bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of DNA Sequencing and Analysis Methods on 16S rRNA Gene Bacterial Community Analysis of Dairy Products
Authors: Xue Zhengyao , Kable Mary E. , Marco Maria L.
Published: October 2018

Validated methods are urgently needed to improve DNA sequence-based assessments of complex bacterial communities. In this study, we used 16S rRNA PCR amplicon and gDNA mock community standards, consisting of nine, dairy-associated bacterial species, to evaluate the most commonly applied 16S rRNA marker gene DNA sequencing and analysis platforms used in evaluating dairy and other bacterial habitats. Our results show that bacterial metataxonomic assessments are largely dependent on the DNA sequencing platform and read curation method used. DADA2 improved sequence annotation compared with QIIME 1, and when combined with the Ion Torrent PGM DNA sequencing platform and the Greengenes database for taxonomic assignment, the most accurate representation of the dairy mock community standards was reached. This approach will be useful for validating sample collection and DNA extraction methods and ultimately investigating bacterial population dynamics in milk- and dairy-associated environments.
Phenotypic Variation in the Group A
Streptococcus
Due to Natural Mutation of the Accessory Protein-Encoding Gene
rocA
Authors: Sarkar Poulomee , Danger Jessica L. , Jain Ira , Meadows Laura A. , Beam Christopher , Medicielo Josette , Burgess Cameron , Musser James M. , Sumby Paul
Published: October 2018

This study investigates the regulatory and phenotypic consequences of a naturally occurring mutation in a strain of the bacterial pathogen the group A
Streptococcus
(
Streptococcus pyogenes
). We show that this mutation, which occurs in a regulator-encoding gene,
rocA
, leads to altered virulence factor expression and reduces the ability of this isolate to survive in human blood. Critically, the blood survival phenotype and the assortment of genes regulated by RocA differ compared to previous studies into RocA activity. The data are consistent with there being strain- or serotype-specific variability in RocA function. Given that phenotypic variants can lead to treatment failures and escape from preventative regimes, our data provide information with regard to a mechanism of phenotypic variation in a prevalent Gram-positive pathogen.
Self-efficacy and diabetes prevention in overweight South Asians with pre-diabetes
Authors: Cioffi Catherine E , Ranjani Harish , Staimez Lisa R , Anjana Ranjit Mohan , Mohan Viswanathan , Weber Mary Beth
Published: October 2018

Objective

We evaluated the effects of a diabetes prevention itervention on self-efficacy (SE) and the associations between SE and diabetes-related outcomes among overweight Asian Indian adults with pre-diabetes in a randomized controlled translational trial (the Diabetes Community Lifestyle Improvement Program, D-CLIP).

Research design and methods

Data were obtained from 550 adults who were randomized to a diabetes prevention program or standard of care. Dietary and exercise-related SEs were measured at baseline, core intervention completion (4  months), and annually until the end of follow-up (3 years or diabetes diagnosis). Mixed-effects regressions described changes in SE over time by treatment group. Among treatment participants, multivariable-adjusted models described associations of SE at baseline and intervention completion with diabetes incidence and other secondary outcomes (weight, waist circumference (WC), exercise, and energy intake).

Results

From baseline to 4  months, dietary (β=10.3, p=0.04) and exercise (β=0.49, p=0.04) SE increased significantly in the treatment arm only; however, this increase from baseline was no longer significant at later time points. Among treatment participants, there was no association of dietary or exercise SE with diabetes incidence, but baseline exercise SE was independently associated with improved weight, WC, and exercise at 4  months (p<0.05). Change in exercise SE from baseline to intervention completion also predicted increased exercise at 4, 12, and 24 months (p<0.05).

Conclusions

Exposure to D-CLIP resulted in improved SE at treatment completion, but this effect was not sustained over longer follow-up. Several short-term and long-term secondary outcomes, but not diabetes risk, were significantly associated with exercise SE, suggesting this psychosocial trait may facilitate success in achieving certain health goals.

Trial registration number

NCT01283308.
Mapping the landscape of global programmes to evaluate health interventions in pregnancy: the need for harmonised approaches, standards and tools
Authors: Zuber Patrick L F , Moran Allisyn C , Chou Doris , Renaud Françoise , Halleux Christine , Peña-Rosas Juan Pablo , Viswanathan Kavitha , Lackritz Eve , Jakob Robert , Mason Elizabeth , Lamprianou Smaragda , Guillard-Maure Christine
Published: October 2018

Pregnant women and their babies are among the populations most vulnerable to untoward health outcomes. Yet current standards for evaluating health interventions cannot be met during pregnancy because of lack of adequate evidence. The situation is even more concerning in low-income and middle-income countries, where the need for effective interventions is the greatest. Meeting the Sustainable Development Goals for health will require strengthened attention to maternal and child health. In this paper we examine ongoing initiatives aimed at improving the assessment of maternal interventions. We review current methodologies to monitor outcomes of maternal interventions and identify where harmonisation is needed. Based on this analysis we identify settings where different minimal data sets should be considered taking into consideration the clinical realities. Stronger coordination mechanisms and a roadmap to support harmonised monitoring of maternal interventions across programmes and partners, working on improving pregnancy and early childhood health events, will greatly enhance ability to generate evidence-based policies.
Do current guidelines for waist circumference apply to black Africans? Prediction of insulin resistance by waist circumference among Africans living in America
Authors: Kabakambira J Damascene , Baker Jr Rafeal L , Briker Sara M , Courville Amber B , Mabundo Lilian S , DuBose Christopher W , Chung Stephanie T , Eckel Robert H , Sumner Anne E
Published: October 2018

Background

To lower the risk of diabetes and heart disease in Africa, identification of African-centred thresholds for inexpensive biomarkers of insulin resistance (IR) is essential. The waist circumference (WC) thresholds that predicts IR in African men and women have not been established, but investigations recently conducted in Africa using indirect measures of IR suggest IR is predicted by WC of 80–95 cm in men and 90–99 cm in women. These WC cannot be used for guidelines until validated by direct measurements of IR and visceral adipose tissue (VAT). Therefore, we determined in a group of African-born black people living in America (A) the WC, which predicts IR and (B) the influence of abdominal fat distribution on IR.

Methods

The 375 participants (age 38±10  years (mean±SD), 67% men) had IR determined by HOMA-IR and Matsuda index. VAT and subcutaneous adipose tissue (SAT) were measured by abdominal CT scans. Optimal WC for the prediction of IR was determined in sex-specific analyses by area under the receiver operating characteristic (AUC-ROC) and Youden index.

Results

Women had more SAT (203±114 vs 128±74  cm2) and less VAT than men (63±48 vs 117±72  cm2, p<0.001). Optimal WC for prediction of IR in men and women were: 91 cm (AUC-ROC: 0.80±0.03 (mean±SE)) and 96 cm (AUC-ROC: 0.81±0.08), respectively. Regression analyses revealed a significant sex–VAT interaction (p<0.001). Therefore, for every unit increase in VAT, women had a 0.94 higher unit increase in SAT and 0.07 higher unit increase in WC than men.

Conclusion

Working with a group of African-born black people living in America, we accessed technology, which validated observations made in Africa. Higher SAT at every level of VAT explained why the WC that predicted IR was higher in women (96 cm) than men (91 cm). For Africans to benefit from WC measurements, convening a panel of experts to develop evidence-based African-centred WC guidelines may be the way forward.
Proficiency-based progression training: an ‘end to end’ model for decreasing error applied to achievement of effective epidural analgesia during labour: a randomised control study
Authors: Kallidaikurichi Srinivasan Karthikeyan , Gallagher Anthony , O’Brien Niall , Sudir Vinod , Barrett Nick , O’Connor Raymund , Holt Francesca , Lee Peter , O’Donnell Brian , Shorten George
Published: October 2018

Background

Training procedural skills using proficiency-based progression (PBP) methodology has consistently resulted in error reduction. We hypothesised that implementation of metric-based PBP training and a valid assessment tool would decrease the failure rate of epidural analgesia during labour when compared to standard simulation-based training.

Methods

Detailed, procedure-specific metrics for labour epidural catheter placement were developed based on carefully elicited expert input. Proficiency was defined using criteria derived from clinical performance of experienced practitioners. A PBP curriculum was developed to train medical personnel on these specific metrics and to eliminate errors in a simulation environment.

Seventeen novice anaesthetic trainees were randomly allocated to undergo PBP training (Group P) or simulation only training (Group S). Following training, data from the first 10 labour epidurals performed by each participant were recorded. The primary outcome measure was epidural failure rate.

Results

A total of 74 metrics were developed and validated. The inter-rater reliability (IRR) of the derived assessment tool was 0.88. Of 17 trainees recruited, eight were randomly allocated to group S and six to group P (three trainees did not complete the study). Data from 140 clinical procedures were collected. The incidence of epidural failure was reduced by 54% with PBP training (28.7% in Group S vs 13.3% in Group P, absolute risk reduction 15.4% with 95% CI 2% to 28.8%, p=0.04).

Conclusion

Procedure-specific metrics developed for labour epidural catheter placement discriminated the performance of experts and novices with an IRR of 0.88. Proficiency-based progression training resulted in a lower incidence of epidural failure compared to simulation only training.

Trial registration number

NCT02179879.NCT02185079; Post-results.
Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions
Authors: Lorenc Ava , Feder Gene , MacPherson Hugh , Little Paul , Mercer Stewart W , Sharp Deborah
Published: October 2018

Objective

To identify potentially effective complementary approaches for musculoskeletal (MSK)–mental health (MH) comorbidity, by synthesising evidence on effectiveness, cost-effectiveness and safety from systematic reviews (SRs).

Design

Scoping review of SRs.

Methods

We searched literature databases, registries and reference lists, and contacted key authors and professional organisations to identify SRs of randomised controlled trials for complementary medicine for MSK or MH. Inclusion criteria were: published after 2004, studying adults, in English and scoring >50% on Assessing the Methodological Quality of Systematic Reviews (AMSTAR); quality appraisal checklist). SRs were synthesised to identify research priorities, based on moderate/good quality evidence, sample size and indication of cost-effectiveness and safety.

Results

We included 84 MSK SRs and 27 MH SRs. Only one focused on MSK–MH comorbidity. Meditative approaches and yoga may improve MH outcomes in MSK populations. Yoga and tai chi had moderate/good evidence for MSK and MH conditions. SRs reported moderate/good quality evidence (any comparator) in a moderate/large population for: low back pain (LBP) (yoga, acupuncture, spinal manipulation/mobilisation, osteopathy), osteoarthritis (OA) (acupuncture, tai chi), neck pain (acupuncture, manipulation/manual therapy), myofascial trigger point pain (acupuncture), depression (mindfulness-based stress reduction (MBSR), meditation, tai chi, relaxation), anxiety (meditation/MBSR, moving meditation, yoga), sleep disorders (meditative/mind–body movement) and stress/distress (mindfulness). The majority of these complementary approaches had some evidence of safety—only three had evidence of harm. There was some evidence of cost-effectiveness for spinal manipulation/mobilisation and acupuncture for LBP, and manual therapy/manipulation for neck pain, but few SRs reviewed cost-effectiveness and many found no data.

Conclusions

Only one SR studied MSK–MH comorbidity. Research priorities for complementary medicine for both MSK and MH (LBP, OA, depression, anxiety and sleep problems) are yoga, mindfulness and tai chi. Despite the large number of SRs and the prevalence of comorbidity, more high-quality, large randomised controlled trials in comorbid populations are needed.
Study protocol for evaluating the effectiveness of depression management on gylcaemic control in non-communicable diseases clinics in Malawi
Authors: Udedi Michael Mphatso , Pence Brian W , Kauye Felix , Muula Adamson S
Published: October 2018

Introduction

Depression is associated with negative patient outcomes for chronic diseases and likely affects consistent physical non-communicable diseases (NCDs) care management in relation to clinic attendance and medication adherence. We found no published studies on the integration of depression management in physical NCD clinics in Malawi and assessing its effects on patient and service outcomes. Therefore, the aim of this study is to evaluate the effectiveness of integrating depression screening and management in physical NCD routine care on patient and service outcomes in Malawi. We will also determine the sensitivity and specificity of the Patient Health Questionnaire-9 (PHQ-9) in the detection of depression in NCD clinics.

Methods and analysis

The study will have two phases. Phase I will involve the validation of the PHQ-9 screening tool for depression, using a cross-sectional study design involving 323 participants, in two specialised physical NCD clinics in one of the 28 districts of Malawi. Using a quasi-experimental study design in four districts of Malawi not involved in the phase I study, the phase II study will evaluate the effectiveness of integrating depression screening (using PHQ-9) and management (based on a specially designed toolkit). Outcomes will be measured at 3 months and 6 months among patients with comorbid diabetes (poorly controlled) and depression attending physical NCD clinics in Malawi.

Ethics and dissemination

Ethical approval was obtained from the University of Malawi, College of Medicine Research and Ethics Committee (COMREC) on 31 August 2017 (reference P.07/17/2218). The findings will be disseminated through presentations at journal clubs, senior management of the Ministry of Health, national and international conferences as well as submission to peer-reviewed publications. Policy briefs will also be created.

Trial registration number

PACTR201807135104799.
Protocol for a multicentre, dual prospective and retrospective cohort study investigating timing of ileostomy closure after anterior resection for rectal cancer: The CLOSurE of Ileostomy Timing (CLOSE-IT) study
Authors: Vaughan-Shaw Peter G , Gash Katherine , Adams Katie , Vallance Abigail E , Pilkington Sophie A , Torkington Jared , Cornish Julie A
Published: October 2018

Introduction

A defunctioning ileostomy is often formed during rectal cancer surgery to reduce the potentially fatal sequelae of anastomotic leak. Once the ileostomy is closed and bowel continuity restored, many patients can suffer poor bowel function, that is, low anterior resection syndrome (LARS). It has been suggested that delay to closure can increase incidence of LARS which is known to significantly reduce quality of life. Despite this, within the UK, time to closure of ileostomy is not subject to national targets within the National Health Service and delay to closure exceeds 18 months in one-third of patients. Clinical factors, surgeon and patient preference or service pressures may all impact time to closure, yet to date no study has investigated this. The aim of this UK-wide study is to assess time to ileostomy closure and identify reasons for delays.

Methods and analysis

A UK-wide multicentre prospective snapshot study, together with retrospective analysis of ileostomy closure through The Dukes’ Club Research Collaborative including patients undergoing ileostomy closure in a 3-month period (April to June 2018) and all patients who underwent anterior resection and ileostomy formation over a historical 12-month period (2015). Time to closure and incidence of ‘non-closure’ will be calculated. Units will be surveyed to determine local clinical and management protocols and barriers to timely closure. Multivariate linear regression analysis will be used to determine factors significantly associated with delay to ileostomy closure.

Ethics and dissemination

Study approved by the South West-Exeter Research Ethics Committee and the Health Research Authority. Study results will be submitted for presentation at international conferences and for publication in peer-reviewed journals. Results will be presented to and discussed with the patient and public representatives and relevant national bodies to facilitate the development of consensus guidelines on optimum treatment pathways.
Improving comprehensive care for patients with diabetes
Authors: Kutz Tamar L , Roszhart Jameson M , Hale Marshall , Dolan Virginia , Suchomski Gerald , Jaeger Cassie
Published: October 2018

Patients with diabetes require access to systematic and ongoing care delivered by a team of healthcare providers. Despite national attention and well-accepted best practices, diabetic care, blood pressure and haemoglobin A1c (A1c) levels for patients with diabetes in our primary care setting were highly variable and below the Healthcare Effectiveness Data and Information Set (HEDIS) 75th percentile benchmark. From January 2015 to January 2016, 22% of patients with diabetes in our primary care setting had both blood pressure and A1c levels controlled and 23% had their annual diabetic care bundle completed, which includes A1c and blood pressure measurements, foot examination and nephropathy attention. Lack of standardised care algorithms, electronic health record documentation and education was identified. Lean Six Sigma methodologies were used to re-engineer the care that patients with diabetes receive. Key improvement initiatives focused on standardisation of accepted care practices through electronic templates, education and re-evaluation of patients to make 90-day, rapid cycle changes. Interventions were piloted in one primary care clinic then expanded to eight additional clinics. At the pilot site, the per cent of patients who completed the diabetic care bundle increased from 33% to 71% and the per cent of patients with diabetes with both A1c and blood pressure controlled increased from 31% to 43% (two-proportion test, p<0.01) postintervention. On rollout to eight additional clinics, the per cent of patients who completed the diabetic care bundle increased from 23% to 67% and the per cent of patients with diabetes with both their A1c and their blood pressure controlled increased from 22% to 41% (two-proportion test, p<0.01). After the interventions, nephropathy attention, A1c and blood pressure metrics exceeded HEDIS 75th percentile. Standardisation of accepted care practices for patients with diabetes improved compliance with diabetic care bundle completion and patient outcomes in the primary care setting.
Bridging the gap between clinicians and fitness professionals: a challenge to implementing exercise as medicine
Authors: Pojednic Rachele , Bantham Amy , Arnstein Fred , Kennedy Mary A , Phillips Edward
Published: October 2018

Objective

Health clubs (HC) and personal trainers (PT) are traditional outlets for the promotion of physical activity (PA) and exercise programming. As physicians are increasingly being called on to write exercise prescriptions for their patients, this study sought to investigate the level of integration between the healthcare and fitness systems.

Design

An internet study was designed with five domains to understand physicians’: (1) overall perception of HC, (2) appropriateness and recommendation of HC and PT to their patients, (3) attitude regarding specific aspects of HC, (4) support of patient participation in HC sponsored exercise and (5) elements of HC that physicians would like to know for referral.

Methods

An electronic survey was sent to members of two mailing lists of primary care and sports medicine specialty physicians during 2011–2012.

Results

On a Likert scale of 1–10 412 physicians reported being familiar with HC (8.9±2.1), indicated a favourable view of HC (7.9±2.2), and believe HC to be an appropriate venue for their patients (7.5±2.3). However, physicians only recommend HC to 41%±28% of their patients and PT for only 21%±21.6% of patients. Physicians ranked expense and convenience as the most problematic elements of HC (8.1±2.1 and 6.3±2.5, respectively). 72% of physicians indicated cost as most concerning when recommending a specific HC.

Conclusion

HC and PT are a significant implementation system for the promotion of physical activity, yet physicians are concerned with several elements of HC and are not adequately relying on this partnership to promote physical activity to their patients.
Incidence and risk factors of medial tibial stress syndrome: a prospective study in Physical Education Teacher Education students
Authors: Bliekendaal Sander , Moen Maarten , Fokker Young , Stubbe Janine H , Twisk Jos , Verhagen Evert
Published: October 2018

Objective

Medial tibial stress syndrome (MTSS) is a common lower extremity overuse injury often causing long-term reduction of sports participation. This study aimed to investigate the incidence and risk factors of MTSS in first-year Dutch Physical Education Teacher Education (PETE) students.

Methods

This prospective study consisted of physical measures at baseline (height, weight, fat percentage, 3000 m run test, navicular drop test, hip internal and external range of motion, hip adduction and adduction strength, single leg squat and shin palpation), an intake questionnaire at baseline (age, sport participation, presence of MTSS, MTSS history, insole use and use of supportive shoes) and an MTSS registration procedure during the academic year of 2016–2017 (10  months) using a validated questionnaire. In total 221 first-year PETE students were included, of whom 170 (77%) were male and 51 (23%) female. The evaluation of risk factors was conducted with univariable and multivariable logistic generalised estimating equation analyses.

Results

In total 55 (25%) subjects, 35 (21%) men and 20 (39%) women, developed MTSS during the follow-up period. The associated risk factors were female sex (OR=3.14, 95% CI 1.39 to 7.11), above-average age (OR=0.31, 95% CI 0.13 to 0.76), above-average body mass index (OR=2.29, 95% CI 1.02 to 5.16) and history of MTSS (OR=5.03, 95% CI 1.90 to 13.30).

Conclusion

The incidence of MTSS is high in PETE students. Several risk factors were identified. These results demonstrate the need for prevention and may provide direction to preventive intervention design.
A simple clinical assessment is superior to systematic triage in prediction of mortality in the emergency department
Authors: Iversen Anne Kristine Servais , Kristensen Michael , Østervig Rebecca Monett , Køber Lars , Sölétormos György , Lundager Forberg Jakob , Eugen-Olsen Jesper , Rasmussen Lars Simon , Schou Morten , Iversen Kasper Karmark
Published: October 2018

Objective

To compare the Danish Emergency Process Triage (DEPT) with a quick clinical assessment (Eyeball triage) as predictors of short-term mortality in patients in the emergency department (ED).

Methods

The investigation was designed as a prospective cohort study conducted at North Zealand University Hospital. All patient visits to the ED from September 2013 to December 2013 except minor injuries were included. DEPT was performed by nurses. Eyeball triage was a quick non-systematic clinical assessment based on patient appearance performed by phlebotomists. Both triage methods categorised patients as green (not urgent), yellow, orange or red (most urgent). Primary analysis assessed the association between triage level and 30-day mortality for each triage method. Secondary analyses investigated the relation between triage level and 48-hour mortality as well as the agreement between DEPT and Eyeball triage.

Results

A total of 6383 patient visits were included. DEPT was performed for 6290 (98.5%) and Eyeball triage for 6382 (~100%) of the patient visits. Only patients with both triage assessments were included. The hazard ratio (HR) for 48-hour mortality for patients categorised as yellow was 0.9 (95% CI 0.4 to 1.9) for DEPT compared with 4.2 (95% CI 1.2 to 14.6) for Eyeball triage (green is reference). For orange the HR for DEPT was 2.2 (95% CI 1.1 to 4.4) and 17.1 (95% CI 5.1 to 57.1) for Eyeball triage. For red the HR was 30.9 (95% CI 12.3 to 77.4) for DEPT and 128.7 (95% CI 37.9 to 436.8) for Eyeball triage. For 30-day mortality the HR for patients categorised as yellow was 1.7 (95% CI 1.2 to 2.4) for DEPT and 2.4 (95% CI 1.6 to 3.5) for Eyeball triage. For orange the HR was 2.6 (95% CI 1.8 to 3.6) for DEPT and 7.6 (95% CI 5.1 to 11.2) for Eyeball triage, and for red the HR was 19.1 (95% CI 10.4 to 35.2) for DEPT and 27.1 (95% CI 16.9 to 43.5) for Eyeball triage. Agreement between the two systems was poor (kappa 0.05).

Conclusion

Agreement between formalised triage and clinical assessment is poor. A simple clinical assessment by phlebotomists is superior to a formalised triage system to predict short-term mortality in ED patients.
Increased vascular endothelial growth factor D is associated with atrial fibrillation and ischaemic stroke
Authors: Berntsson John , Smith J Gustav , Johnson Linda S B , Söderholm Martin , Borné Yan , Melander Olle , Orho-Melander Marju , Nilsson Jan , Engström Gunnar
Published: October 2018

Objective

Vascular endothelial growth factor D (VEGF-D) has important functions in lymphangiogenesis and angiogenesis. High plasma levels of VEGF-D have been associated with incidence of heart failure. The association of VEGF-D with atrial fibrillation (AF) and stroke is unclear and we hypothesised that VEGF-D could also be associated with incidence of AF and ischaemic stroke.

Methods

VEGF-D was measured in fasting blood samples of 4689 subjects (40% men) without a history of AF from the Malmö Diet and Cancer Study, a prospective, population-based study in Sweden. Median age was 58 years (range 46–68). Cox regression analyses, adjusted for multiple risk factors, was used to assess AF and ischaemic stroke risk in relation to VEGF-D levels.

Results

During a median follow-up time of 20.6 years, there were 637 cases of incident AF and 322 cases of first ischaemic stroke. After adjustment, VEGF-D was significantly associated with AF (HR 1.13(95% CI 1.04 to 1.23) per 1 SD increase) and ischaemic stroke (HR 1.14(95% CI 1.02 to 1.28) per 1 SD). The association with ischaemic stroke was explained by an increased incidence of AF-related stroke. HRs per 1 SD were 1.34 (95% CI 1.04 to 1.71) for AF-related ischaemic stroke and 1.04 (95% CI 0.90 to 1.19) for ischaemic stroke without AF.

Conclusions

Increased VEGF-D concentrations were associated with AF and ischaemic stroke. The relationship with ischaemic stroke was more pronounced in subjects with a diagnosis of AF.
Military medical research in Britain and the USA: the challenge of informed consent
Authors: Gross Michael L
Published: October 2018

Military medical research requires informed consent from test subjects, which is difficult to obtain for deployed (in-theatre) or prehospital studies where patients are incapacitated and legal representatives are not available. Although US and UK regulations make provisions for exceptions to informed consent, these are rarely used, thereby hindering trauma research and prospective experimental studies of new devices, surgeries or drugs. In their place, a survey of research articles published in theJournal of the Royal Army Medical CorpsandMilitary Medicinebetween 2004 and 2018 shows how researchers turned to clinical surveys and retrospective, case or animal studies instead. The reluctance to enrol military personnel in interventional studies stems from past instances of abuse and current misperceptions of soldiers as a particularly vulnerable class of research subjects. Increasing the pool of research subjects to facilitate interventional studies to improve combat casualty care requires honing military medical ethics in two ways. First, it is important to implement existing informed consent regulations without special regard for the status of service personnel. This will expedite approval of waivers of informed consent. Second, aggressively recruiting civilians for military-related medical research increases the number of subjects available for trauma research. Community consultation and public discourse are the proper venues to deliberate on each recommendation.
Non-cardiac chest pain: prognosis and secondary healthcare utilisation
Authors: Mol Karen Anne , Smoczynska Agnieszka , Rahel Braim Mohammed , Meeder Joan Gerard , Janssen Loes , Doevendans Pieter A , Cramer Maarten-Jan
Published: October 2018

Objective

Presentations of non-cardiac chest pain (NCCP) to the emergency department (ED) are increasing. More knowledge of prognosis and healthcare utilisation of patients with NCCP is necessary to optimise their management.

Methods

This study is a prospective, observational, prevalence-based cohort study conducted from September 2015 to February 2016 with 1-year follow-up including all patients 18 years and older referred to the ED with chest pain. Discharge diagnoses, mortality, major adverse cardiac events (MACE), re-presentations to the ED, hospitalisations, cardiac interventions and outpatient monitoring were assessed.

Results

More than 60% of the 1239 patients presenting with chest pain were discharged with NCCP. The all-cause 1-year mortality rate of patients with NCCP was 2.3% compared with 7.2% in patients with cardiac chest pain (CCP) (p<0.001) and the occurrence of MACE was 5.1% vs 8.3%, respectively (p=0.026). Previous history of coronary artery disease (CAD) in patients with NCCP was identified as a predictive factor for MACE (OR 4.30 (95% CI 1.24 to 14.89), p=0.021). Patients with NCCP had more non-invasive interventions than patients with CCP (proportion of 0.225 vs 0.165 per patient, p<0.001) and 13.7% of patients with NCCP re-presented at the ED within 1  year.

Conclusion

The majority of patients referred to the ED with chest pain are discharged with NCCP. The prognosis of patients with NCCP is better than patients with CCP; however, they are at risk for MACE due to a history of CAD. Patients with NCCP moreover use a substantial amount of medical resources, stressing the importance of good triage to minimise unnecessary healthcare utilisation while still preventing MACE.
Changes in the condition, early growth, and trophic position of lake trout (Salvelinus namaycush) in response to an experimental aquaculture operation
Authors: Kennedy Patrick J. , Blanchfield Paul J. , Kidd Karen A. , Paterson Michael J. , Podemski Cheryl L. , Rennie Michael D.
Published: October 2018

We analyzed changes in the condition, early growth, and resource use of lake trout (Salvelinus namaycush) from a Boreal Shield lake in response to an experimental aquaculture operation. Annual small-scale commercial production of rainbow trout (Oncorhynchus mykiss) resulted in increased lake trout body condition during aquaculture operations, which was positively related to minnow catch per unit effort (CPUE). Incremental increases in growth led to larger lake trout following aquaculture. While the littoral energy assimilated by lake trout did not change linearly from 2002 to 2009, we observed a shift towards littoral energy use in the last year of aquaculture and for 2 years after the experiment, coincident with low densities of Mysis diluviana. Lake trout trophic position declined from 2002 to 2009, suggesting increased foraging on secondary versus tertiary consumers. Minnow and slimy sculpin (Cottus cognatus) CPUE increased by 5.2- and 5.5-fold, respectively, and Mysis diluviana densities decreased by 93%. Changes observed in the experimental lake were much greater than those observed in a nearby reference lake. Our results suggest that moderate nutrient enrichment from aquaculture may benefit lake trout in oligotrophic Boreal Shield lakes.
Comment on “Long-term decline of sugar maple following forest harvest, Hubbard Brook Experimental Forest, New Hampshire”
Authors: Bailey Scott W. , Long Robert P. , Horsley Stephen B.
Published: October 2018

Cleavitt et al. (2018, Can. J. For. Res. 48(1): 23–31, doi: 10.1139/cjfr-2017-0233 ) report a lack of sugar maple (Acer saccharum Marsh.) regeneration in Hubbard Brook Experimental Forest (HBEF), Watershed 5 (W5), following whole-tree clearcut harvesting and purport that harvesting-induced soil calcium depletion contributed to regeneration failure of this species. In New England, clearcutting is a silvicultural strategy used to promote less tolerant species, especially birch (Betula spp.; Marquis (1969), Birch Symposium Proceedings, USDA Forest Service; Leak et al. (2014), doi: 10.2737/NRS-GTR-132 ), which is just the outcome that the authors report. While this study reports an impressive, long-term data set, given broad interest in sugar maple and sustainability of forest management practices, we feel that it is critical to more fully explore the role of nutrition on sugar maple dynamics, both prior to and during the experiment, and to more fully review the scientific record on the role of whole-tree clearcutting in nutrient-induced sugar maple dynamics.
Creation of an inflationary universe out of black hole space–time
Authors: Oshita Naritaka , Yokoyama Jun’ichi
Published: October 2018

We investigate the effect of a black hole as a nucleation site of a false vacuum bubble based on the Euclidean actions of relevant configurations. As a result we find a wormhole-like configuration may be spontaneously nucleated once the black hole mass falls below a critical value of order of the Hubble parameter corresponding to the false vacuum energy density. As the space beyond the wormhole throat can expand exponentially, this may be interpreted as creation of another inflationary universe in the final stage of the black hole evaporation.
Detailed study of the Λb → Λcτν̄τ decay
Authors: Di Salvo E. , Fontanelli F. , Ajaltouni Z. J.
Published: October 2018

We examine in detail the semileptonic decay [Formula: see text], which may confirm previous hints, from the analogous [Formula: see text] decay, of a new physics beyond the Standard Model. First of all, starting from rather general assumptions, we predict the partial width of the decay. Then we analyze the effects of five possible new physics interactions, adopting in each case five different form factors. In particular, for each term beyond the Standard Model, we find some constraints on the strength and phase of the coupling, which we combine with those found by other authors in analyzing the analogous semileptonic decays of [Formula: see text]. Our analysis involves some dimensionless quantities, substantially independent of the form factor, but which, owing to the constraints, turn out to be strongly sensitive to the kind of nonstandard interaction. We also introduce a criterion thanks to which one can discriminate among the various new physics terms: the left-handed current and the two-Higgs-doublet model appear privileged, with a neat preference for the former interaction. Finally, we suggest a differential observable that could, in principle, help to distinguish between the two cases.
Random center vortex model
Authors: Altarawneh Derar
Published: October 2018

This work presents a model of center vortices, expressed by random lines in three-dimensional space–time. Monte Carlo methods were used to ensemble these closed random lines. The physical space wherein the vortex lines are defined is a cuboid including periodic boundary conditions. Reconnections are allowed aside from moving, growing, and shrinking of the vortex configuration. Therefore, the ensemble contains a variable number of closed vortex clusters, which are considered significant in realizing the deconfining phase transition. The average vortex density and length are studied as a function of vortex density [Formula: see text] by using this model. At different temperatures, potential [Formula: see text] between quark and antiquark is studied as a function of distance [Formula: see text]. This model is able to emphasize the confinement physics qualitative properties in [Formula: see text] Yang–Mills theory.
Quality inspection method of micro-nano parts based on deep learning
Authors: Li Dongjie , Liu Cong
Published: October 2018

There are some disadvantages such as low efficiency, high work intensity by using the manual methods to detect the quality of micro-nano parts because of the characteristics such as small size and fragile structure. Considering about the disadvantages, computer microscopic vision is introduced into the detection system in this paper, which can collects the image information of the parts into the computer system efficiently. The parts to be detected are transmitted by the spin material platform driven by the stepping motor. It is CNN based on deep learning that used to detect the surface quality and classify the defects of the parts according to the image information in this paper, which can improve the accuracy of the detection and reduce the work intensity of human compared with not only the traditional manual detection methods but also some edge detection methods that former researchers used.
Connection of Generalized Failure Rate and Generalized Reversed Failure Rate with Inequality Curves
Authors: Behdani Zahra , Borzadaran Gholam Reza Mohtashami , Gildeh Bahram Sadeghpour
Published: October 2018

The purpose of this paper is to introduce some properties of generalized failure rate (GFR) and generalized reversed failure rate (GRFR), study their connection with inequality measures and then apply it to make comparisons of some reliability models. In the second part of our paper, we obtain the properties for the GRFR based on the properties of the GFR and weighted distributions. The importance of such a study lies in the usefulness of using. Finally, we present two examples to illustrate the applications of the relationships outlined in this paper. A real dataset is used for clarifying presented concepts.
Third harmonic generation in ZnO semiconductor using the simplified bond hyperpolarizability model
Authors: Hardhienata Hendradi , Priyadi Ignu , Nurjanati Bayti , Alatas Husin
Published: October 2018

We describe the fourth rank tensor and the related third harmonic generation (THG) light intensity profile in a (0002) wurtzite structure using the simplified bond hyperpolarizability model (SBHM). We show that the resulting THG intensity is isotropic e.g., does not depend on the azimuthal rotation angle of the material. Assuming that THG inside wurtzite structures are dominated solely by bulk dipoles, only one fitting parameter in terms of the effective THG hyperpolarizability is required to generate the Rotational Anisotropy THG (RATHG) experiment result.
Effects of Kerr medium in coupled cavities on quantum state transfer
Authors: Manosh T. M. , Ashefas Muhammed , Thayyullathil Ramesh Babu
Published: October 2018

We study the effect of Kerr type nonlinear medium in quantum state transfer (QST). We have investigated the effect of different coupling schemes and Kerr medium parameters [Formula: see text] and [Formula: see text]. We found that the Kerr medium introduced in the connection channel can act like a controller for QST. The numerical simulations are performed without taking the adiabatic approximation. Rotating wave approximation is used in the atom–cavity interaction only in the lower coupling regime.
APPROXIMATION METHODS FOR INHOMOGENEOUS GEOMETRIC BROWNIAN MOTION
Authors: CAPRIOTTI LUCA , JIANG YUPENG , SHAIMERDENOVA GAUKHAR
Published: October 2018

We present an accurate and easy-to-compute approximation of the transition probabilities and the associated Arrow-Debreu (AD) prices for the inhomogeneous geometric Brownian motion (IGBM) model for interest rates, default intensities or volatilities. Through this procedure, dubbed exponent expansion, transition probabilities and AD prices are obtained as a power series in time to maturity. This provides remarkably accurate results — for time horizons up to several years — even when truncated after the first few terms. For farther time horizons, the exponent expansion can be combined with a fast numerical convolution to obtain high-precision results.
Quantifying electron transit in donor-bridge-acceptor systems using probabilistic confidence
Authors: Curtin Evan , Bazargan Gloria , Sohlberg Karl
Published: October 2018

A probabilistic approach to characterizing transit times for quantum particles is generalized to a system of more than two spatial regions and applied to the transport of charge in donor-bridge-acceptor systems. The approach is based on applying conditional probability analysis to a discrete representation of the time-dependent probability density as generated by numerical solution of the time-dependent Schrödinger equation for an initially localized electron. To carry out this analysis, it is first necessary to cast the conditional probability analysis approach in matrix form. The results afford a quantification of the electron transit time and may provide a tool to gain insight into the mechanism of charge transport.
Photoacoustic effect invokes auditory response in infrared neuron stimulation
Authors: Yang Muqun , Guan Tian , He Yonghong
Published: October 2018

Infrared neuron stimulation is regarded as an innovative approach for stimulating cochleae in animals while the exact mechanism still remains unknown. In this paper, we studied compound action potentials of guinea pig cochleae with chronic or acute deafness. We recorded optical compound action potentials and analyzed stretched cochlear preparations by fluorescence microscopy. Photoacoustic signals were measured by hydrophone and microphone, respectively. In our experiment, we observed a switch response effect in vitro and in vivo experiments. Therefore, we proposed photoacoustic effect could invoke auditory response in infrared neuron stimulation.
China’s Massive Restructuring of Party and State Apparatus in 2018
Authors: XUE Jianyue , CHEN Gang
Published: October 2018

The Communist Party of China has embarked on a massive restructuring of the Party and state institutions. The Party has strengthened its grip over the state, taking over six State Council institutions that had previously dealt with the work of civil servants, the media, ethnic affairs, religious affairs, overseas Chinese affairs, and computer network and information security. At the state level, seven ministries were created while six ministries were abolished.
Nature, age and emplacement of the Spongtang ophiolite, Ladakh, NW India
Authors: Catlos Elizabeth J. , Pease Emily C. , Dygert Nick , Brookfield Michael , Schwarz Winfried H. , Bhutani Rajneesh , Pande Kanchan , Schmitt Axel K.
Published: October 2018

The Spongtang ophiolite (Ladakh, NW India) constrains the nature of oceanic lithosphere before Indo-Asia collision and key stages in the development of the Himalayas. We report whole-rock
40
Ar/
39
Ar and
in situ
zircon
238
U–
206
Pb ages from its crustal and upper and lower mantle sequences. Major and trace elements from harzburgite minerals suggest that the ophiolite formed at a mid-ocean ridge-type spreading centre, whereas published spinel compositions from Spongtang dunites are consistent with a suprasubduction-zone setting. Rare earth element-in-two-pyroxene thermometry for the harzburgite yields 1058 ± 13°C whereas temperature from solvus-based two-pyroxene and olivine–spinel thermometry is lower (to 656°C). The distribution suggests that the mantle section of the ophiolite cooled at rates of 100° Ma
−1
or slower. Based on ages, major and trace element geochemistry, and geospeedometric estimates, we model the origin of the Spongtang ophiolite as forming within a mid-ocean ridge-type spreading centre with a spreading rate >2 cm a
−1
in the Neotethyan Ocean, possibly from the Late Triassic to Jurassic. By the Early Cretaceous, the ridge experienced increasing influence of subduction beneath the Spongtang oceanic lithosphere owing to a subduction polarity reversal. Based on
238
U–
206
Pb ages of the youngest Cenozoic zircon grain, latest obduction occurred between 64.3 ± 0.8 and 42.4 ± 0.5 Ma, in accordance with 56.7 ± 5.2 Ma whole-rock
40
Ar/
39
Ar ages.

Supplementary material:
Excel files with details of electron microprobe and inductively coupled plasma mass spectrometry (ICP-MS) analyses, argon isotopic whole-rock and secondary ion mass spectrometry (SIMS) analyses, and the
T
REE
calculations, including an inversion diagram showing regression through measured REE distributions in cpx and opx (from Liang
et al.
2013), are available at
https://doi.org/10.6084/m9.figshare.c.4261856
Folding and Fracturing of Rocks
: the birth of modern structural geology
Authors: Treagus Susan H. , Hudleston Peter J.
Published: October 2018

In 1967, the publication of John Ramsay's book,
Folding and Fracturing of Rocks
, was a landmark event that affected both of us, inspiring us into careers in structural geology. At that time, one of us was a postgraduate student at Imperial College, London, the other a second-year undergraduate at Manchester University. It is hard to convey, 50 years on, how precious this book was then. The true and lasting value is how this book has changed individuals, and influenced the teaching and research in structural geology, in Britain and around the world. In our view,
Folding and Fracturing of Rocks
marks the birth of modern structural geology.