bluuebunny/crossref_metadata_2025 huggingface dataset:
Processing synthetic and human speech in auditory masked priming tasks
Authors: Drake Shiloh , Liffiton Erin
Published: December 2020

Over the last decade, synthetic speech has become increasingly realistic and potentially comparable to human speech. Despite it becoming more realistic, do we process synthetic speech in exactly the same way as we do human speech? In this paper, we explore whether humans process synthetic speech in the same way that they process human speech using auditory masked priming (AMP) tasks. AMP operates on the same assumptions that visual masked priming does; namely, that subconscious perception of related words facilitates lexical access. However, results are mixed as to whether synthetic speech is processed similarly to human speech, especially in AMP tasks. For the present experiment, responses were compared across synthetic speech and human speech conditions at three levels (repetition prime, phonologically related prime, unrelated prime) using real words and nonsense words. If processing is similar for synthetic and human speech, the use of synthetic speech to record stimuli for studies will result in a parsimonious and less resource-intensive method to prepare auditory experiments that do not require human-like phonetic contrasts, as well as informing us as to whether we process human and non-human voices similarly.
Acoustic communication along drill strings for deep subsurface monitoring
Authors: ZangANG Xiaoqin , Yang Yang , Martinez Jayson J. , Salalila Aljon , Deng Zhiqun , Strickland Christopher E.
Published: December 2020

Monitoring at a carbon storage site is necessary to track the movement of CO2 and assure permanence for geologic storage. Therefore, advanced monitoring technologies and effective methods to transmit data from downhole to the surface are needed to decrease the cost and uncertainty in measurements and satisfy regulations for tracking the fate of subsurface CO2. This study covers the design, development, and initial laboratory-scale feasibility study of an acoustic communication system for monitoring the deep subsurface. We set up a metal tubing in lab space as the model and designed the hardware system for acoustic signal transmission and data collection. The attenuation of the signal along the channel and the impulse response of the acoustic channel were characterized. Using an inverse filter processing method, communication signals were successfully recovered and decoded with zero-bit error rates at three testing locations.
A digital stethoscope with active noise suppression and automatic detection of abnormalities in lung sounds
Authors: West James , West Ellington S.
Published: December 2020

Auscultation, the action of listening to sounds from the body, typically with a stethoscope, as a part of medical diagnosis remains one of the most common, and cost-effective diagnostic practices but requires a high level of expertise. Although widely practiced, it is undermined by subjectivity in interpretation, limiting the ability to accurately interpret sounds objectively and repeatedly. Frequently, high environmental noise levels render conventional stethoscopes useless. It is also true that substantial experience is required in order to properly diagnose lung abnormalities such as pneumonia and Covid-19. Here we present a digital stethoscope with active noise suppression and an artificial intelligence algorithm (AI) that identifies lung abnormalities with accuracy comparable to trained medical personal. This new line of respiratory diagnostic tools is appropriate for community health workers in under-resourced regions, for chronic respiratory patients in their home, and for medical professionals in noisy clinics, who wish to improve their ability to hear and interpret lung sounds. This conversation will also explore the opportunities and obstacles associated with bringing a product from the lab to the marketplace.
Measurement and mitigation of heavy-weight impacts
Authors: Dong Wayland , Lo Verde John , Rawlings Samantha , Silva Richard
Published: December 2020

Various mitigation systems have been utilized for addressing heavy-weight impacts within the built environment. There is no standardized measurement system for assessing heavy-weight impacts and no metric for describing the performance of a building assembly, material, or sound level for this type of impact. The authors have continued their investigation into measurement methods for hard and soft heavy-weight impacts on a variety of structures and fitness flooring materials. This paper presents recent results.
Nonlinear effects and economically irrational decisions in a frog communication system
Authors: Ryan Michael J.
Published: December 2020

The general match between biases in the auditory system and spectral and temporal properties of the species-specific advertisement call have made anurans an enviable model for studies of the neuroethology of acoustic communication. Professor Narins' earlier studies on sexual dimorphism in coqui communication is a sterling example. We have revealed a similar congruence between peripheral and central auditory biases in the recognition and preference for conspecific mating calls in túngara frogs. Studies of cognitive aspects of mate choice, however, have revealed a number of difficult to predict nonlinear effects, and even economically irrational decisions, in this communication system; examples include: Weber's law, competitive decoy effects, and perceptual rescue in audio-visual communication. I will conclude by discussing preliminary data on how neuropeptides involved in the neural reward circuits can broaden the acoustic recognition landscape of these frogs.
Inverse-filter method to suppress pressure measurement distortion due to spatial averaging across a membrane hydrophone sensitive element
Authors: Wear Keith A. , Shah Anant , Baker Christian
Published: December 2020

This paper reports an investigation of an inverse-filter method to correct for experimental underestimation of pressure due to spatial averaging across a hydrophone sensitive element. The spatial averaging filter (SAF) depends on hydrophone type (membrane, needle, or fiber-optic), hydrophone geometrical sensitive element diameter, transducer driving frequency, and transducer F number (ratio of focal length to diameter) [Wear, IEEE Trans UFFC  66, 318–339 (2019)]. The absolute difference between theoretical and experimental SAFs for 25 transducer / hydrophone pairs was 7% ± 3% (mean ± standard deviation). Empirical formulas based on SAFs allow for correction for hydrophone spatial averaging errors in peak compressional pressure (pc), peak rarefactional pressure (pr), pulse intensity integral (pii), mechanical index (MI), and spatial-peak-temporal-average intensity (Istpa). The formulas show, for example, that if a 3-MHz, F/2 transducer is driven to moderate nonlinear distortion and measured at the focal point with a 500-μm membrane hydrophone, then spatial averaging errors are approximately 16% (pc), 12% (pr and MI), and 24% (pii and Istpa). The formulas are based on circular transducers but also provide plausible upper bounds for spatial averaging errors for transducers with rectangular-transmit apertures, such as linear and phased arrays.
Changes in Anthropometric and Fitness Characteristics Over a Decade of Young Elite Alpine Ski Racers
Authors: Steidl-Müller Lisa , Hildebrandt Carolin , Ebenbichler Christoph , Luchner Roland , Patterson Carson , Müller Erich , Gonaus Christoph , Raschner Christian
Published: December 2020

Purpose: The aim of this study was to evaluate whether anthropometric and fitness characteristics have changed between former and current elite male and female Austrian young ski racers (U11–U15). Methods: A battery of anthropometric, general, and skiing-specific fitness tests was conducted annually. In total, 1517 participants (846 males, 671 females) who were tested in 2005–2009 (“former athletes” n = 805) and 2015–2019 (“current athletes” n = 712) were included. Independent t tests and Cohen d were calculated to compare the two 5-y periods, separated by sex and age group. The level of significance was set at P < .05. Results: No significant change in anthropometric characteristics was found over the decade. Current young ski racers performed significantly better in the maximal core flexion strength test in all age categories (ES = 0.88–1.50; P < .02). Core extension strength values were higher in current male U12 and female U12 and U13 athletes (ES = 0.54–0.71; P < .01) and better postural stability values in the lateral direction were found in the age categories U12 and U14 (ES = 0.36–0.68; P < .05), as well as in the forward/backward direction in the age categories U12–U14 (ES = 0.38–1.12; P < .03). Lower-leg extension strength values were apparent in the current U13–U15 age categories (ES = 0.36–1.03; P ≤ .001) and lower drop-jump reactive strength indices in the U13–U15 male athletes (ES = 0.49–0.80; P < .01). Conclusions: Current and former young ski racers differ significantly in some fitness parameters, which might lead to the assumption that some aspects (such as core strength) have gained more focus in athletic training during the last years compared with 15 y ago.
Few Structural Brain Changes Associated With Moderate-Intensity Interval Training and Low-Intensity Continuous Training in a Randomized Trial of Fitness and Older Adults
Authors: Martin-Willett Renée , Ellingson Jarrod E. , Fries Jill , Helmuth Timothy , Karoly Hollis , Giordano Gregory , Calhoun Vince D. , Bryan Angela D.
Published: December 2020

This study utilized a randomized control trial to examine whether structural changes in the precuneus, insula, caudate, hippocampus, and putamen were related to exercise. A total of 197 healthy older adults with no evidence of dementia participated in moderate-intensity interval training or low-intensity continuous training for 16 weeks. Size decreased in the right hippocampus such that the effect of time was significant but the interaction with condition was not. For the left hippocampus, size decreased in the low-intensity continuous training condition but increased in the moderate-intensity continuous training plus interval training condition at the trend level. Finally, there was a significant time-by-condition interaction such that the thickness of the left insula increased for low-intensity continuous training and decreased for moderate-intensity continuous training plus interval training. Few structural changes were associated with the exercise intervention. Future studies should examine the effects of exercise on brain structure in high-risk or clinical populations for a longer period of time.
The foundation of efficient robot learning
Authors: Kaelbling Leslie Pack
Published: December 2020

Innate structure reduces data requirements and improves robustness
Ray Bradbury, luminary of the space age, at 100
Bradbury Beyond Apollo
Jonathan R. Eller
University of Illinois Press, 2020. 376 pp.
Authors: Ockert Ingrid
Published: December 2020

A new biography chronicles the golden years of Earth's first martian
Immunotherapy with a sting
Authors: Gajewski Thomas F. , Higgs Emily F.
Published: December 2020

New agonists of an innate immune pathway induce antitumor immunity in mice
Insulin use and new diabetes after acceptance for bariatric surgery: comparison of outcomes after completion of surgery or withdrawal from the program
Authors: Lee Jessica H , Jaung Rebekah , Beban Grant , Evennett Nicholas , Cundy Tim
Published: December 2020

Introduction

In people accepted onto a bariatric surgery program we compared diabetes-related outcomes in those who completed surgery with those who withdrew before having surgery—examining rates of insulin use in people with type 2 diabetes (T2D), and rates of incident diabetes in people without pre-existing T2D.

Research design and methods

771 people were accepted onto the program. 463 people (60%) had T2D at referral, of which 48% completed surgery and 52% withdrew. Of 308 people without T2D at referral, 49% completed surgery, and 51% withdrew. Rates of insulin use and incident diabetes were compared by Kaplan-Meier analyses. Among those with pre-existing T2D, we examined rates of remission and relapse after surgery.

Results

People without T2D who withdrew from the program had higher mean body mass index and glycated hemoglobin levels than those completing surgery (p<0.005). The rate of incident diabetes at 5 years was 19% in those who withdrew versus 0% in those completing surgery (p<0.001). 30% of people with T2D were taking insulin at referral and all stopped insulin after surgery. During follow-up, the rate of insulin (re)introduction was lower in those who completed surgery (8% vs 26% at 5 years, p<0.001). Of those with T2D who completed surgery, 80% had remission, but 34% had relapsed by 5 years. Diabetes relapse was associated with less weight loss after surgery, a longer duration of T2D and previous insulin use.

Conclusions

Despite a high relapse rate, people with T2D who completed surgery had lower insulin use at 5 years than those withdrawing from the program. In people without T2D, bariatric surgery prevented incident diabetes. People without T2D who withdrew from the program were at greater risk of diabetes, suggesting those who could benefit the most in terms of T2D prevention are not completing bariatric surgery.
Establishing thresholds for important benefits considering the harms of screening interventions
Authors: Helsingen Lise Mørkved , Zeng Linan , Siemieniuk Reed Alexander , Lytvyn Lyubov , Vandvik Per Olav , Agoritsas Thomas , Bretthauer Michael , Guyatt Gordon
Published: December 2020

Context and objective

Standards for clinical practice guidelines require explicit statements regarding how values and preferences influence recommendations. However, no cancer screening guideline has addressed the key question of what magnitude of benefit people require to undergo screening, given its harms and burdens. This article describes the development of a new method for guideline developers to address this key question in the absence of high-quality evidence from published literature.

Summary of method

The new method was developed and applied in the context of a recent BMJ Rapid Recommendation clinical practice guideline for colorectal cancer (CRC) screening. First, we presented the guideline panel with harms and burdens (derived from a systematic review) associated with the CRC screening tests under consideration. Second, each panel member completed surveys documenting their views of expected benefits on CRC incidence and mortality that people would require to accept the harms and burdens of screening. Third, the panel discussed results of the surveys and agreed on thresholds for benefits at which the majority of people would choose screening. During these three steps, the panel had no access to the actual benefits of the screening tests. In step four, the panel was presented with screening test benefits derived from a systematic review of clinical trials and microsimulation modelling. The thresholds derived through steps one to three were applied to these benefits, and directly informed the panel’s recommendations.

Conclusion

We present the development and application of a new, four-step method enabling incorporation of explicit and transparent judgements of values and preferences in a screening guideline. Guideline panels should establish their view regarding the magnitude of required benefit, given burdens and harms, before they review screening benefits and make their recommendations accordingly. Making informed screening decisions requires transparency in values and preferences judgements that our new method greatly facilitates.
Methods for estimating economic benefits of surgical interventions in low-income and middle-income countries: a scoping review
Authors: Hilla Amy , Reese Victoria , Nonvignon Justice , Dolan Carrie B.
Published: December 2020

Objectives

Studies indicate that many types of surgical care are cost-effective compared with other health interventions in low-income and middle-income countries (LMICs). However, global health investments to support these interventions remain limited. This study undertakes a scoping review of research on the economic impact of surgical interventions in LMICs to determine the methodologies used in measuring economic benefits.

Design

The Arksey and O’Malley methodological framework for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist were used to review the data systematically. Online databases were used to identify papers published between 2005 and 2020, from which we selected 19 publications that quantitatively examined the economic benefits of surgical interventions in LMICs.

Results

Majority of publications (79%) reported the use of disability-adjusted life-years (DALYs) to assess economic impact. In comparison, 21% used other measures, such as the value of statistical life or cost-effectiveness ratios, or no measure at all. 31% were systematic or retrospective reviews of the literature on surgical procedures in LMICs, while 69% either directly assessed economic impact in a specific area or evaluated the need for surgical procedures in LMICs. All studies reviewed related to the economic impact of surgical procedures in LMICs, with most about paediatric surgical procedures or a specific surgical specialty.

Conclusion

To make informed policy decisions regarding global health investments, the economic impact must be accurately measured. Researchers employ a range of techniques to quantify the economic benefit of surgeries in LMICs, which limits understanding of overall economic value. We conclude that the literature would benefit from a careful selection of methods, incorporating age and disability weights based on the Global Burden of Disease weights, and converting DALYs to dollars using the value of statistical life approach and the human capital approach, reporting both estimates.
Effects of a peer co-facilitated educational programme for parents of children with ADHD: a feasibility randomised controlled trial protocol
Authors: Mundal Ingunn , Gråwe Rolf W , Hafstad Hege , Cuevas Carlos De las , Lara-Cabrera Mariela Loreto
Published: December 2020

Introduction

Significant numbers of children with attention deficit hyperactivity disorder (ADHD) display problems that cause multiple disabilities, deficits and handicaps that interfere with social relationships, development and school achievement. They may have multiple problems, which strain family dynamics and influence the child’s treatment. Parent activation, described as parents’ knowledge, skills and confidence in dealing with their child’s health and healthcare, has been shown to be an important factor in improving health outcomes. Research suggests that parents need edification to learn skills crucial to the treatment and management of their children’s healthcare. Promoting positive parenting techniques may reduce negative parenting factors in families. This study aims to assess the acceptability, feasibility and estimated sample size of a randomised controlled trial (RCT) comparing an ADHD peer co-led educational programme added to treatment as usual (TAU).

Methods and analysis

Using a randomised waitlist controlled trial, parents of children aged 6–12 years newly diagnosed with ADHD, and referred to a child mental health outpatient clinic in Mid-Norway, will receive TAU concomitant with a peer co-facilitated parental engagement educational programme (n=25). Parents in the control group will receive TAU, and the educational programme treatment within a waitlist period of 3–6 months (n=25). Parent activation, satisfaction, well-being, quality of life and treatment adherence, will be assessed at baseline (T0), 2 weeks (T1) pre–post intervention (T2, T3) and at 3 months follow-up (T4). Shared decision making, parents preferred role in health-related decisions and involvement, parent-reported symptoms of ADHD and child’s overall level of functioning will be assessed at T0 and T4. Such data will be used to calculate the required sample size for a full-scale RCT.

Ethics and dissemination

Approval was obtained from the Regional Committee for Medicine and Health Research Ethics in Mid-Norway (ref: 2018/1196). The findings of this study are expected to provide valuable knowledge about how to optimise family education and management of ADHD and will be disseminated through presentations at conferences and publication in peer-reviewed journals.

Trial registration number

NCT04010851.
Simplifying and optimising management of acute malnutrition in children aged 6 to 59 months: study protocol for a community-based individually randomised controlled trial in Kasaï, Democratic Republic of Congo
Authors: Cazes Cécile , Phelan Kevin , Hubert Victoire , Alitanou Rodrigue , Boubacar Harouna , Izie Bozama Liévin , Tshibangu Sakubu Gilbert , Beuscart Aurélie , Yao Cyrille , Gabillard Delphine , Kinda Moumouni , Augier Augustin , Anglaret Xavier , Shepherd Susan , Becquet Renaud
Published: December 2020

Introduction

Acute malnutrition (AM) is a continuum condition, arbitrarily divided into moderate and severe AM (SAM) categories, funded and managed in separate programmes under different protocols. Optimising acute MAlnutrition (OptiMA) treatment aims to simplify and optimise AM management by treating children with mid-upper arm circumference (MUAC) <125 mm or oedema with one product—ready-to-use therapeutic food—at a gradually tapered dose. Our main objective was to compare the OptiMA strategy with the standard nutritional protocol in children 6–59 months presenting with MUAC <125 mm or oedema without additional complications, as well as in children classified as uncomplicated SAM (ie, MUAC <115 mm or weight-for-height Z-score (WHZ) <−3 or with oedema).

Methods and analysis

This study was a non-inferiority, individually randomised controlled clinical trial conducted at community level in the Democratic Republic of Congo. Children 6–59 months presenting with MUAC <125 mm or WHZ <−3 or with bipedal oedema and without medical complication were included after signed informed consent in outpatient health facilities. All participants were followed for 6 months. Success in both arms was defined at 6 months post inclusion as being alive, not acutely malnourished per the definition applied at inclusion and without an additional episode of AM throughout the 6-month observation period. Recovery among children with uncomplicated SAM was the main secondary outcome. For the primary objective, 890 participants were needed, and 480 children with SAM were needed for the main secondary objective. We will perform non-inferiority analyses in per-protocol and intention-to-treat basis for both outcomes.

Ethics and dissemination

Ethics approvals were obtained from the National Health Ethics Committee of the Democratic Republic of Congo and from the Ethics Evaluation Committee of Inserm, the French National Institute for Health and Medical Research (Paris, France). We will submit results for publication to a peer-reviewed journal and disseminate findings in international and national conferences and meetings.

Trial registration number

NCT03751475. Registered 19 September 2018, https://clinicaltrials.gov/ct2/show/NCT03751475.
Association between biomarkers and COVID-19 severity and mortality: a nationwide Danish cohort study
Authors: Hodges Gethin , Pallisgaard Jannik , Schjerning Olsen Anne-Marie , McGettigan Patricia , Andersen Mikkel , Krogager Maria , Kragholm Kristian , Køber Lars , Gislason Gunnar Hilmar , Torp-Pedersen Christian , Bang Casper N
Published: December 2020

Objective

To evaluate the association between common biomarkers, death and intensive care unit (ICU) admission in patients with COVID-19.

Design

Retrospective cohort study. From electronic national registry data, we used Cox analysis and bootstrapping to evaluate associations between baseline levels of biomarkers and standardised absolute risks of death/ICU admission, adjusted for age and gender.

Setting

All hospitals in Denmark.

Participants

1310 patients aged ≥18 years admitted to hospital with COVID-19 from 27th of February to 1st of May 2020, with available biochemistry data.

Main outcome measures

A composite of death/ICU admission occurring within 30 days.

Results

Of the 1310 patients admitted to hospital (54.6% men; median age 73.6 years), 352 (26.9%) experienced the composite endpoint and 263 (20.1%) died. For the composite endpoint, the absolute risks for moderately and severely elevated C reactive protein (CRP) were significantly higher, 21.5% and 39.2%, respectively, compared with 5.0% for those with normal CRP. Moderately and severely elevated leucocytes were significantly higher, 34.5% and 46.6% risk, respectively, compared with 23.2% for those with normal leucocytes. Moderately and severely decreased estimated glomerular filtration rates (eGFR) were significantly higher, 41.5% and 45.9% risk, respectively, compared with 30.4% for those with normal/mildly decreased eGFR. Normal and elevated ureas were significantly higher, 22.3% and 40.6% risk, respectively, compared with 7.3% for those with low urea. Elevated D-dimer was significantly higher, 31.8% risk, compared with 17.5% for those with normal D-dimer. Moderately and severely elevated troponins were significantly higher, 27.7% and 57.3% risk, respectively, compared with 9.4% for those with normal troponin. Elevated procalcitonin was significantly higher, 52.1% risk, compared with 28.0% for those with normal procalcitonin.

Conclusion

In this nationwide study of patients admitted with COVID-19, elevated levels of CRP, leucocytes, procalcitonin, urea, troponins and D-dimer, and low levels of eGFR were associated with higher standardised absolute risk of death/ICU admission within 30 days.
The DemWG study: reducing the risk of hospitalisation through a complex intervention for people with dementia and mild cognitive impairment (MCI) in German shared-housing arrangements: study protocol of a prospective, mixed-methods, multicentre, cluster-randomised controlled trial
Authors: Kratzer André , Scheel Jennifer , Wolf-Ostermann Karin , Schmidt Annika , Ratz Katrin , Donath Carolin , Graessel Elmar
Published: December 2020

Introduction

Shared-housing arrangements (SHAs) are small, home-like care environments in Germany. Residents are predominantly people with dementia. The risk for all-cause hospitalisation is consistently higher for people with dementia compared with people without dementia and there is currently no evidence-based intervention to reduce the risk of hospitalisation. Thus, the DemWG study investigates whether a complex intervention is effective in reducing hospitalisation (primary outcome), behavioural and psychological symptoms of dementia and falls and for stabilising cognitive functioning and quality of life in people with dementia and mild cognitive impairment (MCI) in German SHAs.

Methods and analysis

Based on the UK Medical Research Council framework ‘Developing and evaluating complex interventions’, a prospective, mixed-methods, multicentre, cluster-randomised controlled trial combining primary and secondary data analyses as well as quantitative and qualitative research methods is being conducted. The intervention consists of three parts: (A) education of nursing staff in SHAs; (B) awareness raising and continuing medical education (CME) of general practitioners; (C) multicomponent non-pharmacological group intervention MAKS-mk+ (‘m’=motor training; ‘k’=cognitive training; ‘+’=fall prevention) for people with dementia and MCI. Randomisation is stratified by the German federal states and type of setting (rural vs urban). Neither the trained professionals nor the participants are blinded. Data are collected at baseline and after 6, 12 and 18 months with standardised instruments. Quantitative data will be analysed by multivariate analyses according to the general linear model, qualitative data using qualitative content analysis. Recruitment is still ongoing until 31 December 2020.

Ethics and dissemination

All procedures were approved by the Ethics Committee of the University of Bremen (Ref. 2019-18-06-3). Informed consent will be obtained before enrolment of participants. Due to findings of previous randomised controlled trials, serious adverse events are not expected. Results will be disseminated in peer-reviewed journal publications and conference presentations.

Trial registration number

ISRCTN89825211.
Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review
Authors: Woods Jean-Baptiste , Greenfield Geva , Majeed Azeem , Hayhoe Benedict
Published: December 2020

Objectives

Mental health disorders contribute significantly to the global burden of disease and lead to extensive strain on health systems. The integration of mental health workers into primary care has been proposed as one possible solution, but evidence of clinical and cost effectiveness of this approach is unclear. We reviewed the clinical and cost effectiveness of mental health workers colocated within primary care practices.

Design

Systematic literature review.

Data sources

We searched the Medline, Embase, PsycINFO, Healthcare Management Information Consortium (HMIC) and Global Health databases.

Eligibility criteria

All quantitative studies published before July 2019 were eligible for the review; participants of any age and gender were included. Studies did not need to report a certain outcome measure or comparator in order to be eligible.

Data extraction and synthesis

Data were extracted using a standardised table; however, pooled analysis proved unfeasible. Studies were assessed for risk of bias using the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool and the Cochrane collaboration’s tool for assessing risk of bias in randomised trials.

Results

Fifteen studies from four countries were included. Mental health worker integration was associated with mental health benefits to varied populations, including minority groups and those with comorbid chronic diseases. Furthermore, the interventions were correlated with high patient satisfaction and increases in specialist mental health referrals among minority populations. However, there was insufficient evidence to suggest clinical outcomes were significantly different from usual general practitioner care.

Conclusions

While there appear to be some benefits associated with mental health worker integration in primary care practices, we found insufficient evidence to conclude that an onsite primary care mental health worker is significantly more clinically or cost effective when compared with usual general practitioner care. There should therefore be an increased emphasis on generating new evidence from clinical trials to better understand the benefits and effectiveness of mental health workers colocated within primary care practices.
Systemic adverse effects from inhaled corticosteroid use in asthma: a systematic review
Authors: Patel Roshni , Naqvi Sumrah A , Griffiths Chris , Bloom Chloe I
Published: December 2020

Background

Oral corticosteroid use increases the risk of systemic adverse effects including osteoporosis, bone fractures, diabetes, ocular disorders and respiratory infections. We sought to understand if inhaled corticosteroid (ICS) use in asthma is also associated with increased risk of systemic effects.

Methods

MEDLINE and Embase databases were searched to identify studies that were designed to investigate ICS-related systemic adverse effects in people with asthma. Studies were grouped by outcome: bone mineral density (BMD), respiratory infection (pneumonia or mycobacterial infection), diabetes and ocular disorder (glaucoma or cataracts). Study information was extracted using the PICO checklist. Risk of bias was assessed using the Cochrane Risk of Bias tool (randomised controlled trials) and Risk of Bias In Non-randomised Studies of Interventions-I tool (observational studies). A narrative synthesis was carried out due to the low number of studies reporting each outcome.

Results

Thirteen studies met the inclusion criteria, 2 trials and 11 observational studies. Study numbers by outcome were: six BMD, six respiratory infections (four pneumonia, one tuberculosis (TB), one non-TB mycobacteria), one ocular disorder (cataracts) and no diabetes. BMD studies found conflicting results (three found loss of BMD and three found no loss), but were limited by study size, short follow-up and lack of generalisability. Studies addressing infection risk generally found positive associations but suffered from a lack of power, misclassification and selection bias. The one study which assessed ocular disorders found an increased risk of cataracts. Most studies were not able to fully adjust for known confounders, including oral corticosteroids.

Conclusion

There is a paucity of studies assessing systemic adverse effects associated with ICS use in asthma. Those studies that have been carried out present conflicting findings and are limited by multiple biases and residual confounding. Further appropriately designed studies are needed to quantify the magnitude of the risk for ICS-related systemic effects in people with asthma.
Workload of learners during simulated paediatric cardiopulmonary resuscitation
Authors: Young Ann L , Doughty Cara B , Williamson Kaitlin C , Won Sharon K , Rus Marideth C , Villarreal Nadia N , Camp Elizabeth A , Lemke Daniel S
Published: December 2020

Introduction

Learner workload during simulated team-based resuscitations is not well understood. In this descriptive study, we measured the workload of learners in different team roles during simulated paediatric cardiopulmonary resuscitation.

Methods

Paediatric emergency nurses and paediatric and emergency medicine residents formed teams of four to eight and randomised into roles to participate in simulation-based, paediatric resuscitation. Participant workload was measured using the NASA Task Load Index, which provides an average workload score (from 0 to 100) across six subscores: mental demand, physical demand, temporal demand, performance, frustration and mental effort. Workload is considered low if less than 40, moderate if between 40 and 60 and high if greater than 60.

Results

There were 210 participants representing 40 simulation teams. 138 residents (66%) and 72 nurses (34%) participated. Team lead reported the highest workload at 65.2±10.0 (p=0.001), while the airway reported the lowest at 53.9±10.8 (p=0.001); team lead had higher scores for all subscores except physical demand. Team lead reported the highest mental demand (p<0.001), while airway reported the lowest. Cardiopulmonary resuscitation coach and first responder reported the highest physical demands (p<0.001), while team lead and nurse recorder reported the lowest (p<0.001).

Conclusions

Workload for learners in paediatric simulated resuscitation teams was moderate to high and varied significantly based on team role. Composition of workload varied significantly by team role. Measuring learner workload during simulated resuscitations allows improved processes and choreography to optimise workload distribution.
Mitochondrial Lon-induced mtDNA leakage contributes to PD-L1–mediated immunoescape via STING-IFN signaling and extracellular vesicles
Authors: Cheng An Ning , Cheng Li-Chun , Kuo Cheng-Liang , Lo Yu Kang , Chou Han-Yu , Chen Chung-Hsing , Wang Yi-Hao , Chuang Tsung-Hsien , Cheng Shih-Jung , Lee Alan Yueh-Luen
Published: December 2020

Background

Mitochondrial Lon is a chaperone and DNA-binding protein that functions in protein quality control and stress response pathways. The level of Lon regulates mitochondrial DNA (mtDNA) metabolism and the production of mitochondrial reactive oxygen species (ROS). However, there is little information in detail on how mitochondrial Lon regulates ROS-dependent cancer immunoescape through mtDNA metabolism in the tumor microenvironment (TME).

Methods

We explored the understanding of the intricate interplay between mitochondria and the innate immune response in the inflammatory TME.

Results

We found that oxidized mtDNA is released into the cytosol when Lon is overexpressed and then it induces interferon (IFN) signaling via cGAS-STING-TBK1, which upregulates PD-L1 and IDO-1 expression to inhibit T-cell activation. Unexpectedly, upregulation of Lon also induces the secretion of extracellular vehicles (EVs), which carry mtDNA and PD-L1. Lon-induced EVs further induce the production of IFN and IL-6 from macrophages, which attenuates T-cell immunity in the TME.

Conclusions

The levels of mtDNA and PD-L1 in EVs in patients with oral cancer function as a potential diagnostic biomarker for anti-PD-L1 immunotherapy. Our studies provide an insight into the immunosuppression on mitochondrial stress and suggest a therapeutic synergy between anti-inflammation therapy and immunotherapy in cancer.
Distractions in the cardiac catheterisation laboratory: impact for cardiologists and patient safety
Authors: Mahadevan Kalaivani , Cowan Elena , Kalsi Navneet , Bolam Helena , Arnett Richard , Hobson Alex , Guha Kaushik , Morton Geraint , Brennan Peter A , Kalra Paul R
Published: December 2020

Objective

To understand human factors (HF) contributing to disturbances during invasive cardiac procedures, including frequency and nature of distractions, and assessment of operator workload.

Methods

Single centre prospective observational evaluation of 194 cardiac procedures in three adult cardiac catheterisation laboratories over 6 weeks. A proforma including frequency, nature, magnitude and level of procedural risk at the time of each distraction/interruption was completed for each case. The primary operator completed a National Aeronautical and Space Administration (NASA) task load questionnaire rating mental/physical effort, level of frustration, time-urgency, and overall effort and performance.

Results

264 distractions occurred in 106 (55%) out of 194 procedures observed; 80% were not relevant to the case being undertaken; 14% were urgent including discussions of potential ST-elevation myocardial infarction requiring emergency angioplasty. In procedures where distractions were observed, frequency per case ranged from 1 to 16 (mean 2.5, SD ±2.2); 43 were documented during high-risk stages of the procedure. Operator rating of NASA task load parameters demonstrated higher levels of mental and physical workload and effort during cases in which distractions occurred.

Conclusions

In this first description of HF in adult cardiac catheter laboratories, we found that fewer than half of all procedures were completed without interruption/distraction. The majority were unnecessary and without relation to the case or list. We propose the introduction of a ‘sterile cockpit’ environment within catheter laboratories, as adapted from aviation and used in surgical operating theatres, to minimise non-emergent interruptions and disturbances, to improve operator conditions and overall patient safety.
From comprehensive field inventories to remotely sensed wall-to-wall stand attribute data — a brief history of management inventories in the Nordic countries
Authors: Maltamo M. , Packalen P. , Kangas A.
Published: December 2020

Forest management inventories (FMIs) provide critical information, usually at the stand level, for forest management planning. A typical FMI includes (i) the delineation of the inventory area to stands by applying auxiliary information; (ii) the classification of the stands according to categorical attributes such as age, site fertility, main tree species, and stand development; and (iii) measurement, modelling, and prediction of stand attributes of interest. The emergence of wall-to-wall remote-sensing data has enabled a paradigm change in FMIs from highly subjective, visual assessments to objective, model-based inferences. Previously, optical remote-sensing data were used to complement visual assessments, especially in stand delineation and height measurements. The evolution of airborne laser scanning (ALS) has made objective estimation of forest characteristics with known accuracy possible. New optical and Lidar-based sensors and platforms will allow further improvements of accuracy. However, there are still bottlenecks related to species-specific stand attribute information in mixed stands and assessments of tree quality. Here, we concentrate on approaches and methods that have been applied in the Nordic countries in particular.
Frontrunners in the race to develop a SARS-CoV-2 vaccine
Authors: Russell Raquel L. , Pelka Peter , Mark Brian L.
Published: December 2020

Numerous studies continue to be published on the COVID-19 pandemic that is being caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Given the rapidly evolving global response to SARS-CoV-2, here we primarily review the leading COVID-19 vaccine strategies that are currently in Phase III clinical trials. Nonreplicating viral vector strategies, inactivated virus, recombinant protein subunit vaccines, and nucleic acid vaccine platforms are all being pursued in an effort to combat the infection. Preclinical and clinal trial results of these efforts are examined as well as the characteristics of each vaccine strategy from the humoral and cellular immune responses they stimulate, effects of any adjuvants used, and the potential risks associated with immunization such as antibody-dependent enhancement. A number of promising advancements have been made toward the development of multiple vaccine candidates. Preliminary data now emerging from phase III clinical trials show encouraging results for the protective efficacy and safety of at least 3 frontrunning candidates. There is hope that one or more will emerge as potent weapons to protect against SARS-CoV-2.
$$\omega \rightarrow 3\pi $$ and $$\omega \pi ^{0}$$ transition form factor revisited
Authors:   JPAC Collaboration, Albaladejo M. , Danilkin I. , Gonzàlez-Solís S. , Winney D. , Fernández-Ramírez C. , Blin A. N. Hiller , Mathieu V. , Mikhasenko M. , Pilloni A. , Szczepaniak A.
Published: December 2020

In light of recent experimental results, we revisit the dispersive analysis of the $$\omega \rightarrow 3\pi $$

ω
→
3
π

decay amplitude and of the $$\omega \pi ^0$$

ω

π
0

transition form factor. Within the framework of the Khuri–Treiman equations, we show that the $$\omega \rightarrow 3\pi $$

ω
→
3
π

Dalitz-plot parameters obtained with a once-subtracted amplitude are in agreement with the latest experimental determination by BESIII. Furthermore, we show that at low energies the $$\omega \pi ^0$$

ω

π
0

transition form factor obtained from our determination of the $$\omega \rightarrow 3\pi $$

ω
→
3
π

amplitude is consistent with the data from MAMI and NA60 experiments.
Approximate Entropy and Empirical Mode Decomposition for Improved Speaker Recognition
Authors: Metzger Richard A. , Doherty John F. , Jenkins David M. , Hall Donald L.
Published: December 2020

When processing real-world recordings of speech, it is highly probable noise will be present at some instance in the signal. Compounding this problem is the situation when the noise occurs in short, impulsive bursts at random intervals. Traditional signal processing methods used to detect speech rely on the spectral energy of the incoming signal to make a determination whether or not a segment of the signal contains speech. However when noise is present, this simple energy detection is prone to falsely flagging noise as speech. This paper will demonstrate an alternative way of processing a noisy speech signal utilizing a combination of information theoretic and signal processing principles to differentiate speech segments from noise. The utilization of this preprocessing technique will allow a speaker recognition system to train statistical speaker model using noise-corrupted speech files, and construct models statistically similar to those constructed from noise-free data. This preprocessing method will be shown to outperform traditional spectrum-based methods for both low-entropy and high-entropy noise in low signal-to-noise ratio environments, with a reduction in the feature space distortion when measured using the Cauchy–Schwarz (CS) distance metric.
From the chair
Authors: West John
Published: December 2020

In late July of this year, SIGHPC's main conference, Supercomputing (SC) 2020, announced that in light of the pandemic it would switch to a virtual meeting. Since our October issue is normally a preview of SC, we'll keep with tradition but highlight how several elements of the program have changed.

Of course, these unpredictable times mean a lot can still shift. So please be sure to monitor the SC20 website's Virtual Event FAQ page for updates.
Editors' introduction
Authors: Talgam-Cohen Inbal , Weinberg S. Matthew
Published: December 2020

This issue of SIGecom Exchanges contains a letter from the new SIGecom Diversity and Inclusion Chair, three research letters, two brief book announcements, and a workshop summary.
Invitation to participate in the symposium on foundations of responsible computing
Authors: Ligett Katrina
Published: December 2020

The Symposium on the Foundations of Responsible Computing (FORC), a conference that will be in its second year in 2021, invites participation from the SIGecom community. FORC 2021 will have both an archival publication option, and also the option to submit papers to a non-archival track that welcomes papers that are in submission or have recently appeared at other archival conferences. In particular, papers that appeared at EC 2020 or will be submitted to EC 2021 are welcome in the FORC 2021 non-archival track.
Recent Progress in Polymer-Based Building Materials
Authors: Shen Jingjing , Liang Jianwei , Lin Xinfeng , Lin Hongjian , Yu Jing , Yang Zhaogang
Published: December 2020

With the development of human society, the requirements for building materials are becoming higher. The development of polymer materials and their application in the field of architecture have greatly enhanced and broadened the functions of building materials. With the development of material science and technology, many functional materials have been developed. Polymer materials have many excellent properties compared with inorganic materials, and they can also be improved to enhance functional properties by blending or adding various additives (such as flame retardants, antistatic agents, and antioxidants). In this paper, polymer-based building materials are introduced with three classes according to the applications, that is, substrates, coatings, and binders, and their recent signs of progress in the preparations and applications are carefully demonstrated.
Eyebrow Regrowth in Patients with Frontal Fibrosing Alopecia Treated with Low-Dose Oral Minoxidil
Authors: Pirmez Rodrigo , Spagnol Abraham Leonardo
Published: December 2020

Introduction: The eyebrows are an important facial feature that shape one’s physical appearance and play a role in non-verbal communication. Partial or complete eyebrow loss is seen in most patients with frontal fibrosing alopecia (FFA). Despite the scarring nature of FFA, eyebrow hair regrowth has been previously reported. Nevertheless, treatment options and supporting evidence remain scarce. Case Presentation: We report eyebrow regrowth in 7 patients with FFA treated with low-dose oral minoxidil (OM). Conclusion: Low-dose OM could be a promising adjunctive therapy for treatment of the eyebrows in patients with FFA, particularly in early disease.