbine tone noise is investigated through comparison with measurements. To start with, a benchmark problem on flat plates is presented, and results are put together with those published by other authors. Then, numerical predictions are compared with measurements from two low-pressure turbines (LPTs), which have been tested in different facilities. The first specimen is a three-stage cold flow rig, noise tested in the Centro de Tecnologías Aeronáuticas (CTA) facility (Bilbao, Spain) in 2012 and funded by the Clean Sky EU Program. The second is the advanced near-term low emissions (ANTLE) LPT rig, full-scale, cold flow, noise tested in the twin shaft test facility (TSTF) in Rolls-Royce (Derby, UK) in 2005 and funded by the SILENCE(R) EU Funded Program. The comparison includes multistage effects, clocking sensitivities, and acoustic scattering through outlet guide vanes (OGVs).
BPNN–QSTR Friction Model for Organic Compounds as Potential Lubricant Base Oils
Authors: Gao Xinlei , Wang Ruitao , Wang Zhan , Dai Kang
Published: December 2015

A series of ball–disk contact friction tests were carried out using a microtribometer to study the tribological characteristics of steel/steel rubbing pairs immersed in 47 different organic compounds as lubricant base oils. The structures and their friction data were included in a back-propagation neural network (BPNN) quantitative structure tribo-ability relationship (QSTR) model. Following leave-one-out (LOO) cross-validation, the BPNN model shows good predictability and accuracy for the friction parameter (R2 = 0.994, R2(LOO) = 0.849, and q2 = 0.935). Connectivity indices (CHI) show the large positive contribution to friction, which imply that friction performance has a strong correlation with molecular structure. The BPNN–QSTR models can flexibly and easily estimate the friction properties of lubricant base oils.
Closed Form Solution for Outflow Between Corotating Disks
Authors: Singh Achhaibar
Published: December 2015

Mathematical expressions are derived for flow velocities and pressure distributions for a laminar flow in the gap between two rotating concentric disks. Fluid enters the gap between disks at the center and diverges to the outer periphery. The Navier–Stokes equations are linearized in order to get closed-form solution. The present solution is applicable to the flow between corotating as well as contrarotating disks. The present results are in agreement with the published data of other investigators. The tangential velocity is less for contrarotating disks than for corotating disks in core region of the radial channel. The flow is influenced by rotational inertia and convective inertia both. Dominance of rotational inertia over convective inertia causes backflow. Pressure depends on viscous losses, convective inertia, and rotational inertias. Effect of viscous losses on pressure is high at small throughflow Reynolds number. The convective and rotational inertia influence pressure significantly at high throughflow and rotational Reynolds numbers. Both favorable and unfavorable pressure gradients can be found simultaneously depending on a combination of parameters.
Prediction of In Vivo Knee Joint Loads Using a Global Probabilistic Analysis
Authors: Navacchia Alessandro , Myers Casey A. , Rullkoetter Paul J. , Shelburne Kevin B.
Published: December 2015

Musculoskeletal models are powerful tools that allow biomechanical investigations and predictions of muscle forces not accessible with experiments. A core challenge modelers must confront is validation. Measurements of muscle activity and joint loading are used for qualitative and indirect validation of muscle force predictions. Subject-specific models have reached high levels of complexity and can predict contact loads with surprising accuracy. However, every deterministic musculoskeletal model contains an intrinsic uncertainty due to the high number of parameters not identifiable in vivo. The objective of this work is to test the impact of intrinsic uncertainty in a scaled-generic model on estimates of muscle and joint loads. Uncertainties in marker placement, limb coronal alignment, body segment parameters, Hill-type muscle parameters, and muscle geometry were modeled with a global probabilistic approach (multiple uncertainties included in a single analysis). 5–95% confidence bounds and input/output sensitivities of predicted knee compressive loads and varus/valgus contact moments were estimated for a gait activity of three subjects with telemetric knee implants from the “Grand Challenge Competition.” Compressive load predicted for the three subjects showed confidence bounds of 333 ± 248 N, 408 ± 333 N, and 379 ± 244 N when all the sources of uncertainty were included. The measured loads lay inside the predicted 5–95% confidence bounds for 77%, 83%, and 76% of the stance phase. Muscle maximum isometric force, muscle geometry, and marker placement uncertainty most impacted the joint load results. This study demonstrated that identification of these parameters is crucial when subject-specific models are developed.
The Numerical Solution of the Bagley–Torvik Equation With Fractional Taylor Method
Authors: Krishnasamy V. S. , Razzaghi M.
Published: December 2015

In this paper, a numerical method for solving the fractional Bagley–Torvik equation is given. This method is based on using fractional Taylor vector approximation. The operational matrix of the fractional integration for fractional Taylor vector is given and is utilized to reduce the solution of the Bagley–Torvik equation to a system of algebraic equations. Illustrative examples are included to demonstrate the validity and applicability of this technique.
Conditions on the Cable-Routing Matrix for Wrench Closure of Multilink Cable-Driven Manipulators
Authors: Lau Darwin , Oetomo Denny
Published: December 2015

Wrench-closure is an important property of cable-driven parallel manipulators (CDPMs), representing the ability to generate wrench in any direction by positive cable forces. For single link CDPMs, it is well known that m ≥ n + 1 cables are necessary for an n degrees-of-freedom CDPM to achieve wrench-closure. However, for multilink cable-driven manipulators (MCDMs), this condition is too relaxed and the cable routing should also be considered. In this paper, necessary conditions to achieve wrench-closure for MCDMs are mathematically derived based on the cable routing arrangements. Since the approach is independent on the exact attachment locations, the proposed necessary conditions can be efficiently validated during the design and synthesis of MCDMs. Analysis is performed on a range of different MCDM structures to identify cable arrangements that do not satisfy wrench-closure for an MCDM.
Neutron study of phospholipids 1-palmitoyl-2-oleoyl-sn-glycero-3-phospho-ethanolamine spray coating on titanium implants
Authors: Golub Maksym , Lott Dieter , Garamus Vasil M. , Laipple Daniel , Stoermer Michael , Watkins Erik B. , Schreyer Andreas , Willumeit-Römer Regine
Published: December 2015

Permanent implants made from titanium are widely used and successfully implemented in medicine to address problems related to orthopedic and oral disorders. However, implants that interact in all cases optimally and durably with bone tissue have yet to be developed. Here, the authors suggest a phospholipids 1-palmitoyl-2-oleoyl-sn-glycero-3-phospho-ethanolamine (POPE) lipid coating to partially mimic the biological cell membrane. To improve the homogeneity of the POPE distribution on the metal surface, the lipids are applied by spray coating. It is shown that the spray coating leads to two types of multilamellar POPE structures. Our experimental results demonstrate that these coatings are stable in a liquid environment in the range of physiological temperatures due to the unique interbilayer interaction of POPE lipids. Additionally, the interaction of the POPE multilayer structure with human serum albumin is considered. A simultaneous analysis of the specular and off-specular data provides structural information necessary to assess the quality of the coating for future applications.
Modal sound transmission loss of a single leaf panel: Asymptotic solutions
Authors: Wang Chong
Published: December 2015

In a previously published paper [C. Wang, J. Acoust. Soc. Am. 137(6), 3514–3522 (2015)], the modal sound transmission coefficients of a single leaf panel were discussed with regard to the inter-modal coupling effects. By incorporating such effect into the equivalent modal radiation impedance, which is directly related to the modal sound transmission coefficient of each mode, the overall sound transmission loss for both normal and randomized sound incidences was computed through a simple modal superposition. Benefiting from the analytical expressions of the equivalent modal impedance and modal transmission coefficients, in this paper, behaviors of modal sound transmission coefficients in several typical frequency ranges are discussed in detail. Asymptotic solutions are also given for the panels with relatively low bending stiffnesses, for which the sound transmission loss has been assumed to follow the mass law of a limp panel. Results are also compared to numerical analysis and the renowned mass law theories.
Microscopic prediction of speech intelligibility in spatially distributed speech-shaped noise for normal-hearing listeners
Authors: Geravanchizadeh Masoud , Fallah Ali
Published: December 2015

A binaural and psychoacoustically motivated intelligibility model, based on a well-known monaural microscopic model is proposed. This model simulates a phoneme recognition task in the presence of spatially distributed speech-shaped noise in anechoic scenarios. In the proposed model, binaural advantage effects are considered by generating a feature vector for a dynamic-time-warping speech recognizer. This vector consists of three subvectors incorporating two monaural subvectors to model the better-ear hearing, and a binaural subvector to simulate the binaural unmasking effect. The binaural unit of the model is based on equalization-cancellation theory. This model operates blindly, which means separate recordings of speech and noise are not required for the predictions. Speech intelligibility tests were conducted with 12 normal hearing listeners by collecting speech reception thresholds (SRTs) in the presence of single and multiple sources of speech-shaped noise. The comparison of the model predictions with the measured binaural SRTs, and with the predictions of a macroscopic binaural model called extended equalization-cancellation, shows that this approach predicts the intelligibility in anechoic scenarios with good precision. The square of the correlation coefficient (r2) and the mean-absolute error between the model predictions and the measurements are 0.98 and 0.62 dB, respectively.
Stress Management in Physical Education Class: An Experiential Approach To Improve Coping Skills and Reduce Stress Perceptions in Adolescents
Authors: Lang Christin , Feldmeth Anna Karina , Brand Serge , Holsboer-Trachsler Edith , Pühse Uwe , Gerber Markus
Published: December 2015

In most physical education (PE) syllabuses, promoting life skills constitutes an important educational objective. The aim of this study was to implement a coping training program (EPHECT) within regular PE and to evaluate its effects on coping and stress among vocational students. Eight classes from a vocational school were selected for study; four were allocated to the intervention group (IG) and four to the control group (CG). The study examined intervention effects between pre- and postintervention, and postintervention and 6-months follow-up. Compared with the CG, the IG showed improved coping skills from pre- to postintervention. From postintervention to follow-up, stress decreased for the IG. A path analysis suggests an indirect effect on stress perception at follow-up via improved adaptive coping skills. The findings support EPHECT as a positive contribution to the development of adaptive coping skills. The project further shows how physical educators can translate psychological theory into practice.
Racecadotril for acute diarrhoea in children: systematic review and meta-analyses
Authors: Gordon Morris , Akobeng Anthony
Published: December 2015

Objective

Racecadotril is an antisecretory agent that can prevent fluid/electrolyte depletion from the bowel as a result of acute diarrhoea without affecting intestinal motility. An up-to-date systematic review is indicated to summarise the evidence on racecadotril for the treatment of acute diarrhoea in children.

Design

A Cochrane format systematic review of randomised controlled trials (RCTs). Data extraction and assessment of methodological quality were performed independently by two reviewers. Methodological quality was assessed using the Cochrane risk of bias tool.

Patients

Children with acute diarrhoea, as defined by the primary studies.

Interventions

RCTs comparing racecadotril with placebo or other interventions.

Main outcome measurs

Duration of illness, stool output/volume and adverse events.

Results

Seven RCTs were included, five comparing racecadotril with placebo or no intervention, one with pectin/kaolin and one with loperamide. Moderate to high risk of bias was present in all studies. There was no significant difference in efficacy or adverse events between racecadotril and loperamide. A meta-analysis of three studies with 642 participants showed significantly shorter duration of symptoms with racecadotril compared with placebo (mean difference −53.48 h, 95% CI −65.64 to −41.33). A meta-analysis of five studies with 949 participants showed no significant difference in adverse events between racecadotril and placebo (risk ratio 0.99, 95% CI 0.73 to 1.34).

Conclusions

There is some evidence that racecadotril is more effective than placebo or no intervention in reducing the duration of illness and stool output in children with acute diarrhoea. However, the overall quality of the evidence is limited due to sparse data, heterogeneity and risk of bias. Racecadotril appears to be safe and well tolerated.
Are primary care factors associated with hospital episodes for adverse drug reactions? A national observational study
Authors: McKay Ailsa J , Newson Roger B , Soljak Michael , Riboli Elio , Car Josip , Majeed Azeem
Published: December 2015

Objective

Identification of primary care factors associated with hospital admissions for adverse drug reactions (ADRs).

Design and setting

Cross-sectional analysis of 2010–2012 data from all National Health Service hospitals and 7664 of 8358 general practices in England.

Method

We identified all hospital episodes with an International Classification of Diseases (ICD) 10 code indicative of an ADR, in the 2010–2012 English Hospital Episode Statistics (HES) admissions database. These episodes were linked to contemporary data describing the associated general practice, including general practitioner (GP) and patient demographics, an estimate of overall patient population morbidity, measures of primary care supply, and Quality and Outcomes Framework (QOF) quality scores. Poisson regression models were used to examine associations between primary care factors and ADR-related episode rates.

Results

212 813 ADR-related HES episodes were identified. Rates of episodes were relatively high among the very young, older and female subgroups. In fully adjusted models, the following primary care factors were associated with increased likelihood of episode: higher deprivation scores (population attributable fraction (PAF)=0.084, 95% CI 0.067 to 0.100) and relatively poor glycated haemoglobin (HbA1c) control among patients with diabetes (PAF=0.372; 0.218 to 0.496). The following were associated with reduced episode likelihood: lower GP supply (PAF=−0.016; −0.026 to −0.005), a lower proportion of GPs with UK qualifications (PAF=−0.035; −0.058 to −0.012), lower total QOF achievement rates (PAF=−0.021; −0.042 to 0.000) and relatively poor blood pressure control among patients with diabetes (PAF=−0.144; −0.280 to −0.022).

Conclusions

Various aspects of primary care are associated with ADR-related hospital episodes, including achievement of particular QOF indicators. Further investigation with individual level data would help develop understanding of the associations identified. Interventions in primary care could help reduce the ADR burden. ADRs are candidates for primary care sensitive conditions.
Systems science and systems thinking for public health: a systematic review of the field
Authors: Carey Gemma , Malbon Eleanor , Carey Nicole , Joyce Andrew , Crammond Brad , Carey Alan
Published: December 2015

Objectives

This paper reports on findings from a systematic review designed to investigate the state of systems science research in public health. The objectives were to: (1) explore how systems methodologies are being applied within public health and (2) identify fruitful areas of activity.

Design

A systematic review was conducted from existing literature that draws on or uses systems science (in its various forms) and relates to key public health areas of action and concern, including tobacco, alcohol, obesity and the social determinants of health.

Data analysis

117 articles were included in the review. An inductive qualitative content analysis was used for data extraction. The following were systematically extracted from the articles: approach, methodology, transparency, strengths and weaknesses. These were then organised according to theme (ie, commonalities between studies within each category), in order to provide an overview of the state of the field as a whole. The assessment of data quality was intrinsic to the goals of the review itself, and therefore, was carried out as part of the analysis.

Results

4 categories of research were identified from the review, ranging from editorial and commentary pieces to complex system dynamic modelling. Our analysis of each of these categories of research highlighted areas of potential for systems science to strengthen public health efforts, while also revealing a number of limitations in the dynamic systems modelling being carried out in public health.

Conclusions

There is a great deal of interest in how the application of systems concepts and approach might aid public health. Our analysis suggests that soft systems modelling techniques are likely to be the most useful addition to public health, and align well with current debate around knowledge transfer and policy. However, the full range of systems methodologies is yet to be engaged with by public health researchers.
Burden of poor oral health in older age: findings from a population-based study of older British men
Authors: Ramsay S E , Whincup P H , Watt R G , Tsakos G , Papacosta A O , Lennon L T , Wannamethee S G
Published: December 2015

Objectives

Evidence of the extent of poor oral health in the older UK adult population is limited. We describe the prevalence of oral health conditions, using objective clinical and subjective measures, in a population-based study of older men.

Design

Cross-sectional study.

Setting and participants

A representative sample of men aged 71–92 years in 2010–2012 from the British Regional Heart Study, initially recruited in 1978–1980 from general practices across Britain. Physical examination among 1660 men included the number of teeth, and periodontal disease in index teeth in each sextant (loss of attachment, periodontal pocket, gingival bleeding). Postal questionnaires (completed by 2147 men including all participants who were clinically examined) included self-rated oral health, oral impacts on daily life and current perception of dry mouth experience.

Results

Among 1660 men clinically examined, 338 (20%) were edentulous and a further 728 (43%) had <21 teeth. For periodontal disease, 233 (19%) had loss of attachment (>5.5 mm) affecting 1–20% of sites while 303 (24%) had >20% sites affected. The prevalence of gingival bleeding was 16%. Among 2147 men who returned postal questionnaires, 35% reported fair/poor oral health; 11% reported difficulty eating due to oral health problems. 31% reported 1–2 symptoms of dry mouth and 20% reported 3–5 symptoms of dry mouth. The prevalence of edentulism, loss of attachment, or fair/poor self-rated oral health was greater in those from manual social class.

Conclusions

These findings highlight the high burden of poor oral health in older British men. This was reflected in both the objective clinical and subjective measures of oral health conditions. The determinants of these oral health problems in older populations merit further research to reduce the burden and consequences of poor oral health in older people.