bluuebunny/crossref_metadata_2025 huggingface dataset:
Birth weight and prepubertal body size predict menarcheal age in India, Peru, and Vietnam
Authors: Aurino Elisabetta , Schott Whitney , Penny Mary E. , Behrman Jere R.
Published: September 2017

Evidence on the associations of birth weight and prepubertal nutritional status with menarcheal age for low‐ and middle‐income countries is limited. We investigated these relationships using the Young Lives younger cohort for 2001 Indian, Peruvian, and Vietnamese girls born in 2001–2002. Girls were followed at approximately ages 1, 5, 8, and 12 years. Weibull survival models estimated hazards of earlier menarche on the basis of birth weight Z‐scores (BWZ), and age‐8 BMI‐for‐age Z‐scores (BMIZ) and height‐for‐age Z‐scores (HAZ). Estimates controlled for potential individual‐, mother‐, and household‐level confounders and for changes in anthropometry between 1 and 8 years. In adjusted models, BWZ predicted later age at menarche (hazard ratio (HR) = 0.90, 95% CI: 0.83–0.97). Conversely, HAZ (HR = 1.66, 95% CI 1.5–1.83) and BMIZ at 8 years (HR = 1.28, 95% CI: 1.18–1.38) predicted earlier menarche. Changes in HAZ and BMIZ between 1 and 8 years were not associated with earlier menarche. Associations were consistent across countries, though with variation in estimated magnitudes. Maternal height and age were associated with later menarche. This evidence points to consistently robust and opposite associations of birth weight versus prepubertal attained height and body mass index with menarcheal age in three diverse settings with regard to nutrition, ethnicity, and socioeconomic status.
Interspecies dynamics among bacteria associated with canine periodontal disease
Authors: Sanguansermsri P. , Nobbs A.H. , Jenkinson H.F. , Surarit R.
Published: September 2017

The etiology and pathogenic mechanisms associated with canine periodontal disease are less well understood than the disease in humans. In this study we have reconstructed defined consortia biofilms in vitro of microorganisms identified as prevalent in a same‐breed cohort of dogs with or without periodontal disease. Frederiksenia canicola and Neisseria canis were selected as potential early colonizers of salivary pellicle, and Fusobacterium nucleatum and Porphyromonas gulae were included as high incidence canine oral bacteria. N. canis formed a biofilm substratum under aerobic conditions, but was unable to tolerate anaerobic conditions. Fr. canicola exhibited synergistic biofilm growth with Po. gulae under anaerobic conditions, but displayed an antagonistic relationship with Fu. nucleatum. However, strong co‐adhesion between Fu. nucleatum and Po. gulae was able to overcome the inhibitory effects of Fr. canicola to facilitate three‐species biofilm formation. Parvimonas micra, an anaerobic, asaccharolytic Gram‐positive coccus found only under disease conditions in vivo, was able to form biofilms in conjunction with Fr. canicola and Po. gulae. Furthermore, the specific proteolytic activities of biofilms containing Fr. canicola and Po. gulae or Fu. nucleatum and Po. gulae were increased several‐fold upon the addition of Pa. micra. This suggests that anaerobic cocci such as Pa. micra might provide a catalyst for progressive tissue destruction, inflammation and alveolar bone loss in canine periodontal disease, in keeping with the keystone‐pathogen hypothesis.
The power of frontal midline theta and post‐error slowing to predict performance recovery: Evidence for compensatory mechanisms
Authors: Valadez Emilio A. , Simons Robert F.
Published: September 2017

Past studies utilizing cognitive control tasks have noted that trials following errors are characterized by slowed reaction time. Despite the assumption long held by researchers that this slowing is compensatory (in the service of post‐error performance recovery), studies consistently show that post‐error trials are no more accurate than post‐correct trials. As a result, it has recently been proposed that post‐error slowing (PES) is merely part of an orienting response that serves no task‐relevant cognitive control purpose. Frontal midline theta (FMθ) oscillations represent another potential compensatory mechanism serving cognitive control processes, yet past studies relying on ERPs have failed to find an association between FMθ and post‐error accuracy. The present study investigated the potentially adaptive role of PES and FMθ oscillations during a flanker task using trial‐by‐trial comparisons. Results indicated that error‐related FMθ oscillations signal the need for enhanced top‐down cognitive control and that PES supports cognitive control by providing the added time needed to achieve greater confidence in judgment. Overall, findings provide convergent evidence that both error‐related FMθ and PES predict performance recovery following errors.
A Classic Revisited: In Praise of Red Tape
Authors: Holzer Marc
Published: September 2017

Related Content: Balfour (PAR November/December 2017)

Related Content: Nickels (PAR November/December 2017)

Related Content: Zeemering (PAR November/December 2017)

Related Content: Hamilton (PAR November/December 2017)

Related Content: Ali (PAR November/December 2017)

Related Content: Schachter (PAR November/December 2017)
Science synthesis for management as a way to advance ecosystem restoration: evaluation of restoration scenarios for the Florida Everglades
Authors: Wetzel Paul R. , Davis Stephen E. , van Lent Thomas , Davis Steven M. , Henriquez Hiram
Published: September 2017

Restoration of large ecosystems, like the Florida Everglades, is complex because they cover large areas that span many jurisdictional boundaries and encompass a range of stakeholders whose survival and livelihood are intertwined with the ecosystem. The Everglades is well studied, but linking scientific information to restoration action requires that information be coproduced and carefully communicated to make scientific information credible, relevant, and accepted by stakeholders. Guided by decision‐maker key questions, the Synthesis of Everglades Restoration and Ecosystem Services (SERES) project used a team of specialists to synthesize scientific information across disciplines and evaluate four restoration scenarios that differed in water storage and removal of barriers to overland flow. Capital and operation costs were calculated for all scenarios and the results were communicated to policymakers and other stakeholders with the help of a graphic artist. Restoration options were evaluated in areas of hydrology, soil accretion, landscape processes, and small fish and wading bird dynamics. All scenarios provided substantial improvements to the biological system compared to the existing conditions. The option that expanded aboveground surface water storage and reduced barriers to water flow by 69% which allowed an estimated 91% of predrainage flows to reach the Gulf provided the best ecologic benefits for the least resources spent. The SERES project provides a practical process for improving knowledge exchange among stakeholders involved in restoring large‐scale ecosystems.
Changes in the breath sound spectrum during methacholine inhalation in children with asthma
Authors: Tabata Hideyuki , Enseki Mayumi , Nukaga Mariko , Hirai Kota , Matsuda Shinichi , Furuya Hiroyuki , Kato Masahiko , Mochizuki Hiroyuki
Published: September 2017

ABSTRACT

Background and objective

An effort‐independent breath sound analysis is expected to be a safe and simple method for clinical assessment of changes in airway function. The effects of bronchoconstriction and bronchodilation on novel breath sound parameters in asthmatic children were investigated.

Methods

The study population included 49 children with atopic asthma (male = 33; mean age: 10.2 years). We evaluated breath sound parameters of the highest frequency of the power spectrum (HFp), frequency limiting 50% and 99% of the power spectrum (F50 and F99) and roll‐off from 600 Hz to the HFp (Slope). We also assessed new parameters obtained using the ratios of sound spectrum parameters (spectrum curve indices), such as the ratio of the third and fourth power area to the total power area (P3/PT and P4/PT), the ratio of the third and fourth areas to the total area under the curve (A3/AT and B4/AT) and the ratio of power and frequency at 75% of HFp and 50% of HFp (RPF75 and RPF50). This was measured before and after methacholine inhalation challenge and after β2 agonist inhalation.

Results

The parameters, F50 and F99, showed no changes after methacholine inhalation. Conversely, the A3/AT (12.5–10.0%, P < 0.001), B4/AT (7.6–5.5%, P < 0.001), RPF75 (6.7–4.0 dBm/Hz, P < 0.001) and RPF50 (5.8–4.3 dBm/Hz, P < 0.001) were significantly decreased. These values returned to the original level after β2 agonist inhalation.

Conclusion

Spectrum curve indices indicate bronchoconstriction and bronchodilation. These parameters may play a role in the assessment of airway narrowing in asthmatic children.
Thymic Atrophy: Experimental Studies and Therapeutic Interventions
Authors: Majumdar S. , Nandi D.
Published: September 2017

The thymus is essential for T cell development and maturation. It is extremely sensitive to atrophy, wherein loss in cellularity of the thymus and/or disruption of the thymic architecture occur. This may lead to lower naïve T cell output and limited TCR diversity. Thymic atrophy is often associated with ageing. What is less appreciated is that proper functioning of the thymus is critical for reduction in morbidity and mortality associated with various clinical conditions including infections and transplantation. Therefore, therapeutic interventions which possess thymopoietic potential and lower thymic atrophy are required. These treatments enhance thymic output, which is a vital factor in generating favourable outcomes in clinical conditions. In this review, experimental studies on thymic atrophy in rodents and clinical cases where the thymus atrophies are discussed. In addition, mechanisms leading to thymic atrophy during ageing as well as during various stress conditions are reviewed. Therapies such as zinc supplementation, IL7 administration, leptin treatment, keratinocyte growth factor administration and sex steroid ablation during thymic atrophy involving experiments in animals and various clinical scenarios are reviewed. Interventions that have been used across different scenarios to reduce the extent of thymic atrophy and enhance its output are discussed. This review aims to speculate on the roles of combination therapies, which by acting additively or synergistically may further alleviate thymic atrophy and boost its function, thereby strengthening cellular T cell responses.
Exploring Thematic Nightmare Content and Associated Self‐Harm Risk
Authors: Hochard Kevin D. , Ashcroft Sam , Carroll Janine , Heym Nadja , Townsend Ellen
Published: September 2017

Nightmares have been shown to be robust predictors of self‐harm risk, beyond depressive symptoms and hopelessness at times. However, few studies have investigated associations between nightmare content and increased self‐harm risk. This study explored associations of thematic nightmare content with history of self‐harm, and risk of self‐harm phenomena the morning following a nightmare. A mixed‐method diary study was performed. Prospective nightmare reports were obtained from 72 participants. A total of 47 nightmare reports met inclusion criteria and were analyzed for themes using inductive thematic analysis. Chi‐square and bootstrap Pearson's correlation tests were performed to assess the associations between nightmare themes and self‐harm history, and risk of self‐harm phenomena following a nightmare. “Powerlessness to Change Behavior” was associated with a history of self‐harm engagement, whereas “Financial Hardship” indicated reduced risk. Themes were not significantly associated with increased risk of self‐harm phenomena following a nightmare. Content may be of use in detecting lifetime history of self‐harm engagement, particularly in populations where disclosure is seen as taboo. However, nightmare symptom severity remains a better indicator of risk. Evidence for the utility of nightmare content in assessing immediate self‐harm risk is presently lacking. Replication with increased power is recommended.
Characterization of aluminum and titanium nitride films prepared by reactive sputtering under different poisoning conditions of target
Authors: Arif Muhammad , Sauer Markus , Foelske-Schmitz Annette , Eisenmenger-Sittner Christoph
Published: September 2017

The authors present an experimental approach to investigate the effect of the target poisoning level on the microstructure, preferred orientation, and composition of aluminum nitride (AlN) and titanium nitride (TiN) films grown on natively oxidized silicon (Si) wafers. Cylindrical aluminum (Al) and titanium targets are reactively sputtered in the poisoning mode using nitrogen as the reactive gas during direct current reactive magnetron sputtering. For each target, the nitride films are deposited during the first 10 min of poisoning and after 60 min of poisoning for 10 min each. Higher substrate temperatures as well as changes in the surface morphology are observed for both AlN and TiN samples prepared after long-term poisoning. After long-term poisoning of Al, the nitrogen content is increased and the preferred crystallographic orientation is changed from [101] to [103]. In the case of TiN, the deposited film is transformed into titanium rich coatings with higher compressive stress and a preferred orientation of [220] after long-term poisoning of the target. It is found that the different target poisoning levels and the corresponding energy of the incident particles influence the properties of the deposited films.
Web-based self-management support for people with type 2 diabetes (HeLP-Diabetes): randomised controlled trial in English primary care
Authors: Murray Elizabeth , Sweeting Michael , Dack Charlotte , Pal Kingshuk , Modrow Kerstin , Hudda Mohammed , Li Jinshuo , Ross Jamie , Alkhaldi Ghadah , Barnard Maria , Farmer Andrew , Michie Susan , Yardley Lucy , May Carl , Parrott Steve , Stevenson Fiona , Knox Malcolm , Patterson David
Published: September 2017

Objective

To determine the effectiveness of a web-based self-management programme for people with type 2 diabetes in improving glycaemic control and reducing diabetes-related distress.

Methods and design

Individually randomised two-arm controlled trial.

Setting

21 general practices in England.

Participants

Adults aged 18 or over with a diagnosis of type 2 diabetes registered with participating general practices.

Intervention and comparator

Usual care plus either Healthy Living for People with Diabetes (HeLP-Diabetes), an interactive, theoretically informed, web-based self-management programme or a simple, text-based website containing basic information only.

Outcomes and data collection

Joint primary outcomes were glycated haemoglobin (HbA1c) and diabetes-related distress, measured by the Problem Areas in Diabetes (PAID) scale, collected at 3 and 12 months after randomisation, with 12 months the primary outcome point. Research nurses, blind to allocation collected clinical data; participants completed self-report questionnaires online.

Analysis

The analysis compared groups as randomised (intention to treat) using a linear mixed effects model, adjusted for baseline data with multiple imputation of missing values.

Results

Of the 374 participants randomised between September 2013 and December 2014, 185 were allocated to the intervention and 189 to the control. Final (12 month) follow-up data for HbA1c were available for 318 (85%) and for PAID 337 (90%) of participants. Of these, 291 (78%) and 321 (86%) responses were recorded within the predefined window of 10–14 months. Participants in the intervention group had lower HbA1c than those in the control (mean difference −0.24%; 95% CI −0.44 to −0.049; p=0.014). There was no significant overall difference between groups in the mean PAID score (p=0.21), but prespecified subgroup analysis of participants who had been more recently diagnosed with diabetes showed a beneficial impact of the intervention in this group (p = 0.004). There were no reported harms.

Conclusions

Access to HeLP-Diabetes improved glycaemic control over 12 months.

Trial registration number

ISRCTN02123133.
01 Investigating the population characteristics, processes and outcomes of pre-hospital psychiatric and self-harm emergencies in scotland: a national record linkage study
Authors: Best Catherine , Dougall Nadine , Skar Silje , Fitzpatrick David , Evans Josie , Corfield Andrew , Goldie Isabella , Maxwell Margaret , Snooks Helen , Stark Cameron , White Chris , Wojcik Wojtek
Published: September 2017

Background

Effective management of people who present to ambulance services with a psychiatric or self-harm emergency is essential to ensure positive outcomes. However very little is known about this vulnerable patient population. Therefore, this study aimed to investigate their demographic characteristics, care pathways, and clinical and service outcomes. This information will be valuable for service planning and intervention development.

Methods

We conducted a retrospective cohort study of patients attended by the Scottish Ambulance Service in 2011 with ambulance clinician attendance codes relating to ‘psychiatric emergency’ or ‘self-harm’. Patients resident in Scotland and>=16 years on first contact were included. We used NHS Scotland’s Unscheduled Care Data Mart to link data from:–the ambulance service; emergency departments (ED); general and psychiatric inpatient hospital admissions episodes; and death records.

Results

There were 9014 calls from 6802 people. Slightly more males (n=4708, 52%) than females (n=4306, 48%) were attended. Most were discharged from ED with no known follow-up (n=4566; 51%). Some were left at home (n=1003 attendances, 11%). Almost half of the people (n=3238, 48%) made at least one repeat call. People who self-discharge from ED were more likely to have another ambulance attendance for psychiatric emergency/self-harm within the same year (Pearson chi square=5.24, p=0.02). Two hundred and seventy-nine (4%) people died within the study period, 97 (35%) were recorded as suicide. Ethical approval (NRES 15/EM/0260) and other data approvals were received.

Conclusion

While linked data analysis may not identify all relevant cases, it provides important information to guide the development and evaluation of evidence-based interventions. Ambulance service and ED are missing opportunities to improve outcomes for people who experience a psychiatric emergency or who self-harm. New interventions could lead to decreases in the number of suicides, episodes of self-harm and levels of patient distress; and ambulance and ED service use.
PP11 Do paediatric early warning score relate to emergency department outcomes for children aged 0–2 years brought in by ambulance?
Authors: Broughton William
Published: September 2017

Background

Current ambulance service policy requires paramedics in certain parts of the UK to transport children aged 0–2 years to hospital, regardless of their presenting complaint. A number of Paediatric Early Warning Scores (PEWS) exist to detect deterioration in the hospitalised child. This study aims to evaluate and understand the potential utility of PEWS in an ambulance service setting.

Method

This study is a retrospective analysis of patient reports over a 12 month period (June 2013–June 2014). PEWS are calculated using ambulance vital signs and compared against the following ED discharge outcomes: admission to hospital, GP referral and discharge home. Data analysis consisted of the variables of sensitivity; specificity; positive and negative predictive values; positive and negative likelihood ratios; and ROC curve for the PEWS values against the three main outcomes.

Results

From a randomised sample of 300 patient records, 131 were excluded based on the exclusion criteria listed above, leaving 169 complete data sets that were included for analysis. Of the 169 record analysed, 100 (59.2%) were discharged to home, 30 (17.8%) referred to their GP, and 18 (10.7%) were admitted following assessment in the ED.PEWS for admissionshowed low sensitivity (6.8%–10.12%).PEWS for GP referralalso demonstrated low sensitivity (15.53%–18.12%).PEWS for discharge to homeshowed higher sensitivity and specificity than other outcomes.

Discussion

Overall, PEWS has some degree of high specificity in all outcome measures, but often with wide confidence intervals. PEWS is weakly sensitive across all outcomes, and this is demonstrated in the AUCs for each outcome measure. As a potential diagnostic test to predict ED outcome, in this study PEWS is shown to perform poorly. Further work is therefore required to determine the utility of PEWS, or other early warning scores, for use in an out-of-hospital setting.
PP13 New signs to encourage the use of automated external defibrillators by the lay public
Authors: Smith Christopher M , Colquhoun Michael C , Samuels Marc , Hodson Mark , O’Sullivan Judy , Mitchell Sarah
Published: September 2017

Background

Public Access Defibrillation – the use of Automated External Defibrillators (AEDs) by lay bystanders before the arrival of Emergency Medical Services – is an important strategy in delivering prompt defibrillation to victims of out-of-hospital cardiac arrest and can greatly improve survival rates. Such public-access AEDs are used rarely: one barrier might be poor understanding and content of current signage to indicate their presence. The aim of this project was to develop a sign, with public consultation, that better indicated the function of an AED and an associated poster to encourage its use.

Methods

Two public surveys were undertaken, in July and December 2015, to investigate perceptions of the current AED location sign recommended for use in the UK and to produce an improved location sign and associated information poster.

Results

1895 and 2115 respondents to the surveys. Fewer than half (47.9%, 895/1870) understood what the current location sign indicated. One of four design options for a location sign best explained the indication for (preferred by 56.0%, 1023/1828) and best encouraged the use of a public AED (51.8%, 946/1828). 83.5% (1766/2115) preferred an illustration of a stylised heart trace to the lightning bolt used at present. From five wording options, ‘Defibrillator – Heart Restarter’ was the most popular (29.4%, 622/2115). An associated poster was developed using design features from the new location sign, findings from the surveys and expert group input regarding its content.

Conclusions

This is the first time that public consultation has been used to design a public AED location sign. Effective signage has the potential to help break down the barriers to more widespread use of AEDs in public places.
PP14 Development of a prehospital assessment to identify stroke mimic conditions
Authors: McClelland Graham , Rodgers Helen , Flynn Darren , Price Chris
Published: September 2017

Background

Despite routine use of pre-hospital identification instruments, approximately 30% of suspected stroke admissions are stroke mimics (SM). Early identification may allow “false positive” SM patients to be directed to appropriate care and improve healthcare resource utilisation.

Methods

A retrospective database of ambulance records containing a paramedic impression of stroke was linked to hospital specialist diagnosis data from 01/06/13 to 31/05/16. Logistic regression identified clinical features predictive of SM. An assessment score was constructed prioritising specificity over sensitivity.

Results

1650 patients (mean age 75.3, 47% male, 40% SM) were included. 1520 (92%) were Face Arm Speech Test (FAST) positive. Table 1 describes the characteristics in the SM assessment. Each characteristic scores 1 point if present.

Table 1

Stroke mimic characteristics

CharacteristicStroke patients
(n=982)Mimic patients (n=668)Diagnostic Odds Ratio
(95% CI)Systolic blood pressure<95 mmHg3136 (2–13)Temperature>38.0°C AND heart rate>90bpm21814 (3–59)History of epilepsy AND seizures01118 (2–138)*Age<40 years4249 (3–26)History of migraine AND headache2129 (2–40)

*Approximated

86% (66/77) of suspected stroke patients scoring 1 were SM. 100% (6/6) of patients scoring >1 characteristic were SM. A score ≥1 identified SM with 11% (95% CI, 8–13) sensitivity, 99% (95% CI, 98–99) specificity, positive predictive value of 87% (95% CI, 79–94), negative predictive value of 62% (95% CI, 60–64) and a diagnostic odds ratio of 11 (95% CI, 6–20, p<0.0001).

Conclusions

Amongst ambulance patients with suspected stroke, a small number of SM can be identified with a high degree of certainty. This simple tool needs further validation, prospective testing in the pre-hospital environment with characteristics systematically recorded and consideration of potential clinical impact.
02 A pilot study to assess the feasibility of paramedics delivering antibiotic treatment to ‘red flag’ sepsis patients
Authors: Chippendale Jonathan , Lloyd Adele , Payne Tanya , Dunmore Sally , Stoddart Bethan
Published: September 2017

Background

Sepsis is associated with a 36% mortality rate rising up to 50% for septic shock. Currently when an East Midlands Ambulance Service (EMAS) clinician recognises ‘red flag’ sepsis, only the oxygen and fluid elements of the ‘Sepsis 6’ care bundle are delivered, omitting the antibiotic therapy. Each hour antibiotics are delayed there is an increased risk of septic shock which is associated with a 7.6% greater risk of death. Ambulance clinicians are therefore appropriately placed to assess and commence treatment at the earliest point of recognition. The aim of this pilot was to assess the feasibility of paramedic training in recognising ‘red flag’ sepsis, obtaining blood cultures and administering a broad spectrum antibiotic to patients in the pre-hospital environment.

Methods

A prospective six month feasibility pilot evaluation was introduced in May 2016. Paramedics were trained and given access to a broad spectrum antibiotic along with a patient group directive (PGD) to administer the antibiotic to ‘red flag’ sepsis patients. Training included sepsis recognition, taking of blood cultures and PGD compliance.

Results

20 paramedics volunteered and successfully completed the training. Of the patients that were identified as ‘red flag’ sepsis (n=113) 93% (n=107) were confirmed as infected by hospital record. 98 blood samples were harvested of which only 7.14% (n=7) were reported contaminated compared to an overall 8.48% of those taken in ED during the same time period. 80% (n=90) of patients assessed by paramedics met the criteria and were treated with meropenem. PGD compliance was 100%.

Conclusion

EMAS paramedics were accurate and reliable in their recognition of identifying ‘red flag’ sepsis and able to administer meropenem safely in accordance with the PGD. EMAS paramedic blood sample contamination rate was lower than those taken in the ED.
03 Data linkage across ambulance services and acute trusts: challenges and opportunities
Authors: Clark Sophie , Porter Alison , Halter Mary , Dorning Holly
Published: September 2017

Background

Most callers to 999 ambulance services are transported to hospital emergency departments (EDs), but ambulance services receive no information on patient outcomes. PHED Data is a two-year mixed-methods observational study of the process and potential benefits of linking data from EDs with ambulance service data to allow analysis of patient outcomes. We report on our first aim, to examine the potential opportunities and challenges to routinely linking these data.

Methods

We approached six acute trusts, selected to give a range of performance, location and size, from an English metropolitan area. We used a structured learning log to collect data on the process, time input and reflections. We analysed these data with descriptive statistics, and qualitatively for themes.

Results

All six trusts we approached agreed to participate. Data were linked using an algorithm based on date, time and patient demographics. We achieved a dataset of 7 75 018 records covering 2012–2016, and a linkage rate of 81%.

We identified five stages of the process: senior approval; exploring data availability; information governance agreement; data transfer and linking.

The most intensive phases were; negotiating senior approval (mean research team input per trust of 8 hours 5 min [SD 8 hours 3 min] plus additional time from acute trusts), and data linkage (mean research team input per trust 12 hours 40 min [SD 7 hours 4 min]).

The stage which took the longest was information governance (mean 19 weeks).

Key themes included the positive attitudes of trusts to participating, the range of decision-makers involved, and the need for sustained input from the research team.

Conclusions

We have found the process of data linkage to be feasible, but requires dedicated time from research and trust staff, over a prolonged period, in order to achieve initial set up. Linked data are now being analysed.
Randomised controlled trial of two advanced and extended cardiac rehabilitation programmes
Authors: Sunamura Madoka , ter Hoeve Nienke , van den Berg-Emons Rita J G , Geleijnse Marcel L , Haverkamp Mirjam , Stam Henk J , Boersma Eric , van Domburg Ron T
Published: September 2017

Objective

The OPTICARE (OPTImal CArdiac REhabilitation) randomised controlled trial compared two advanced and extended cardiac rehabilitation (CR) programmes to standard CR for patients with acute coronary syndrome (ACS). These programmes were designed to stimulate permanent adoption of a heart-healthy lifestyle. The primary outcome was the SCORE (Systematic COronary Risk Evaluation) 10-year cardiovascular mortality risk function at 18 months follow-up.

Methods

In total, 914 patients with ACS (age, 57 years; 81% men) were randomised to: (1) 3 months standard CR (CR-only); (2) standard CR including three additional face-to-face active lifestyle counselling sessions and extended with three group fitness training and general lifestyle counselling sessions in the first 9 months after standard CR (CR+F); or (3) standard CR extended for 9 months with five to six telephone general lifestyle counselling sessions (CR+T).

Results

In an intention-to-treat analysis, we found no difference in the SCORE risk function at 18 months between CR+F and CR-only (3.30% vs 3.47%; p=0.48), or CR+T and CR-only (3.02% vs 3.47%; p=0.39). In a per-protocol analysis, two of three modifiable SCORE parameters favoured CR+F over CR-only: current smoking (13.4% vs 21.3%; p<0.001) and total cholesterol (3.9 vs 4.3 mmol/L; p<0.001). The smoking rate was also lower in CR+T compared with the CR-only (12.9% vs 21.3%; p<0.05).

Conclusions

Extending CR with extra behavioural counselling (group sessions or individual telephone sessions) does not confer additional benefits with respect to SCORE parameters. Patients largely reach target levels for modifiable risk factors with few hospital readmissions already following standard CR.

Trial registration number

ClinicalTrials.gov NCT01395095; results.
Secondary mitral regurgitation (part 1): volumetric quantification and analysis
Authors: Gaasch William H , Meyer Theo E
Published: September 2017

Secondary mitral regurgitation (MR) develops as a consequence of left ventricular (LV) dilatation and dysfunction, which complicates its evaluation and management. The goal of this article is to review the assessment of secondary MR with special emphasis on quantification and analysis of LV volume data. At the present time, the optimal method for making these measurements appears to be cardiac MRI. In severe MR (both primary and secondary), the regurgitant fraction (RF) exceeds 50%, and as a result, the LV end diastolic volume (EDV) is increased. In secondary MR, the ejection fraction is depressed (generally <40%) and despite an RF >50%, the regurgitant volume (RegV) rarely meets the current published criteria for severe MR (>60 mL). The ratio of the RegV to EDV, which is very low in secondary MR, reflects the effect of the RegV on the ventricle and it may be predictive of the fractional change in LV size that can be expected after correction of MR. Accurate measurement of the volumetric parameters is essential to proper management of patients with secondary MR.
Empirical validation of the New Zealand serious non-fatal injury outcome indicator for ‘all injury’
Authors: Cryer Colin , Davie Gabrielle S , Gulliver Pauline J , Petridou Eleni Th , Dessypris Nick , Lauritsen Jens , Macpherson Alison K , Miller Ted R , de Graaf Brandon
Published: September 2017

Our purpose was to empirically validate the official New Zealand (NZ) serious non-fatal ’all injury' indicator. To that end, we aimed to investigate the assumption that cases selected by the indicator have a high probability of admission. Using NZ hospital in-patient records, we identified serious injury diagnoses, captured by the indicator, if their diagnosis-specific survival probability was ≤0.941 based on at least 100 admissions. Corresponding diagnosis-specific admission probabilities from regions in Canada, Denmark and Greece were estimated. Aggregate admission probabilities across those injury diagnoses were calculated and inference made to New Zealand. The admission probabilities were 0.82, 0.89 and 0.90 for the regions of Canada, Denmark and Greece, respectively. This work provides evidence that the threshold set for the official New Zealand serious non-fatal injury indicator for ’all injury' captures injuries with high aggregate admission probability. If so, it is valid for monitoring the incidence of serious injuries.
Tumor Histopathological Response to Neoadjuvant Chemotherapy in Childhood Solid Malignancies: Is it Still Impressive?
Authors: Hanafy Ehab , Al Jabri Abdullah , Gadelkarim Gelan , Dasaq Abdulaziz , Nazim Faisal , Al Pakrah Mohammed
Published: September 2017

The management of oncological malignancies has significantly improved over the last decades. In modern medicine, new concepts and trends have emerged paving the way for the era of personalized and evidence-based strategies adapted to the patients’ prognostic variables and requirements. Several challenges do exist that are encountered during the management, including the difficulty to assess chemotherapy response with certainty. Having known that neoadjuvant chemotherapy might be the only solution for a proportion of patients with tumors that are unresectable at diagnosis, emergence of strategies that use risk group-directed therapy became an integral part in the management of oncological malignancies. Tumor histopathological change post neoadjuvant chemotherapy is one of the most important predictors of management outcome and is being used in many chemotherapy protocols as an essential determinant of the most suitable postoperative chemotherapy regimen. Bone tumors are the classic models of this approach; however, other childhood solid tumors show significant variations in outcome as a result of tumor histopathological response to neoadjuvant chemotherapy. The aim of this review is therefore to summarize the significance of histopathological responses seen after neoadjuvant chemotherapy in childhood solid tumors. Moreover, it suggests that the effect on tumor histopathology through modifying neoadjuvant chemotherapy and, on the other hand, toxicities from intensifying adjuvant chemotherapy might either necessitate the change of a number of arm groups in different protocol regimens or include newer chemotherapeutic agents adjuvantly for better outcome and lesser toxicities in poor tumor histopathological responders.
Magnetic resonance imaging to detect local tissue reactions after vaccination in sheep in vivo
Authors: Bernau Maren , Kremer‐Rücker Prisca Valerie , Kreuzer Lena Sophie , Schwanitz Sebastian , Cussler Klaus , Hoffmann Andreas , Scholz Armin Manfred
Published: September 2017

Objectives

Vaccination is one of the most effective methods to keep up the health status in humans and in livestock. Therefore, farm animals are vaccinated several times during their lifetime. Although vaccines are being checked regarding their local reactogenicity, side effects occur frequently—especially in the case of the application of adjuvanted products. Many reports exist about local reactions in sheep. The present study aimed at testing MRI as a method to document injection site reactions three‐dimensionally.

Design

Two groups of Merino lambs (n=16 each) were vaccinated subcutaneously into the left neck side. Two different, licensed inactivated vaccines were used. Both groups of lambs were anaesthetised and scanned using MRI at days 1, 3, 8, 15, 22 and 29 after vaccination.

Setting

The study was performed on a commercial‐like farm.

Participants

Thirty‐two Merino lambs entered the experiment, 16 male and 16 female ones (one animal died at day 22 after vaccination). At first examination day they were approximately three months old.

Primary and secondary outcome measures

Volume differences were measured between vaccination and control neck side to evaluate the time pattern of local tissue reactions.

Results

Local tissue reactions were visible on the skin surface and also appeared in deeper tissue layers on MRI. These deeper reactions would not have been found without MRI or, alternatively, without sacrificing the animals. Some of these extensive local reactions lasted for more than 29 days.

Conclusions

The in vivo MRI results proved suitable to record local tissue reactions in terms of three‐dimensional extent over a longer period of time in large farm animals without the need to sacrifice test animals. A three‐dimensional MRI examination of the injection site during regulatory licensing studies offers an objective evaluation that could be used in a benefit‐risk assessment of veterinary vaccines.

Trial registration number

District Government of Upper Bavaria:55.2‐1‐54‐2532‐2‐13.
Statistical description of morphological characteristics of bedforms in seepage affected alluvial channels
Authors: Patel Mahesh , Majumder Shantanaba , Kumar Bimlesh
Published: September 2017

In this study, experiments were performed in a curvilinear cross-sectional threshold alluvial channel with no seepage and with seepage conditions to understand the influence of downward seepage in an alluvial channel. We observed that a stable channel during the no seepage condition started to approach a stable channel in the transporting stage with downward seepage. Increased value of Shields stress was observed after the application of seepage. In addition, this study deals with the effect of downward seepage on the evolution of alluvial bedforms. In this regard, multi-temporal bed elevation profiles were collected along the test section of channel, which are used to characterize migrating bedforms. Results reveal greater fluctuations and variability on the channel bed under the influence of increased seepage discharge. Slope of the power spectral density with wave number was significantly increased with an increment in seepage percentage, showing more inhomogeneous arrangement of bedforms and larger roughness over the channel boundary.
Landscape-scale regulators of water transparency in mountain lakes: implications of projected glacial loss
Authors: Olson Mark H. , Fischer Janet M. , Williamson Craig E. , Overholt Erin P. , Theodore Nora
Published: September 2017

We examined factors regulating water transparency in a set of 33 lakes located in the Canadian Rocky Mountains. Eighteen lakes had catchments that included glaciers and 15 did not. In each lake, we quantified midsummer attenuation rates for three ultraviolet wavelengths and photosynthetically active radiation and measured chromophoric dissolved organic matter (CDOM) absorbance, turbidity, and chlorophyll a fluorescence. We also used GIS to quantify characteristics of lake catchments. Across lakes, turbidity and CDOM absorbance were arrayed on orthogonal gradients that intersected in a region of low turbidity and low CDOM absorbance. Nonglacially fed lakes had low turbidity and attenuation rates were regulated by CDOM absorbance, which increased with the percentage of the catchment covered by vegetation. Glacially fed lakes had low CDOM absorbance and attenuation rates increased with turbidity, which increased with the percentage of the catchment covered by permanent ice. Glaciers are retreating rapidly in the Canadian Rockies. As catchments become deglaciated, turbidity will likely decrease and the regulator of lake transparency is likely to switch to CDOM, which will have broad implications for lake ecosystems.
Scattering properties of two singularly interacting particles on the half-line
Authors: Egger Sebastian , Kerner Joachim
Published: September 2017

We analyze scattering in a system of two (distinguishable) particles moving on the half-line [Formula: see text] under the influence of singular two-particle interactions. Most importantly, due to the spatial localization of the interactions, the two-body problem is of a non-separable nature. We will discuss the presence of embedded eigenvalues and using the obtained knowledge about the kernel of the resolvent, we prove a version of the limiting absorption principle. Furthermore, by an appropriate adaptation of the Lippmann–Schwinger approach, we are able to construct generalized eigenfunctions which consequently allow us to establish an explicit expression for the (on-shell) scattering amplitude. An approximation of the scattering amplitude in the weak-coupling limit is also derived.
Influence maximization based on partial network structure information: A comparative analysis on seed selection heuristics
Authors: Erkol Şirag , Yücel Gönenç
Published: September 2017

In this study, the problem of seed selection is investigated. This problem is mainly treated as an optimization problem, which is proved to be NP-hard. There are several heuristic approaches in the literature which mostly use algorithmic heuristics. These approaches mainly focus on the trade-off between computational complexity and accuracy. Although the accuracy of algorithmic heuristics are high, they also have high computational complexity. Furthermore, in the literature, it is generally assumed that complete information on the structure and features of a network is available, which is not the case in most of the times. For the study, a simulation model is constructed, which is capable of creating networks, performing seed selection heuristics, and simulating diffusion models. Novel metric-based seed selection heuristics that rely only on partial information are proposed and tested using the simulation model. These heuristics use local information available from nodes in the synthetically created networks. The performances of heuristics are comparatively analyzed on three different network types. The results clearly show that the performance of a heuristic depends on the structure of a network. A heuristic to be used should be selected after investigating the properties of the network at hand. More importantly, the approach of partial information provided promising results. In certain cases, selection heuristics that rely only on partial network information perform very close to similar heuristics that require complete network data.
Adaptive IGAFEM with optimal convergence rates: Hierarchical B-splines
Authors: Gantner Gregor , Haberlik Daniel , Praetorius Dirk
Published: September 2017

We consider an adaptive algorithm for finite element methods for the isogeometric analysis (IGAFEM) of elliptic (possibly non-symmetric) second-order partial differential equations in arbitrary space dimension [Formula: see text]. We employ hierarchical B-splines of arbitrary degree and different order of smoothness. We propose a refinement strategy to generate a sequence of locally refined meshes and corresponding discrete solutions. Adaptivity is driven by some weighted residual a posteriori error estimator. We prove linear convergence of the error estimator (respectively, the sum of energy error plus data oscillations) with optimal algebraic rates. Numerical experiments underpin the theoretical findings.
Unsaturated deformable porous media flow with thermal phase transition
Authors: Krejčí Pavel , Rocca Elisabetta , Sprekels Jürgen
Published: September 2017

In this paper, a continuum model is introduced for fluid flow in a deformable porous medium, where the fluid may undergo phase transitions. Typically, such problems arise in modeling liquid–solid phase transformations in groundwater flows. The system of equations is derived here from the conservation principles for mass, momentum, and energy and from the Clausius–Duhem inequality for entropy. It couples the evolution of the displacement in the matrix material, of the capillary pressure, of the absolute temperature, and of the phase fraction. Mathematical results are proved under the additional hypothesis that inertia effects and shear stresses can be neglected. For the resulting highly nonlinear system of two PDEs, one ODE and one ordinary differential inclusion with natural initial and boundary conditions, existence of global in time solutions are proved by means of cut-off techniques and suitable Möser-type estimates.
Examples of reflection positive field theories
Authors: Trinchero R.
Published: September 2017

The requirement of reflection positivity (RP) for Euclidean field theories is considered. This is done for the cases of a scalar field, a higher derivative scalar field theory and the scalar field theory defined on a non-integer dimensional space (NIDS). It is shown that regarding RP, the analytical structure of the corresponding Schwinger functions plays an important role. For the higher derivative scalar field theory, RP does not hold. However for the scalar field theory on a NIDS, RP holds in a certain range of dimensions where the corresponding Minkowskian field is defined on a Hilbert space with a positive definite scalar product that provides a unitary representation of the Poincaré group. In addition, and motivated by the last example, it is shown that, under certain conditions, one can construct non-local reflection positive Euclidean field theories starting from the corrected two point functions of interacting local field theories.
Three classes of non-lightlike curve evolution according to Darboux frame and geometric phase
Authors: Gürbüz Nevin
Published: September 2017

In this paper, we present three classes of non-lightlike curve evolution according to the Darboux frame and we give three geometric phases according to three classes in Minkowski 3-space.
海外华人移民劳工的阶级意识之形成与特征
Authors: 武 斌 , 刘 宏
Published: September 2017

国际移民研究的主流观点是强调身份认同（诸如种族背景，社会网络、文化）的同质性或相似性。与之相左，我们认为这一观点低估了在同种族雇主和移民劳工之间存在着的利益矛盾与冲突。上述观点源于在意大利威尼托（Veneto）及英国中东部（East Midlands）两大区域的田野调查。本文揭示了海外华人移民劳工的阶级意识，强调它与传统的种族血缘地缘关系同时并存，对于理解海外华人社会起着重要的作用。通过收集分析相关证据，本文得出以下结论：一是海外华人移民劳工的阶级意识正在形成中；二是阶级意识形成的背后涉及诸多因素，表现形式十分复杂；三是阶级意识体现了移民劳工的内部团结与外部合作程度，有助于维护他们自身的合法权益；四是现阶段移民劳工的阶级意识不能高估或夸大，因为它的作用范围有限，只是影响海外华人社会发展的诸多要素之一。
语言使用与华裔族群认同
Authors: 何 佩瑶 , 祝 家丰 , 周 芳萍
Published: September 2017

现今马来西亚华裔学生在中学阶段接受不相同的语言教育，其中包括政府国民型中学的马来文教学和华文独立中学的母语教育。多元的语言学习和复杂的语言使用影响学生的族群认同建构。本研究对这两个类别的中学生进行多层面族群认同的分析，同时探讨他们的语言使用状况，并找出族群认同和华文使用之间的关系。本研究对族群认同的定义，主要参考 Phinney（1992）的族群心理认同，并采用其问卷调查。研究分析结果发现马来西亚华裔中学生有相同的语言使用模式，并且是以华文主要用语。其次，不同学校类别的中学生也呈现相同的族群认同模式，于理性、感性和行为上均没有显著差异。研究结果也证实华文的使用和中学生的族群认同之间存在一个正面的关系。研究所得分析肯定了马来西亚华裔对母语教育的坚持。再者，华裔中学生通过学习华文，能更广泛地使用华文，从而加深族群历史文化的认识，以建构马来西亚华裔族群认同。在马来西亚多元语境下有意义地学习和使用华文必能影响学生的族群认同建构。
On the minimum vertex covering transversal dominating sets in graphs and their classification
Authors: Vasanthi R. , Subramanian K.
Published: September 2017

Let [Formula: see text] be a simple and connected graph. A dominating set [Formula: see text] is said to be a vertex covering transversal dominating set if it intersects every minimum vertex covering set of [Formula: see text]. The vertex covering transversal domination number [Formula: see text] is the minimum cardinality among all vertex covering transversal dominating sets of [Formula: see text]. A vertex covering transversal dominating set of minimum cardinality [Formula: see text] is called a minimum vertex covering transversal dominating set or simply a [Formula: see text]-set. In this paper, we prove some general theorems on the vertex covering transversal domination number of a simple connected graph. We also provide some results about [Formula: see text]-sets and try to classify those sets based on their intersection with the minimum vertex covering sets.