bluuebunny/crossref_metadata_2025 huggingface dataset:
Hospital readmission risk prediction based on claims data available at admission: a pilot study in Switzerland
Authors: Brüngger Beat , Blozik Eva
Published: June 2019

Objectives

Evaluating whether future studies to develop prediction models for early readmissions based on health insurance claims data available at the time of a hospitalisation are worthwhile.

Design

Retrospective cohort study of hospital admissions with discharge dates between 1 January 2014 and 31 December 2016.

Setting

All-cause acute care hospital admissions in the general population of Switzerland, enrolled in the Helsana Group, a large provider of Swiss mandatory health insurance.

Participants

The mean age of 138 222 hospitalised adults included in the study was 60.5 years. Patients were included only with their first index hospitalisation. Patients who deceased during the follow-up period were excluded, as well as patients admitted from and/or discharged to nursing homes or rehabilitation clinics.

Measures

The primary outcome was 30-day readmission rate. Area under the receiver operating characteristic curve (AUC) was used to measure the discrimination of the developed logistic regression prediction model. Candidate variables were theory based and derived from a systematic literature search.

Results

We observed a 30-day readmission rate of 7.5%. Fifty-five candidate variables were identified. The final model included pharmacy-based cost group (PCG) cancer, PCG cardiac disease, PCG pain, emergency index admission, number of emergency visits, costs specialists, costs hospital outpatient, costs laboratory, costs therapeutic devices, costs physiotherapy, number of outpatient visits, sex, age group and geographical region as predictors. The prediction model achieved an AUC of 0.60 (95% CI 0.60 to 0.61).

Conclusions

Based on the results of our study, it is not promising to invest resources in large-scale studies for the development of prediction tools for hospital readmissions based on health insurance claims data available at admission. The data proved appropriate to investigate the occurrence of hospitalisations and subsequent readmissions, but we did not find evidence for the potential of a clinically helpful prediction tool based on patient-sided variables alone.
Prevalence of post-traumatic stress disorder and associated factors among Koshe landslide survivors, Addis Ababa, Ethiopia: a community-based, cross-sectional study
Authors: Asnakew Sintayehu , Shumet Shegaye , Ginbare Worknesh , Legas Getasew , Haile Kalkidan
Published: June 2019

Objectives

To assess the prevalence of post-traumatic stress disorder (PTSD) and associated factors among the survivors of Koshe landslide, Addis Ababa, Ethiopia, 2018.

Design

Community-based cross-sectional design.

Setting

Koshe landslide, Addis Ababa, Ethiopia.

Participants

We recruited 830 participants for interviews using the simple random sampling technique.

Measurement

We collected data by face-to-face interviews. The civilian version of the PTSD checklist was used to measure the symptoms of the disorder. The Perceived Stress Scale and the Oslo-3 social support instruments were used to assess the factors. Coded variables were entered into Epi data V.4.2 and exported to SPSS V.24 for analysis. Bivariate and multivariate logistic regressions with OR and 95% CI were employed.

Result

A total of 830 participants were interviewed, with a response rate of 98.2%. The prevalence of PTSD was 37.3% with 95% CI 34.1 to 40.8. In the multivariate logistic regression, female sex (adjusted odds ratio (AOR)=1.74, 95% CI 1.21 to 2.50), divorce (AOR=2.08, 95% CI 1.26 to 3.43), sustained physical injury (AOR=8.28, 95% CI 5.04 to 13.61), history of mental illness (AOR=5.55, 95% CI 2.30 to 13.36), family history of mental illness (AOR=2.82, 95% CI 1.48 to 5.37), poor social support (AOR=3.64, 95% CI 1.99 to 6.69) and high perceived stress (AOR=3.08, 95% CI 1.43 to 6.64) were associated with PTSD.

Conclusion and recommendations

The prevalence of PTSD among the survivors of Koshe landslide was high. We recommend that an early PTSD-focused regular screening be carried out by trained health professionals; linkage with mental health service providers also needs to be considered.
Psychological correlates and binge drinking behaviours among Canadian youth: a cross-sectional analysis of the mental health pilot data from the COMPASS study
Authors: Butler Alexandra , Romano Isabella , Patte Karen , Ferro Mark A , de Groh Margaret , Jiang Ying , Leatherdale Scott T
Published: June 2019

Objective

The objective of this study was to examine associations between depression, anxiety and binge drinking among a large sample of Canadian youth, while testing the moderating effect of flourishing. This research uses data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, Sedentary Behaviour (COMPASS) study (2012–2021) with a large sample size collecting data on youth health behaviours within Canadian secondary schools.

Design

Cross-sectional

Setting

14 secondary schools across Ontario and British Columbia, Canada.

Participants

A sample of grade 9–12 students (n=6570) who participated in the Mental Health pilot of the COMPASS study

Primary and secondary outcome measures

Self-reported questionnaires assessed student binge drinking behaviours (5≥drinks), symptoms of depression (Center for Epidemiologic Studies Depression Scale (Revised)−10 scores≥10) and anxiety (Generalised Anxiety Disorder 7-item Scale scores≥10), and flourishing (Diener’s Flourishing Scale: 8–40).

Results

In our sample of 6570 students, 37.0% of students reported binge drinking in the last year, and 41.4% and 31.7% of students report clinically-relevant symptoms of depression and anxiety, respectively. Anxiety (adjusted OR (AOR): 0.57, (99% CI 0.15 to 2.22)) and depression (AOR: 1.98, (99% CI 0.76 to 5.13)) symptoms were not found to be associated with binge drinking and we did not detect any moderating role of flourishing. Rather, factors that were associated with increased odds of binge drinking included sports team participation (AOR: 1.67, (99% CI 1.37 to 2.03)) and use of other substances (tobacco (AOR: 3.00, (99% CI 2.12 to 4.25)) and cannabis (AOR: 7.76, (99% CI 6.36 to 9.46))). Similar associations were found for frequency of binge drinking.

Conclusions

Consistent with existing literature, binge drinking behaviours were problematic, as well as clinically-relevant symptoms of depression and anxiety. However, mental health problems and well-being may not be responsible for explaining patterns of binge drinking in youth. Targeted intervention efforts towards student athletes and concurrent substance users are necessary for addressing binge drinking in youth populations.
Oral insulin therapy for primary prevention of type 1 diabetes in infants with high genetic risk: the GPPAD-POInT (global platform for the prevention of autoimmune diabetes primary oral insulin trial) study protocol
Authors: Ziegler Anette-Gabriele , Achenbach Peter , Berner Reinhard , Casteels Kristina , Danne Thomas , Gündert Melanie , Hasford Joerg , Hoffmann Verena Sophia , Kordonouri Olga , Lange Karin , Elding Larsson Helena , Lundgren Markus , Snape Matthew D , Szypowska Agnieszka , Todd John A , Bonifacio Ezio
Published: June 2019

Introduction

The POInT study, an investigator initiated, randomised, placebo-controlled, double-blind, multicentre primary prevention trial is conducted to determine whether daily administration of oral insulin, from age 4.0 months to 7.0 months until age 36.0 months to children with elevated genetic risk for type 1 diabetes, reduces the incidence of beta-cell autoantibodies and diabetes.

Methods and analysis

Infants aged 4.0 to 7.0 months from Germany, Poland, Belgium, UK and Sweden are eligible if they have a >10.0% expected risk for developing multiple beta-cell autoantibodies as determined by genetic risk score or family history and human leucocyte antigen genotype. Infants are randomised 1:1 to daily oral insulin (7.5 mg for 2 months, 22.5 mg for 2 months, 67.5 mg until age 36.0 months) or placebo, and followed for a maximum of 7 years. Treatment and follow-up is stopped if a child develops diabetes. The primary outcome is the development of persistent confirmed multiple beta-cell autoantibodies or diabetes. Other outcomes are: (1) Any persistent confirmed beta-cell autoantibody (glutamic acid decarboxylase (GADA), IA-2A, autoantibodies to insulin (IAA) and zinc transporter 8 or tetraspanin 7), or diabetes, (2) Persistent confirmed IAA, (3) Persistent confirmed GADA and (4) Abnormal glucose tolerance or diabetes.

Ethics and dissemination

The study is approved by the ethical committees of all participating clinical sites. The results will be disseminated through peer-reviewed journals and conference presentations and will be openly shared after completion of the trial.

Trial registration number

NCT03364868.
Chronic hepatitis B virus case-finding in UK populations born abroad in intermediate or high endemicity countries: an economic evaluation
Authors: Martin Natasha K , Vickerman Peter , Khakoo Salim , Ghosh Anjan , Ramsay Mary , Hickman M , Williams Jack , Miners Alec
Published: June 2019

Objectives

The majority (>90%) of new or undiagnosed cases of hepatitis B virus (HBV) in the UK are among individuals born in countries with intermediate or high prevalence levels (≥2%). We evaluate the cost-effectiveness of increased HBV case-finding among UK migrant populations, based on a one-time opt out case-finding approach in a primary care setting.

Design

Cost-effectiveness evaluation. A decision model based on a Markov approach was built to assess the progression of HBV infection with and without treatment as a result of case-finding. The model parameters, including the cost and effects of case-finding and treatment, were estimated from the literature. All costs were expressed in 2017/2018 British Pounds (GBPs) and health outcomes as quality-adjusted life-years (QALYs).

Intervention

Hepatitis B virus case-finding among UK migrant populations born in countries with intermediate or high prevalence levels (≥2%) in a primary care setting compared with no intervention (background testing).

Results

At a 2% hepatitis B surface antigen (HBsAg) prevalence, the case-finding intervention led to a mean incremental cost-effectiveness ratio of £13 625 per QALY gained which was 87% and 98% likely of being cost-effective at willingness to pay (WTP) thresholds of £20 000 and £30 000 per additional QALY, respectively. Sensitivity analyses indicated that the intervention would remain cost-effective under a £20 000 WTP threshold as long as HBsAg prevalence among the migrant population is at least 1%. However, the results were sensitive to a number of parameters, especially the time horizon and probability of treatment uptake.

Conclusions

HBV case-finding using a one-time opt out approach in primary care settings is very likely to be cost-effective among UK migrant populations with HBsAg prevalence ≥1% if the WTP for an additional QALY is around £20 000.
Association between participation in the Families First Home Visiting programme and First Nations families’ public health outcomes in Manitoba, Canada: a retrospective cohort study using linked administrative data
Authors: Enns Jennifer E , Chartier Mariette , Nickel Nathan , Chateau Dan , Campbell Rhonda , Phillips-Beck Wanda , Sarkar Joykrishna , Burland Elaine , Lee Janelle Boram , Katz Alan , Santos Rob , Brownell Marni
Published: June 2019

Objective

To determine whether the Families First Home Visiting (FFHV) programme, which provides home visiting services to families across Manitoba, is associated with improved public health outcomes among First Nations families facing multiple parenting challenges.

Design

Retrospective cohort study using population-based administrative data.

Setting

Manitoba, Canada.

Participants

First Nations children born in Manitoba in 2003–2009 (n=4010) and their parents enrolled in FFHV compared with non-enrolled families with a similar risk profile.

Intervention

FFHV supports public health in Manitoba by providing home visiting services to First Nations and non-First Nations families with preschool children and connecting them with resources in their communities.

Outcomes

Predicted probability (PP) and relative risk (RR) of childhood vaccination, parental involvement in community support programmes and children’s development at school entry.

Results

FFHV participation was associated with higher rates of complete childhood vaccination at age 1 (PP: FFHV 0.715, no FFHV 0.661, RR 1.08, 95% CI 1.03 to 1.14) and age 2 (PP: FFHV 0.465, no FFHV 0.401, RR 1.16, 95% CI 1.08 to 1.25), and with parental involvement in community support groups (PP: FFHV 0.149, no FFHV 0.097, RR 1.54, 95% CI 1.27 to 1.86). However, there was no difference between FFHV participants and non-participants in rates of children being vulnerable in at least one developmental domain at age 5 (PP: FFHV 0.551, no FFHV 0.557, RR 1.00, 95% CI 0.91 to 1.11).

Conclusions

FFHV supports First Nations families in Manitoba by promoting childhood vaccination and connecting families to parenting resources in their communities, thus playing an important role in fulfilling the mandate of public health practice.
Comparison of physical activity and body compA validated question from the osition in a cohort of children born extremely preterm or with extremely low birth weight to matched term-born controls: a follow-up study
Authors: Engan Mette , Vollsæter Maria , Øymar Knut , Markestad Trond , Eide Geir Egil , Halvorsen Thomas , Juliusson Petur , Clemm Hege
Published: June 2019

Objectives

To compare physical activity and body composition in a cohort of children born extremely preterm/extremely low birth weight (EP/ELBW) with term-born (TB) controls.

Methods

A regional cohort of children born during 1999–2000 at gestational age <28 weeks or with birth weight <1000 g and their individually matched TB controls were examined in 2010–2011. Information on physical activity was obtained from parental questionnaires, and body composition was determined by anthropometry and dual X-ray absorptiometry.

Results

Fifty-seven EP/ELBW and 57 TB controls were included at a mean age of 11.6 years. Compared with the TB children, the EP/ELBW-born children exercised less often (22% vs 44% exercised more than 3 days per week), had lower physical endurance and poorer proficiency in sports and play and were less vigorous during exercise (p<0.05). They also had lower values (mean; 95 % CI) for muscle mass (0.9; 0.3–1.5 kg), total bone mineral density z-score (0.30; 0.13–0.52 units) and fat mass ratio (0.14; 0.06–0.21 units). The association between physical activity and bone mineral and skeletal muscle mass accrual was significantly weaker for the EP/ELBW-born than the TB children.

Conclusions

The EP/ELBW-born children were less physically active, had signs of an unfavourable body composition with less muscle mass and lower bone mineral density than the TB controls. The association between physical activity and the measures of body composition was weaker in the group of EP/ELBW-born children.
Reducing door-to-needle times in stroke thrombolysis to 13 min through protocol revision and simulation training: a quality improvement project in a Norwegian stroke centre
Authors: Ajmi Soffien Chadli , Advani Rajiv , Fjetland Lars , Kurz Kathinka Dehli , Lindner Thomas , Qvindesland Sigrunn Anna , Ersdal Hege , Goyal Mayank , Kvaløy Jan Terje , Kurz Martin
Published: June 2019

Background

In eligible patients with acute ischaemic stroke, rapid revascularisation is crucial for good outcome. At our treatment centre, we had achieved and sustained a median door-to-needle time of under 30 min. We hypothesised that further improvement could be achieved through implementing a revised treatment protocol and in situ simulation-based team training sessions. This report describes a quality improvement project aiming to reduce door-to-needle times in stroke thrombolysis.

Methods

All members of the acute stroke treatment team were surveyed to tailor the interventions to local conditions. Through a review of responses and available literature, the improvement team suggested changes to streamline the protocol and designed in situ simulation-based team training sessions. Implementation of interventions started in February 2017. We completed 14 simulation sessions from February to June 2017 and an additional 12 sessions from November 2017 to March 2018. Applying Kirkpatrick’s four-level training evaluation model, participant reactions, clinical behaviour and patient outcomes were measured. Statistical process control charts were used to demonstrate changes in treatment times and patient outcomes.

Results

A total of 650 consecutive patients, including a 3-year baseline, treated with intravenous thrombolysis were assessed. Median door to needle times were significantly reduced from 27 to 13 min and remained consistent after 13 months. Risk-adjusted cumulative sum charts indicate a reduced proportion of patients deceased or bedridden after 90 days. There was no significant change in balancing measures (stroke mimics, fatal intracranial haemorrhage and prehospital times).

Conclusions

Implementing a revised treatment protocol in combination with in situ simulation-based team training sessions for stroke thrombolysis was followed by a considerable reduction in door-to-needle times and improved patient outcomes. Additional work is needed to assess sustainability and generalisability of the interventions.
Mutational profiling and immunohistochemical analysis of a surgical series of ampullary carcinomas
Authors: Harthimmer Mads Rohde , Stolborg Uffe , Pfeiffer Per , Mortensen Michael Bau , Fristrup Claus , Detlefsen Sönke
Published: June 2019

Aims

Knowledge regarding the genetic features of ampullary carcinoma (AC) in European patients is limited. The utility of tumour markers for the establishment of a malignant diagnosis in biopsies from the ampullary region has not been fully elucidated. We aimed to describe the clinical, pathological, immunohistochemical (IHC) and genetic features of a Danish series of surgically resected ACs.

Methods

Surgically resected ACs (n=59) were examined regarding (1) clinicopathological features, (2) histological subtypes, (3) expression of IMP3, maspin, MUC5AC and S100P and (4) next-generation sequencing using a hybrid capture-based platform (Illumina HiSeq2500), including 315 cancer-related genes plus introns from 28 genes often rearranged or altered in cancer. Tumour mutational burden (TMB) and microsatellite instability (MSI) were also evaluated.

Results

Pancreatobiliary adenocarcinomas (PB-AC), intestinal adenocarcinomas (INT-AC), other ampullary tumours and mixed adenocarcinomas represented 45.8%, 23.7%, 16.9% and 13.6%. The proportion of IHC-positive ACs (score ≥2) was: Maspin (94.9%), IMP3 (67.8%), S100P (39.0%) and MUC5AC (18.6%). Most frequently altered genes wereTP53(59.3%),KRAS(40.7%),APC(27.8%),SMAD4(20.4%),CDKN2A(16.7%) andARID2/PIK3CA(each 11.1%). MUC5AC and S100P were frequently expressed in PB-AC,APCalterations frequent in INT-AC,SOX9alterations were exclusive in INT-AC andMDM2andFRS2alterations in PB-AC. Four of 49 ACs (8.2%) were TMB-high/MSI-high and showed loss of MLH1 and PMS2.

Conclusions

PB-AC was the most frequent histological subtype of AC. Maspin and IMP3 were the IHC tumour markers with the highest sensitivity. Adenocarcinoma subtypes differed regarding several genetic alterations, whose predictive value remains to be evaluated.
Hidden burden of arrhythmias in patients with small atrial septal defects: a nationwide study
Authors: Udholm Sebastian , Nyboe Camilla , Redington Andrew , Nielsen-Kudsk Jens Erik , Nielsen Jens Cosedis , Hjortdal Vibeke Elisabeth
Published: June 2019

Background

In recent Danish nationwide register-based study, adults with small, unrepaired atrial septal defects (ASD) have increased risk of pneumonia, atrial fibrillation (AF) and stroke. Moreover, they revealed higher mortality than the background population.

Objective

In this nationwide study, we evaluate the hidden burden of atrial and ventricular arrhythmias in adult patients with a small, unrepaired ASD without a previous diagnosis of AF.

Methods

All Danish patients, aged 18–65, diagnosed between 1953 and 2011 with an unrepaired ASD and no documented AF were invited for 7 days Holter-recording, echocardiography and 6 min walk test. The first 48 hours Holter-recording was completely analysed, while only AF was screened for throughout all 7 days. Furthermore, the entire patient group were characterised using the unique Danish registries.

Results

A total of 151 patients (mean age 32 years) were included. Approximately 80% of the patients had spontaneous closure of their defect. Despite this, occult arrhythmias were frequent. The most common arrhythmia was supraventricular tachycardia (n=24, 16%) with non-sustained atrial arrhythmias in 21 patients and AF in two patients. A considerable number of patients had non-sustained ventricular tachycardia (n=12, 8%). Patients with ASD and tachyarrhythmias had increased right ventricular to left ventricular diastolic area in echocardiography and higher age when compared with ASD patients without arrhythmias.

Conclusion

Adult patients with small, unrepaired ASD have a hidden burden of both atrial and ventricular tachyarrhythmias. The mechanism likely relates to the residua of previous right-heart volume overload and incomplete reverse remodelling. Our results support guidelines recommending continued follow-up of patients with small, unrepaired ASD.
LAPRA-TY for laparoscopic repair of traumatic diaphragmatic hernia without intracorporeal knot tying
Authors: Choi Jeff , Pan Jenny , Forrester Joseph D , Spain David , Browder Timothy D
Published: June 2019

Case Presentation

A 38-year-old man was brought in by ambulance as a trauma activation after sustaining a self-inflicted stab wound in the left upper quadrant with a kitchen knife. His primary survey was unremarkable and his vital signs were normal. Secondary survey revealed a 2 cm transverse stab wound inferior and medial to the left nipple. Extended focused assessment with sonography for trauma (FAST) did not show intra-abdominal or pericardial fluid and chest X-ray did not show a definite pneumothorax or hemothorax.

What would you do?

Wound exploration at bedside.

Admit for observation and serial examinations.

Exploratory laparotomy and open repair of traumatic diaphragmatic injury (TDI).

Thoracotomy and open repair of TDI.

Diagnostic laparoscopy and laparoscopic repair of TDI.
Secure Data Deduplication with Reliable Data Deletion in Cloud
Authors: Meng Wenjuan , Ge Jianhua , Jiang Tao
Published: July 2019

A cloud storage system which incorporates the deletion and deduplication functionalities will have both security and efficiency advantages over exiting solutions which provide only one of them. However, the security models of secure data deletion and data deduplication functionalities are not compatible with each other, which will cause security and efficiency vulnerability under coercive adversaries. To solve these security and efficiency challenges, we define and construct a scheme, whose security relies on the proper erasure of keys in the wrapped key tree and periodical update of the deduplication encryption keys. Moreover, we enhance the efficiency of the proposed scheme by introducing incremental data update, where only the changed part is encrypted/decrypted and uploaded/downloaded in data updating. Further security analysis shows that the proposed scheme is secure against coercive attack. Finally, the practical implementation shows that our scheme is performance efficient in computation, storage and communication for both the cloud storage server and users.
Enhanced electrocatalytic activity of cobalt phthalocyanines when “clicked” to graphene oxide nanosheets
Authors: Mpeta Lekhetho S. , Nyokong Tebello
Published: July 2019

Alkyne-terminated Co phthalocyanine (CoPc) derivatives are linked to reduced graphene oxide nanosheets (GONS) via click chemistry and the conjugates are used for the electrocatalytic oxidation of 2-mercaptoethanol. CoPc derivatives where the alkyne group is separated from the Pc ring by an aliphatic and benzene ring (complex 3) showed the best catalytic activity (in terms of oxidation potential) in comparison to when only aliphatic chains were employed without the benzene ring (complex 2) and when there were no substituents (complex 1). The anodic oxidation of 2-mercaptoethanol on 3-GONS (linked) occurred at the least positive oxidation potential (-0.22 V vs. Ag|AgCl). 3-GONS (linked) was found to have the highest sensitivity with the lowest limit of detection of 0.08 [Formula: see text]M. When the CoPc derivative and GONS were not linked but placed sequentially on the electrode, the electrocatalytic activity (in terms of LOD) was poorer than when linked. The electrodes modified with CoPc clicked to GONS are highly promising electrochemical sensors in terms of stability, sensitivity, good catalytic activity and ease of fabrication.
5,10,15-Triarylcorrole atropisomerism
Authors: Bischetti Martina , Pomarico Giuseppe , Nardis Sara , Mandoj Federica , Cicero Daniel O. , Paolesse Roberto
Published: July 2019

A series of 5,10,15-triarylcorroles has been prepared, with the meso-aryl rings functionalized with different substituents to investigate their influence on the aryl ring rotation with respect to the corrole plane. The study has been carried out by different NMR techniques, allowing the complete assignment of the 1H NMR spectra and giving insights on the kinetic and thermodynamic factors driving the atropisomerism in triarylcorrole derivatives.
Combinatorial Register Allocation and Instruction Scheduling
Authors: Lozano Roberto Castañeda , Carlsson Mats , Blindell Gabriel Hjort , Schulte Christian
Published: July 2019

This article introduces a combinatorial optimization approach to register allocation and instruction scheduling, two central compiler problems. Combinatorial optimization has the potential to solve these problems optimally and to exploit processor-specific features readily. Our approach is the first to leverage this potential
in practice
: it captures the
complete
set of program transformations used in state-of-the-art compilers,
scales
to medium-sized functions of up to 1,000 instructions, and generates
executable
code. This level of practicality is reached by using constraint programming, a particularly suitable combinatorial optimization technique. Unison, the implementation of our approach, is open source, used in industry, and integrated with the LLVM toolchain.

An extensive evaluation confirms that Unison generates better code than LLVM while scaling to medium-sized functions. The evaluation uses systematically selected benchmarks from MediaBench and SPEC CPU2006 and different processor architectures (Hexagon, ARM, MIPS). Mean estimated speedup ranges from 1.1% to 10% and mean code size reduction ranges from 1.3% to 3.8% for the different architectures. A significant part of this improvement is due to the integrated nature of the approach. Executing the generated code on Hexagon confirms that the estimated speedup results in actual speedup. Given a fixed time limit, Unison solves optimally functions of up to 946 instructions, nearly an order of magnitude larger than previous approaches.

The results show that our combinatorial approach can be applied in practice to trade compilation time for code quality beyond the usual compiler optimization levels, identify improvement opportunities in heuristic algorithms, and fully exploit processor-specific features.
A Three‐Dimensional Cooperative Guidance Law Based on Consensus Theory for Maneuvering Targets
Authors: Zhang Wenjie , Du Xiao , Xia Qunli
Published: July 2019

In this paper, a cooperative guidance law based on consensus theory is proposed for multiple flight vehicles against a maneuvering target in a three‐dimensional plane. The proposed guidance law has three orientation components: the one along the line‐of‐sight (LOS) ensures that all flight vehicles reach the target simultaneously, and the other two normal to the LOS in longitudinal and lateral plane guarantee the accurate interception. The target maneuverings are estimated by a finite‐time convergence disturbance observer (FTDOB) and are compensated into the kinematic equation to achieve more accurate interception. Using the Lyapunov stability theorem, time‐to‐go of all flight vehicles’ convergence is proved. Mathematical simulations verify the effectiveness of the proposed cooperative guidance law.
The Mechanism of Phillyrin from the Leaves of Forsythia suspensa for Improving Insulin Resistance
Authors: Xu Xiaoqing , Saadeldeen Fatma S. A. , Xu Lanting , Zhao Yingying , Wei Jinfeng , Wang Hui-Min David , Liu Zhenhua , Kang Wenyi
Published: July 2019

Three lignans, phillyrin, forsythia ester A, and rosin-β-D-furan glucose, were isolated from Forsythia suspensa which is a famous Traditional Chinese Medicine used for clearing heat and detoxifying, reducing swelling and dispersing knot, and dispersing wind heat. In this study, the effects of phillyrin, forsythia ester A, and rosin-β-D-furan glucose on insulin resistance of 3T3-L1 adipocytes were investigated by the method of glucose oxidase-peroxidase (GOD-POD) and the mechanism was assayed by the method of western blot. The results indicated that phillyrin, forsythia ester A, and rosin-β-D-furan glucose could improve the glucose uptake in 3T3-L1 adipocytes under insulin resistance (IR). Among them, phillyrin showed significant activity in increasing glucose consumption at the concentrations of 100 μM and 200 μM (P < 0.001). The mechanism of improving insulin resistance may be that phillyrin could raise the protein phosphorylation of IRS-1 and Akt and the expression levels of GLUT4 protein.
Experimental Study on Stress Evolution and Microseismic Signals under Vibration Conditions of Coal during Excavation and Subsequent Waiting Time
Authors: Wang Qifei , Li Chengwu , Lyu Pingyang , Zhao Yuechao , Ai Dihao , Xie Beijing
Published: July 2019

An experiment designed to simulate coal during excavation was conducted. Microseismic signals of coal under vibration conditions during excavation and subsequent waiting time of the coal roadway at different excavation speeds were collected and analyzed. During the excavation and subsequent waiting time, the stress in coal is redistributed, and the concentrated stress is gradually transferred to the deeper section of the coal seam. The Hilbert–Huang transform (HHT) is used to effectively denoise the collected signals. According to the noise‐reduced signal, the amplitude and pulse number of the microseismic signals emitted during the excavation process are much larger than those of the waiting time process. During excavation, the energy and event numbers of microseismic signals increase first and then decrease as the excavation speed increases. The faster the excavation speed, the more the energy, and the higher the event numbers of the microseismic signals released during the subsequent waiting time. When the excavation speed is faster, more elastic potential accumulates in the coal seam and the concentration stress is greater. As the concentrated stress moves forward in time without excavation, more coal seams fail, and more microseismic signals are released. The microseismic signal and the stress evolution law can provide a reasonable explanation for the forward movement of the concentrated stress and coal failure during roadway excavation.
NOTCH Signaling via WNT Regulates the Proliferation of Alternative, CCR2-Independent Tumor-Associated Macrophages in Hepatocellular Carcinoma
Authors: Ye Yu-Chen , Zhao Jun-Long , Lu Yi-Tong , Gao Chun-Chen , Yang Yang , Liang Shi-Qian , Lu Ying-Ying , Wang Lin , Yue Shu-Qiang , Dou Ke-Feng , Qin Hong-Yan , Han Hua
Published: July 2019

Tumor-associated macrophages (TAM) play pivotal roles in tumor progression and metastasis, but the contribution and regulation of different macrophage populations remain unclear. Here we show that Notch signaling plays distinct roles in regulating different TAM subsets in hepatocellular carcinoma (HCC). Myeloid-specific NOTCH blockade by conditional disruption of recombination signal binding protein Jκ (RBPj cKO) significantly delayed the growth of subcutaneously inoculated Lewis lung carcinoma (LLC), but accelerated orthotopically inoculated hepatic Hepa1-6 tumors in mice. In contrast to subcutaneous LLC, RBPj cKO significantly increased the number of TAMs in hepatic Hepa1-6 tumors despite impeded differentiation of monocyte-derived TAMs (moTAM). The dominating TAMs in orthotopic HCC manifested properties of Kupffer cells (KC) and hence are tentatively named KC-like TAMs (kclTAM). The increased proliferation of RBPj cKO kclTAMs was maintained even in Ccr2−/− mice, in which moTAMs were genetically blocked. NOTCH signaling blockade accelerated proliferation of kclTAMs via enhanced β-catenin–dependent WNT signaling, which also downregulated IL12 and upregulated IL10 expression by kclTAMs likely through c-MYC. In addition, myeloid-specific RBPj cKO facilitated hepatic metastasis of colorectal cancer but suppressed lung metastasis in mice, suggesting that the phenotype of RBPj cKO in promoting tumor growth was liver-specific. In patient-derived HCC biopsies, NOTCH signaling negatively correlated with WNT activation in CD68+ macrophages, which positively correlated with advanced HCC stages. Therefore, NOTCH blockade impedes the differentiation of moTAMs, but upregulates Wnt/β-catenin signaling to promote the proliferation and protumor cytokine production of kclTAMs, facilitating HCC progression and hepatic metastasis of colorectal cancer.

Significance:

These findings highlight the role of NOTCH and WNT signaling in regulating TAMs in hepatocellular carcinoma.
A Randomized Controlled Trial Testing Provision of Fecal and Blood Test Options on Participation for Colorectal Cancer Screening
Authors: Symonds Erin L. , Hughes Donna , Flight Ingrid , Woodman Richard , Chen Gang , Ratcliffe Julie , Pedersen Susanne K. , Fraser Robert J.L. , Wilson Carlene J. , Young Graeme P.
Published: July 2019

Suboptimal participation is commonly observed in colorectal cancer screening programs utilizing fecal tests. This randomized controlled trial tested whether the offer of a blood test as either a “rescue” strategy for fecal test nonparticipants or an upfront choice, could improve participation. A total of 1,800 people (50–74 years) were randomized to control, rescue, or choice groups (n = 600/group). All were mailed a fecal immunochemical test (FIT, OC-Sensor, Eiken Chemical Company) and a survey assessing awareness of the screening tests. The rescue group was offered a blood test 12 weeks after FIT nonparticipation. The choice group was given the opportunity to choose to do a blood test (Colvera, Clinical Genomics) instead of FIT at baseline. Participation with any test after 24 weeks was not significantly different between groups (control, 37.8%; rescue, 36.9%; choice, 33.8%; P > 0.05). When the rescue strategy was offered after 12 weeks, an additional 6.5% participated with the blood test, which was greater than the blood test participation when offered as an upfront choice (1.5%; P < 0.001). Awareness of the tests was greater for FIT than for blood (96.2% vs. 23.1%; P < 0.0001). In a population familiar with FIT screening, provision of a blood test either as a rescue of FIT nonparticipants or as an upfront choice did not increase overall participation. This might reflect a lack of awareness of the blood test for screening compared with FIT.
Hidden Burden of Electronic Health Record‐Identified Familial Hypercholesterolemia: Clinical Outcomes and Cost of Medical Care
Authors: Patel Prashant , Hu Yirui , Kolinovsky Amy , Geng Zhi , Ruhl Jeffrey , Krishnamurthy Sarath , deRichemond Caroline , Khan Ayesha , Kirchner H. Lester , Metpally Raghu , Jones Laney K. , Sturm Amy C. , Carey David , Snyder Susan , Williams Marc S. , Mehra Vishal C.
Published: June 2019

Background

Familial hypercholesterolemia (
FH
), is a historically underdiagnosed, undertreated, high‐risk condition that is associated with a high burden of cardiovascular morbidity and mortality. In this study, we use a population‐based approach using electronic health record (
EHR
)‐based algorithms to identify
FH
. We report the major adverse cardiovascular events, mortality, and cost of medical care associated with this diagnosis.

Methods and Results

In our 1.18 million
EHR‐
eligible cohort,
International Classification of Diseases, Ninth Revision
(

ICD
‐9

) code‐defined hyperlipidemia was categorized into
FH
and non‐
FH
groups using an
EHR
algorithm designed using the modified Dutch Lipid Clinic Network criteria. Major adverse cardiovascular events, mortality, and cost of medical care were analyzed. A priori associated variables/confounders were used for multivariate analyses using binary logistic regression and linear regression with propensity score–based weighted methods as appropriate. EHR
FH
was identified in 32 613 individuals, which was 2.7% of the 1.18 million
EHR
cohort and 13.7% of 237 903 patients with hyperlipidemia.
FH
had higher rates of myocardial infarction (14.77% versus 8.33%;
P
<0.0001), heart failure (11.82% versus 10.50%;
P
<0.0001), and, after adjusting for traditional risk factors, significantly correlated to a composite major adverse cardiovascular events variable (odds ratio, 4.02; 95% CI, 3.88–4.16;
P
<0.0001), mortality (odds ratio, 1.20; CI, 1.15–1.26;
P
<0.0001), and higher total revenue per‐year (incidence rate ratio, 1.30; 95% CI, 1.28–1.33;
P
<0.0001).

Conclusions

EHR
‐based algorithms discovered a disproportionately high prevalence of
FH
in our medical cohort, which was associated with worse outcomes and higher costs of medical care. This data‐driven approach allows for a more precise method to identify traditionally high‐risk groups within large populations allowing for targeted prevention and therapeutic strategies.
Four new species of Actinopus (Mygalomorphae: Actinopodidae) from Uruguay
Authors: DUNIESKY RIOS-TAMAYO
Published: July 2019

Actinopus specimens from different localities in Uruguay that did not match any of the previously species present in the country were examined, and four new species are described: A. coboi sp. nov., from Colonia province; A. fernandezi sp. nov., from Salto province; A. simoi sp. nov., from Maldonado province; and A. uruguayense sp. nov., from Colonia and Cerro Largo provinces. The record of the species A. longipalpis for Montevideo is rejected and A. liodon is considered “species inquirenda”. Actinopus coboi has spermathecae with an apical lobe diagonally directed; A. fernandezi is characterized by a stylized copulatory bulb and its greater number of retrolateral thorns on tibia II. Actinopus simoi can be distinguished from A. uruguayense by its carapace with a dark coloration; a reddish coloration in the palpal tibia and the shape of its spermathecae and copulatory bulb. With the presence of the Argentinian species—A. gerschiapelliarum, A. puelche and A. insignis—the number of species known in the country is increased to nine. All new species are diagnosed and illustrated; a dichotomous key to all species of Actinopus from Uruguay is also provided.
Decisive Atmospheric Circulation Indices for July–August Precipitation in North China Based on Tree Models
Authors: Tong Xuan , Yan Zhongwei , Xia Jiangjiang , Lou Xiao
Published: July 2019

Numerous circulation indices have been applied in practical climate services focused on regional precipitation. It is beneficial to identify the most influential or decisive indices, but this is difficult with conventional correlation analyses because of the underlying nonlinear mechanisms for precipitation. This paper demonstrates a set of the most influential indices for July–August precipitation in North China, based on the recursive random forest (RRF) method. These decisive circulation indices include the Polar–Eurasia teleconnection, North African subtropical high ridge position, India–Burma trough, Antarctic Oscillation, Northern Hemisphere polar vortex central latitude, North Atlantic Oscillation, and western Pacific subtropical high northern boundary position. Some of these factors have been recognized as directly influential to the regional precipitation, for example, those of the northwestern Pacific subtropical high; however, some are not easily understood. Decision tree (DT) models using these indices were developed to facilitate composite analyses to explain the RRF results. Taking one of the most interesting DT rules as an example, when the North African subtropical high ridge position is sufficiently far south, an anomalous anticyclone occurs in the upstream and an anomalous cyclone in the downstream of North China. This is unfavorable for northward moisture transport in eastern China and hence causes less precipitation in North China than climatology. The present results are not only helpful for improving diagnostic models of regional precipitation, but also enlightening for exploring how global climate change could impact a region by modulating large-scale circulation patterns.
Imagining futures, imagining selves: A narrative approach to ‘risk’ in young men’s lives
Authors: Ravn Signe
Published: June 2019

This article proposes a narrative approach to studying ‘risk’. A narrative approach moves away from common attempts to identify individuals ‘at risk’ of social problems on the basis of static characteristics – risks – that are assumed to have uniform ‘effects’ on individuals. Instead, a narrative approach to analysing ‘risk’ entails a focus on how people make consequential links between events in their lives. By focusing on three cases from a qualitative study in Denmark the article analyses how young people who have extensive experience with ‘risky’ practices – mainly drug use – make sense of these experiences. A particular focus on imagined futures produces two types of insights. First, by analysing how past and present experiences are seen by young people themselves as pointing towards their imagined futures, the article demonstrates how seemingly similar events (risk-taking experiences) can be inscribed in very different future narratives. Second, analysing the process of imagining futures illuminates how the participants see themselves in the world, to what extent they see themselves as agents in their own lives and if their futures are seen as within or beyond their control.
Common Factors: What Are They and What Do They Mean for Humanistic Psychology?
Authors: Elkins David N.
Published: June 2019

Although common factors have been widely discussed in the clinical literature, the two questions addressed in this article remain relevant: (a) What are the common factors? (b) What do they mean for humanistic psychology? The first question is important because there is no “definitive list” of common factors, and lists presented in the literature often differ dramatically. In response to this question, the article suggests that an evidence-based list of nine common factors by Wampold provides a useful and credible list. The second question is also important, particularly to humanistic psychologists. Among other answers, the article shows that research findings on common factors provide scientific support for humanistic psychology’s emphasis on the importance of the human and relational factors in psychotherapy.
The Existential Processing of Archetypes: Some Prospects for Recognition and Elaboration in Existential Therapy
Authors: Buffardi Gianfranco
Published: June 2019

Modern neurosciences have now undermined the notion that so-called archetypes, as conceived of by C. G. Jung in his Analytical Psychology, are innate or preexistent to the psychic development of the individual. Most existential therapists today similarly dismiss the theory of archetypes as being overly deterministic and phenomenologically inaccurate. Nonetheless, archetypes as psychological “models” exert a powerful influence on human existence. Thus, existential therapists cannot merely minimize the archetype’s central role in basic human experience and behavior. From an existential perspective, the archetype develops in the relationship between the individual and the information she or he receives from the world. The archetype itself changes over time and across different cultures, although it self-maintains quite uniformly due to the inextricable linkage it has with the most profound aspects of instinctual human behaviors, such as common emotional responses to specific situations. Therefore, there is undeniably a deep and abiding nexus between our emotions, our instincts, and our archetypes. In this article, the author, a psychiatrist and existential therapist, affirms that the analysis during existential therapy of how the individual has interpreted and elaborated the subjective significance of their own archetypes promotes the expansion of the client’s “internal maps,” and facilitates the creative search for new possibilities in life.
Family Communication and Psychological Health in Children and Adolescents Following a Parent’s Death From Cancer
Authors: Weber Megan , Alvariza Anette , Kreicbergs Ulrika , Sveen Josefin
Published: June 2019

Parentally bereaved children and adolescents are at risk of developing psychological health problems. Evidence for a correlation between communication and broad measures of psychological health exists in other populations. The aim of this study was to examine associations between family communication and specific aspects of psychological health for children and adolescents following a parent’s death from cancer using parent-proxy and adolescent self-reports. Parent-proxy reports for children and adolescents, and adolescent self-reports for Parent–Adolescent Communication, Strengths and Difficulties Questionnaire, and Prolonged Grief-13 child were analyzed using descriptive statistics and Spearman’s correlation. Parents rated communication as moderate in quality and reported good psychological health for children and adolescents. Adolescent self-reports indicated low-quality communication with their parent and poor psychological health. Significant associations between Parent–Adolescent Communication subscales and Strengths and Difficulties Questionnaire subscales were found for each group. Prolonged grief was associated with emotional problems but not communication for all three groups.
Fruit and Vegetable Consumption in Overweight or Obese Individuals: A Meta-Analysis
Authors: Arnotti Karla , Bamber Mandy
Published: June 2019

Researchers have shown that fruit and vegetable consumption (FVC) promotes weight loss and prevents weight gain, thereby reducing risks for chronic health conditions. We conducted a meta-analysis to examine the overall effects of FVC interventions on weight loss for those with body-mass index (BMI) >25; we follow-up with moderator analyses to determine if effects varied based on participants, interventions, methods, or source characteristics. Extensive literature searches were conducted, resulting in 16 studies and providing 17 comparisons, across 3,719 participants. The overall summary effect was large (−2.81kg; p<.001). Several moderators were significant for increased weight loss: low socio-economic status (−4.99kg; p<.001), higher baseline BMI (slope=−0.29; p=.047), longer interventions (slope=0.012; p<.001), and recruitment setting [health care/programs (−3.7kg; p<.001); work/academic settings (−5.2kg: p<.001)]. Future researchers should investigate varying intervention lengths and examine specific needs of subgroups—higher versus lower socio-economic status, and overweight versus obese.