bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethics in Telehealth: Comparison between Guidelines and Practice-based Experience -the Case for Learning Health Systems
Authors: Kuziemsky Craig E. , Hunter Inga , Gogia Shashi B. , lyenger Sriram , Kulatunga Gumindu , Rajput Vije , Subbian Vignesh , John Oommen , Kleber Araujo , Mandirola Humberto F. , Florez-Arango Jose , Al-Shorbaji Najeeb , Meher Sushil , Udayasankaran Jai Ganesh , Basu Arindam
Published: April 2020

Objectives: To understand ethical issues within the tele-health domain, specifically how well established macro level telehealth guidelines map with micro level practitioner perspectives.

Methods: We developed four overarching issues to use as a starting point for developing an ethical framework for telehealth. We then reviewed telemedicine ethics guidelines elaborated by the American Medical Association (AMA), the World Medical Association (WMA), and the telehealth component of the Health Professions council of South Africa (HPCSA). We then compared these guidelines with practitioner perspectives to identify the similarities and differences between them. Finally, we generated suggestions to bridge the gap between ethics guidelines and the micro level use of telehealth.

Results: Clear differences emerged between the ethics guidelines and the practitioner perspectives. The main reason for the differences were the different contexts where telehealth was used, for example, variability in international practice and variations in the complexity of patient-provider interactions. Overall, published guidelines largely focus on macro level issues related to technology and maintaining data security in patient-provider interactions while practitioner concern is focused on applying the guidelines to specific micro level contexts.

Conclusions: Ethics guidelines on telehealth have a macro level focus in contrast to the micro level needs of practitioners. Work is needed to close this gap. We recommend that both telehealth practitioners and ethics guideline developers better understand healthcare systems and adopt a learning health system approach that draws upon different contexts of clinical practice, innovative models of care delivery, emergent data and evidence-based outcomes. This would help develop a clearer set of priorities and guidelines for the ethical conduct of telehealth.
Validity of Shunt Pumping Test as a Screening Modality for Shunt Block: An Experimental Study
Authors: Sharma Manish , Kumar Suman
Published: April 2020

Purpose To ascertain the validity and efficacy of shunt compression test in evaluating a blocked shunt.

Methods An experimental model was created using a Chhabra shunt, and 25 physicians with 1 to 3 years of experience in neurosurgery were asked to assess the block in the model where artificial blocks were created.

Results The sensitivity of test to detect any block was found to be 0.76 (95% confidence interval [CI]: 0.7–0.81), specificity was 0.71 (0.59–0.81), positive likelihood ratio 2.59 (1.81–3.7), and negative likelihood ratio 0.34 (026–0.45). Odds ratio for proximal block was 4.33 (95% CI: 2.01–8.92), and for distal block, it was 10.63 (95% CI: 10.63–22.32). Furthermore, predictive probability for shunt block was maximum when both the ends were considered to be blocked by the investigator and the test was found to be poor in predicting a patent shunt.

Conclusion This is not a very reliable screening test to detect presence of a shunt block. Predicted probability for shunt block was maximum when both the ends were considered to be blocked by the investigator. This study results are not in conformity with the previously held belief that delayed refilling of chamber would clearly aid the diagnosis of proximal end block. It is strongly felt that a deliberate training of shunt compression test would aid a better diagnostic ability.
Pantoea agglomerans as a Cause of Foreign Body Related Septic Arthritis in a Child: Case Report and Review of the Literature
Authors: Demircan Eda , Kasap-Demir Belde , Şahin Hilal , Bayram Arzu , Kanık Ali
Published: April 2020

A previously healthy 7-year-old female patient was admitted with pain and swelling in her left knee and fever. She had injured her left knee 2 weeks ago. Her mother had noticed a protrusion on her knee that she had thought to be associated with a fracture. After being examined by an orthopaedist, fracture was ruled out and the protrusion disappeared. On her admission with fever and painful swollen knee, Pantoea agglomerans was identified in the synovial fluid. On the basis of the close association of P. agglomerans infections with penetrating trauma, the patient and her mother were asked about a history of penetration during the fall, but they denied any possible penetration of a vegetative element since she had fallen on a concrete floor. Although she was treated with antibiotics reported to be sensitive in the antibiogram, she had recurrent septic arthritis. Repeated magnetic resonance imaging (MRI) interpretations revealed a foreign body in the medial aspect of the left knee. The patient underwent arthrotomy and a plant thorn was removed. The postoperative course was uneventful. We reported this case to emphasize that a vegetative foreign body should be kept in mind in septic arthritis caused by P. agglomerans and/or in those resistant to antibiotics. In addition, we reviewed the literature including children having joint and/or bone infections caused by P. agglomerans.
Defects assisted visible light sensing in Zn1 − x(GaSi)x/2O
Authors: Mishra Prashant Kumar , Ayaz Saniya , Kissinquinker Bungkiu , Sen Somaditya
Published: April 2020

Hexagonal wurtzite Zn1 − x(SiGa)x/2O (x = 0, 0.0156, 0.0234, and 0.0312) with a space group of P63mc was synthesized using the solgel method. Investigations of structural, optoelectronic, and photo-sensing study of these samples were performed. Improved crystallinity of the co-doped samples was observed from structural and vibrational studies. The effect of higher charges Ga3+ and Si4+ on various latent defects of ZnO was studied. A predominantly n-type carrier concentration was noticed in all samples. Enhancement in carrier concentration, mobility, and conductivity was observed in the Ga–Si co-doped samples. In this work, the impact of intrinsic defects on photosensing was also studied. UV (290 nm) and visible lights of different wavelengths, blue (450 nm), green (540 nm), and red (640 nm), were sensed. The sensitivity toward the above-mentioned wavelengths was compared for all the samples. Photocurrent was modified with the illumination wavelengths (290, 450, 540, and 640 nm) and also varied with co-doping. A correlation of structural, defect, and optoelectronic properties was discussed, which revealed improved photo-response currents for UV light and for the blue, green and red lights. It was observed that pure ZnO is more sensitive to UV light. However, higher substitution yields better sensitivity for red light. The same result was found for green and blue light sensing.
Survey on negative line loss rate of transformer region: Rectification measures and challenges
Authors: Wu Weijiang , Zhou Yu , Li Ping , Sun Guoqiang , Lin He , Xu Gaojun
Published: April 2020

The system architecture and method for monitoring and statistical analysis of the line losses of the transformer region are introduced. The statistical method for the current system is adopted to determine the functional relationship between the statistical line loss, statistical line loss rate, and gateway power supply of the transformer region. Moreover, the trend of the parameters in a typical residential area is analyzed. Based on the analysis, the three reasons for the formation of transformer regions with a reasonable rate of line loss and the measures for the unreasonable rates are summarized. It is recommended that the line loss monitoring and analysis system should include the functions of approval, examination, and verification, as well as automatic identification. The transformer region without any abnormality in the line loss should be exempt from the review. For the transformer region with a residential elevator, however, the statistical rules should be modified to calculate the actual line loss rate. Finally, the challenges in the management of the transformer region with a negative line loss rate are presented. It is concluded that the application of transformer–customer relationship automatic identification technology and artificial intelligence abnormality diagnosis can significantly improve the efficiency of line loss management.
Understanding the large strain behavior in the lead-free doped Bi1/2(Na0.78K0.22)1/2TiO3–BiMg1/2Ti1/2O3 (BNKT-BMT) piezoelectric system
Authors: Mostovych Nicholas , Won Sung Sik , Kim Ill Won , Kim Seung-Hyun , Kingon Angus I.
Published: April 2020

The ternary solid solution Bi1/2(Na0.78K0.22)1/2TiO3-BiMg1/2Ti1/2O3 (BNKT-BMT) was investigated for high-strain actuator applications. This study of the BNKT-BMT system looked at the macroscopic properties as a function of BMT doping, temperature, and virgin vs poled states in order to gain new insights into the impact of quenched compositional disorder on non-ergodic to ergodic behavior in relaxor ferroelectrics. A gradual transition toward ergodic relaxor ferroelectric behavior was observed in the electric field induced polarization and strain of the BNKT-BMT system with an increase in concentration of BMT and an increase in temperature. BNKT-0%BMT exhibits a remarkable room temperature large-signal piezoelectric strain equivalent to an effective piezoelectric coefficient (d33*) >1000 pm/V at 5.5 kV/mm during the first virgin drive cycle due to the significant strain arising from an irreversible field induced phase transition characteristic of a non-ergodic relaxor ferroelectric. The maximum room temperature large-signal effective piezoelectric coefficient d33* observed for reversible bipolar cycling drive conditions was 685 pm/V at 5.5 kV/mm for BNKT-4%BMT. At elevated temperatures, compositions with reduced BMT exhibited superior d33* performance until a relative maximum d33* was reached and strain performance subsequently declined. This is interpreted in terms of competing strain mechanisms in relaxor ferroelectrics that vary with an increase in ergodicity of the system, as governed by factors such as composition and temperature. The work has implications for industrial actuator systems, such as those in inkjet printers.
Slight lattice changes caused by acoustic propagation can be directly imaged
Authors: Bandari Anashe
Published: April 2020

Simulations reveal the ability of ultrafast electron microscopy to image vibrational and mechanical dynamics in a material.
Accumulative roll bonding of Cu–Zr nanolaminate: Atomistic-scale investigation of structural evolution and grain orientation scatter dependence on rolling parameters
Authors: Reddy K. Vijay , Pal Snehanshu
Published: April 2020

Understanding the role of processing parameters on the atomic-level deformation mechanism and structural evolution during an accumulative roll bonding process is a necessity in scaling-up the production of metallic nanolaminates. In this study, we have developed a novel atomistic model of “nano-rolling” to investigate the effect of roller speed and temperature on the deformation behavior of Cu–Zr nanolaminate. The model takes both the compressive and the shear forces into consideration during the rolling process, making it efficient in reproducing the actual deformation mechanisms. Results from the mobility analysis have shown that the final velocity of the rolled specimen obtained from the simulation is close to the theoretical value. The phenomenon of texture evolution is also analyzed through orientation scatter analysis, where it is revealed that increasing the roller speed facilitates the formation of low angle grain boundaries and twins at lower temperatures. However, texture weakening of the rolled specimen has been observed at elevated temperatures due to the increase in fine grained equiaxed structures. Concurrently, the roller speed and temperature dependent deformation mechanism of the Zr-layer is also captured through atomic displacement analysis, which shows the formation of a smooth and wavy Zr-layer. Through Voronoi analysis, it is revealed that the wavy profile of the Zr-layer has a direct influence on the formation of metallic glass at the Cu–Zr interface as a higher number of icosahedral clusters are observed in specimens with a wavy Zr-layer.
Unusual behavior of Stokes–Einstein relation in liquid mixtures
Authors: Das Arya , Ali Sk. Musharaf
Published: April 2020

The Stokes–Einstein (S–E) relation is well studied for pure liquids. Here, we report the applicability of the S–E relation in liquid mixtures. The breakdown of the S–E relation in organic and aqueous liquid mixtures might be attributed to the self-diffusion coefficient, shear viscosity, or the hydrodynamics radius of the solute–solvent species, which are strongly correlated. The hydrodynamic radius must be adjusted with an effective radius that accounts for the size of the diffusing solute wetted by the solvent molecules. Furthermore, the mutual diffusivity could be the correct option instead of self-diffusivity for the prediction of hydrodynamic radius using the S–E relation, as the mobility of the solute is strongly coupled with the mobility of the solvent molecules. The theoretical hydrodynamic radius obtained from the S–E relation is predicted to be well correlated with the distance between the solute and solvent center of mass calculated from molecular dynamics simulations. The acceptance of this effective hydrodynamic radius is ensured by testing its applicability for a large collection of liquid mixtures.
Machine learning models of the energy curvature vs particle number for optimal tuning of long-range corrected functionals
Authors: Fabrizio Alberto , Meyer Benjamin , Corminboeuf Clemence
Published: April 2020

The average energy curvature as a function of the particle number is a molecule-specific quantity, which measures the deviation of a given functional from the exact conditions of density functional theory. Related to the lack of derivative discontinuity in approximate exchange-correlation potentials, the information about the curvature has been successfully used to restore the physical meaning of Kohn–Sham orbital eigenvalues and to develop non-empirical tuning and correction schemes for density functional approximations. In this work, we propose the construction of a machine-learning framework targeting the average energy curvature between the neutral and the radical cation state of thousands of small organic molecules (QM7 database). The applicability of the model is demonstrated in the context of system-specific gamma-tuning of the LC-ωPBE functional and validated against the molecular first ionization potentials at equation-of-motion coupled-cluster references. In addition, we propose a local version of the non-linear regression model and demonstrate its transferability and predictive power by determining the optimal range-separation parameter for two large molecules relevant to the field of hole-transporting materials. Finally, we explore the underlying structure of the QM7 database with the t-SNE dimensionality-reduction algorithm and identify structural and compositional patterns that promote the deviation from the piecewise linearity condition.
Water-wave interaction with submerged porous elastic disks
Authors: Zheng S. , Meylan M. H. , Greaves D. , Iglesias G.
Published: April 2020

Hydroelastic interaction between water waves and submerged porous elastic disks of negligible thickness in water of finite depth is investigated under the assumption of small amplitude water-wave motion and structural response. The disks are either simply supported or clamped at their edges. Wave power can be absorbed/dissipated by the disks due to their porosity. A theoretical model based on the linear potential flow theory and eigenfunction matching method is developed to solve the wave scattering problem of the submerged disks. An indirect method, employing Kochin functions, is derived based on Green’s theorem to evaluate the wave power absorption/dissipation, and it produces accurate results at a lower computational cost than the conventional method. This theoretical model is applied to perform a multi-parameter study on the performance of a single submerged porous elastic disk, and an array of disks as well, particularly, in terms of near-field wave motion, disk deflection, far-field scattering coefficient, and wave power absorption/dissipation. Deploying multiple disks in an array is found to be a more promising approach for wave power absorption/dissipation compared to enlarging the area of a single disk.
Microscopic sensors using optical wireless integrated circuits
Authors: Cortese Alejandro J. , Smart Conrad L. , Wang Tianyu , Reynolds Michael F. , Norris Samantha L. , Ji Yanxin , Lee Sunwoo , Mok Aaron , Wu Chunyan , Xia Fei , Ellis Nathan I. , Molnar Alyosha C. , Xu Chris , McEuen Paul L.
Published: April 2020

Significance

The smallest objects resolvable by the unaided human eye are approximately 100 μm in size. This limit sets a boundary between the familiar and the microscopic, the visible and invisible worlds. Here we describe the fabrication of tiny wireless sensors, optical wireless integrated circuits (OWICs) for optical wireless integrated circuits. OWICs are truly microscopic in size, visible to the naked eye at best as a tiny, undifferentiated speck, yet they can sense their environment and report the information back to the macroscopic world. They have potential applications in many areas of science and technology, ranging from neuroscience to chemical sensing.
Language processing in advanced learners of English
Authors: Schilk Marco
Published: April 2020

The production and processing of collocations and formulaic language is a field of growing interest in corpus linguistics and experimental psycholinguistics. In the past this fascinating field at the interface of grammar and the lexicon has been mainly studied based on English native speakers, while research focusing on second language speakers and language learners has been comparatively rare. This book proposes an integration of corpus-based and experimental methods by analysing language processing of collocation by advanced learners of English. In using corpus-derived collocational stimuli of native-like and learner-typical language use in an experimental setting, it shows how advanced German L1 learners of English process native-like collocations, L1-based interferences and non-collocating lexical combinations. This book is of interest to anyone interested in the psycholinguistic validity of collocation from a bilingual point of view, as it explores methods of tracking collocational processing of speakers working with different sets of ‘collocational preferences’.
Supporting foreign languages in an Anglophone world
Authors: Porter Alison , Myles Florence , Tellier Angela , Holmes Bernardette
Published: April 2020

Foreign language (FL) learning in English primary schools, statutory provision for most schools since 2014, has been characterised by distinct challenges. The first issue, peculiar to Anglophone settings, concerns how language learning is valued when ubiquitous English learning rationales of economic and social capital are unhelpful. Other challenges, shared globally, relate to provision and practice such as: the importance of progression, motivation, age-appropriate pedagogy and contextual factors. Successful policy implementation in England remains elusive and continues to be characterised by a lack of cohesion, coordination and forward planning. Provision and practice are problematic and linked to deficits in curriculum time, teacher linguistic expertise, planning and progression. This article will explore how both language and broader education policy in England have created conflicting forces for the sustainability of the foreign languages initiative in primary schools. It will examine how networks of researchers, teachers, educationalists and policy makers are supporting implementation through national and local education stakeholder engagement. Through collaboration and co-construction, research-informed practical suggestions are promoted, coupled with the development of solution-focused research agendas.
Language education policy and practice in state education systems
Authors: Hayes David
Published: April 2020

This article considers the complexity of factors involved in developing foreign language educational policy, with
a particular focus on English at the primary level, which fosters student achievement in state educational systems. It examines
both those factors which underpin a successful education system in general (such as equitable provision for all socio-economic
groups within the society) as well as factors which affect language teaching policy and practice for primary school learners in
particular (such as a curriculum which offers teachers and children opportunities to engage in language use which is meaningful in
their contexts). The status and training of highly skilled foreign language teachers for primary aged learners is also accorded
due weight. Using case studies of English as a foreign language in the school systems of South Korea and Thailand, the article
emphasizes the importance of policies which are appropriate to their educational and socio-cultural context and realistic
objectives for young children’s early engagement with learning a foreign language if it is to be a positive experience in primary
schools.
A critical analysis of the German public debate about an early start in primary foreign language education
Authors: Wilden Eva , Porsch Raphaela
Published: April 2020

‘The early start is (not) effective’ is one of the arguments often used in the political debate about early start policies in foreign language (FL) education in Europe and beyond. This paper sets out to explore the central arguments repeatedly used in the political discourse and media coverage on primary FL education in the German context. These arguments, which sometimes are used by both supporters and critics of the early start, will be critically discussed with reference to available empirical findings. As the current political debate in Germany is closely linked to its particular context and the conditions of primary FL education, the paper also provides a short overview of the current situation of primary FL education and primary teacher education in Germany. It will conclude by suggesting potential changes to the current organisation of primary FL education in Germany.
Global language policies
Authors: Enever Janet
Published: April 2020

This paper reviews patterns of primary foreign language policy across the world, analysing the development of policy and subsequent implementation processes with reference to the particular local histories and current politics at regional, national and supranational levels of governance. In providing an overview of current provision and recent research the paper draws on the theoretical frame of historical materialism to consider the impact of global forces in three economic regions of the world today in contexts where substantial growth in the provision of primary foreign languages is now evident – described by Graddol, with reference to English specifically, as a process of “moving up the educational escalator”. Themes threaded throughout the paper include power and resistance to soft policy, perspectives of social justice and an emerging global expectation for accountability and transparency with regard to primary foreign languages policy. In reviewing recent developments in the field of educational policy research the final section raises questions around the extent to which teachers may shape language policy in education, acting as critical interpreters of policy in an agentive role, adapting and refining national and local curriculum policy to meet the needs of their learners.
La conversion du roi Label au milieu des bêtes sauvages
Authors: Barale Elisabetta
Published: April 2020

Dans son édition de l’Estoire del Saint Graal, J.-P. Ponceau affirme que la seconde partie de l’Estoire dou roi Labiel, conte anonyme transmis par le manuscrit Paris, BnF, fr. 24430, constitue la copie tardive du récit dont l’auteur de l’épopée du Graal se serait inspiré pour rédiger l’épisode dans lequel le jeune Célidoine convertit le roi Label au christianisme. Cette contribution se propose de mettre en évidence les ressemblances et les différences entre les deux textes ainsi que de réfléchir sur les procédés de réécriture que le rédacteur de l’ESG aurait adopté afin d’insérer cette histoire secondaire dans l’économie de son roman. Une attention particulière sera accordée à une modification significative: l’emploi de références aux animaux sauvages dans les moments-clés du récit – les rêves du roi et l’épilogue – afin de marquer les étapes du parcours de conversion.
Le couronnement de l’aigle
Authors: Laïd Baptiste
Published: April 2020

Le recueil de fables de Marie de France, le premier recueil de fables en français, reprend à plusieurs reprises, mais toujours dans des fables narrativement isolées, le motif de la cour du qui connaît, presque simultanément, une expansion majeure en français sous la forme du Roman de Renart. Cette métaphore politique, dans laquelle le lion-roi est entouré d’animaux incarnant divers types sociaux, s’accompagne cependant dans le recueil du développement parallèle d’une société aviaire nettement distincte de celle des quadrupèdes. C’est l’aigle qui y règne, l’autour est son sénéchal et cette cour des oiseaux est confrontée à des conflits nouveaux qui permettent d’illustrer des problématiques politiques différentes de celles de la cour des animaux. Quoique les fables qui traitent de cet autre monde, certaines antiques, d’autres entièrement nouvelles, soient éparpillées dans le recueil, elles sont néanmoins reliées par un personnel et des thèmes précis, inscrivant l’ensemble dans une pratique narrative à mi-chemin entre la fable et l’épopée animale. Un tel tissage de fables sous forme de récit discontinu est inédit dans un recueil de fables.
Reinardus en Bohême
Authors: Nejedlý Martin
Published: April 2020

L’article retrace la représentation du renard dans les sources tchèques à travers les siècles. En partant de
l’image du prince perfide de la Chronique de Kosmas (début du XIIe siècle) et du traître flagorneur
dans la Chronique en vieux tchèque dite de Dalimil (début du XIVe siècle), en passant par le renard rusé des fables en
tchèque et par la figure du mauvais conseiller des rois dans le miroir des princes de Smil Flaška de Pardubice (XIVe
siècle), cette veine de représentation négative aboutit au XVe siècle, lors de la révolution hussite, à un portrait
très défavorable de la bête rousse – aussi bien dans le camp de la reforme (La querelle de Prague et de Kutná
Hora, vers 1420) que dans le camp catholique (Pavel Žídek, vers 1463). L’image change peu à peu grâce à l’œuvre de
Dubravius et de Konáč de Hodiškov (XVIe siècle) et avant tout grâce aux manuels de deux jésuites du siècle suivant,
Melchior Hanel et Václav Jandit, présentant le sage renard enseignant les autres animaux. L’adaptation de la matière des premières
branches françaises du Roman de Renart en tchèque (par l’intermédiaire de l’allemand) date de 1845. Au
XXe siècle, ses avatars aboutissent à la figure du héros (ou de l’héroïne) sympathique: la petite renarde rusée,
transcrite en musique par Leoš Janáček, la Compagne malicieuse renarde de Josef Lada et le cynique et rusé « renard roux »
commentant l’histoire tchèque dans la série BD culte Images de l’Histoire tchèque .
The bear myth in Edmund Spenser’s Faerie Queene
Authors: Russell Jesse
Published: April 2020

The animals in Edmund Spenser’s Faerie Queene have been skillfully treated as allegories, but these creatures also deserve a look from a mythological perspective. Perhaps the most important animal to begin with is the bear, which French historian Michel Pastoureau recently has explored in his monumental, The Bear: History of a Fallen King. Using many of Pastoureau’s insights (and criticizing others), we can make room for an analysis of The Faerie Queene as a text in which pre-modern and even ‘prehistorical’ images of bears meet with Early Modern views of the noble creature, demonstrating that, despite Spenser’s allegorical tendencies, the bears in The Faerie Queene still speak.
La chanson de geste et la mise en scène de personnages entre humanité et animalité
Authors: Ribémont Bernard
Published: April 2020

L’objet de cet article est de traiter, dans le corpus épique médiéval, des rapports humanité/bestialité qui peuvent apparaître dans les textes. Nous tenterons d’analyser les différents motifs qui sont en jeu ainsi que les fonctions littéraires de la mise en scène d’animaux en rapport direct avec le monde des humains. Ceci nous conduira à considérer des animaux étranges, fantastiques et merveilleux, mais aussi des êtres humains revêtant des caractéristiques ‘bestiales’. Nous croiserons ainsi certains archétypes (le géant, le monstrueux, l’hybride, etc.) parfois inattendus dans un corpus souvent considéré comme monolithique et centré sur des personnages ne devant pas (trop) sortir du cadre de la société féodale, de ses guerres et croisades.
La frontière entre l’homme et l’animal
Authors: Scala Gavino
Published: April 2020

L’objectif de la présente contribution est d’approfondir les réflexions sur les différents types de lois dans la première traduction française (1282) du De regimine principum et de vérifier la manière dont est considéré l’animal dans ce discours politique. Le droit des animaux y est placé hiérarchiquement sous le droit naturel et il paraît intéressant d’examiner le passage de la source au volgarizzamento en fonction de ces arguments. On verra que la version française abrège fortement les argumentations philosophiques et perd souvent la densité du discours didactico-moral de la source latine. La différence entre homme et animal est l’argument du chapitre xxiii (III livre, ii partie), qui est aussi significatif d’un point de vue philologique: il représente un élément important pour mettre en lumière les rapports entre les manuscrits. Alors qu’un petit groupe de témoins omet complètement le chapitre, la majorité comporte la rubrique ainsi qu’un petit résumé avec des renvois au latin, et trois manuscrits présentent la même rubrique du groupe précédent, mais y ajoutent le texte latin du chapitre en question.
A machine learning workflow for molecular analysis: application to melting points
Authors: Sivaraman Ganesh , Jackson Nicholas E , Sanchez-Lengeling Benjamin , Vázquez-Mayagoitia Álvaro , Aspuru-Guzik Alán , Vishwanath Venkatram , de Pablo Juan J
Published: April 2020

Computational tools encompassing integrated molecular prediction, analysis, and generation are key for molecular design in a variety of critical applications. In this work, we develop a workflow for molecular analysis (MOLAN) that integrates an ensemble of supervised and unsupervised machine learning techniques to analyze molecular data sets. The MOLAN workflow combines molecular featurization, clustering algorithms, uncertainty analysis, low-bias dataset construction, high-performance regression models, graph-based molecular embeddings and attribution, and a semi-supervised variational autoencoder based on the novel SELFIES representation to enable molecular design. We demonstrate the utility of the MOLAN workflow in the context of a challenging multi-molecule property prediction problem: the determination of melting points solely from single molecule structure. This application serves as a case study for how to employ the MOLAN workflow in the context of molecular property prediction.
Long-term stability of ready-to-use 1-mg/mL midazolam solution
Authors: Gilliot Sixtine , Masse Morgane , Feutry Frédéric , Barthélémy Christine , Décaudin Bertrand , Genay Stéphanie , Odou Pascal
Published: April 2020

Purpose

Midazolam is a benzodiazepine derivative commonly used in intensive care units to control sedation. Its use requires dilution of a 5-mg/mL commercial solution to a target concentration of 1 mg/mL. A study was conducted to evaluate the stability of diluted ready-to-use 1-mg/mL midazolam solutions over 365 days when stored in cyclic olefin copolymer vials or polypropylene syringes.

Methods

A specific stability-indicating high-performance liquid chromatography coupled with UV detection method was developed for midazolam hydrochloride and validated for selectivity, linearity, sensitivity, precision, and accuracy. Three storage conditions were tested: –20°C ± 5°C, 5°C ± 3°C, and 25°C ± 2°C at 60% ± 5% relative humidity. Half of the vials were stored upside down to test for the absence of interaction between midazolam and the stopper. Particle contamination, sterility, and pH were assessed.

Results

The limit of stability was set at 90% of the initial concentration. After 1 year’s storage at –20°C and 5°C, concentrations remained superior to 90% under all storage conditions. At 25°C, stability was maintained up to day 90 in syringes (mean [SD], 92.71% [1.43%]) and to day 180 in upright and upside-down vials (92.12% [0.15%] and 91.57% [0.15%], respectively). No degradation products were apparent, no variations in pH values were detected, and containers retained their sterility and conformity with regard to any specific contamination during the study.

Conclusion

The evaluated 1-mg/mL midazolam solution was stable over a 1-year period when stored at a refrigerated (5°C) or frozen (–20°C) temperature in both vials and syringes; with storage at 25°C, the stability duration was lower. The preparation of ready-to-use midazolam solutions by a hospital pharmacy is compatible with clinical practice and could help to decrease risks inherent in dilution in care units.
Assessment of Data Supporting the Efficacy of New Antibiotics for Treating Infections Caused by Multidrug-resistant Bacteria
Authors: Yahav Dafna , Tau Noam , Shepshelovich Daniel
Published: April 2020

Background

Infections caused by multidrug-resistant (MDR) bacteria are a major public health threat. We aimed to assess the data supporting US Food and Drug Administration (FDA) approval of new agents aimed to treat MDR bacterial infections and the data provided by postmarketing studies.

Methods

We identified all drugs with in vitro activity against MDR bacteria initially approved by the FDA between January 2010 and December 2018. Characteristics of trials supporting approval and regulatory pathways were collected from Drugs@FDA. Characteristics of postmarketing studies were extracted from drug labels and ClinicalTrials.gov entries effective 1 June 2019.

Results

Initial approval of 11 newly approved antibiotics with anti-MDR activity was supported by 20 trials, all with noninferiority design. All initially approved indications were for common infections, mostly acute bacterial skin and skin-structure infections, regardless of causative microorganism. The proportion of MDR bacteria in most trials was low (<10% for gram-negative infections, <1% for gram-positive pneumonia). Most trials (90%) excluded immunocompromised and critically ill patients. Of 16 additional postmarketing randomized controlled trials identified through ClinicalTrials.gov, only 2 exclusively included infections caused by MDR bacteria, comprising 116 patients. No drug was granted accelerated approval, which would mandate postmarketing efficacy studies.

Conclusions

The approval of new drugs with potential clinical activity against MDR bacteria is supported by trials evaluating infections caused by non-MDR organisms, using noninferiority design and excluding the patients most likely to require these agents. Subsequent postmarketing efficacy data against these organisms are scarce. Healthcare professionals and regulators should demand more robust data to support clinical decision making.
Ambiguity, Low Risk-Free Rates and Consumption Inequality
Authors: Luo Yulei , Nie Jun , Young Eric R
Published: April 2020

Macroeconomists failed to predict the Great Recession, suggesting that the existing macroeconomic models may have been misspecified. Bearing in mind this potential misspecification or ‘model uncertainty’, how do agents’ optimal decisions change? Furthermore, how large are the welfare costs of model misspecification? To shed light on these questions, we develop a tractable continuous-time general equilibrium model to show that a fear of model misspecification reduces both the equilibrium interest rate and the relative inequality of consumption to income, making the model’s predictions closer to the data. Our quantitative analysis shows that the welfare costs of model uncertainty are sizable.
Advanced interatrial block and P-wave duration are associated with atrial fibrillation and stroke in older adults with heart disease: the BAYES registry
Authors: Martínez-Sellés Manuel , Elosua Roberto , Ibarrola Martin , de Andrés Mireia , Díez-Villanueva Pablo , Bayés-Genis Antoni , Baranchuk Adrian , Bayés-de-Luna Antonio ,   for the BAYES Registry Investigators
Published: April 2020

Aims

Advanced interatrial block (IAB), is an unrecognized surrogate of atrial dysfunction and a trigger of atrial dysrhythmias, mainly atrial fibrillation (AF). Our aim was to prospectively assess whether advanced IAB in sinus rhythm is associated with AF and stroke in elderly outpatients with structural heart disease, a group not previously studied.

Methods and results

Prospective observational registry that included outpatients aged ≥70 years with structural heart disease and no previous diagnosis of AF. Patients were divided into three groups: normal P-wave duration (<120 ms), partial IAB (P-wave duration ≥120 ms, positive in the inferior leads), and advanced IAB [P-wave duration ≥120 ms, biphasic (plus/minus) morphology in the inferior leads]. Among 556 individuals, 223 had normal P-wave (40.1%), 196 partial IAB (35.3%), and 137 advanced IAB (24.6%). After a median follow-up of 694 days, 93 patients (16.7%) developed AF, 30 stroke (5.4%), and 34 died (6.1%). Advanced IAB was independently associated with AF –[hazard ratio (HR) 2.9, 95% confidence interval (CI) 1.7–5.1; P < 0.001], stroke [HR 3.8, 95% CI 1.4–10.7; P = 0.010), and AF/stroke (HR 2.6, 95% CI 1.5–4.4; P = 0.001). P-wave duration (ms) was independently associated with AF (HR 1.05, 95% CI 1.03–1.07; P < 0.001), AF/stroke (HR 1.04, 95% CI 1.02–1.06; P < 0.001), and mortality (HR 1.04, 95% CI 1.00–1.08; P = 0.021).

Conclusions

The presence of advanced IAB in sinus rhythm is independently associated with AF and stroke in an elderly population with structural heart disease and no previous diagnosis of AF. P-wave duration was also associated with all-cause mortality.
Ambient vibration analysis on seismic arrays to investigate the properties of the upper crust: an example from Herdern in Switzerland
Authors: Chieppa Dario , Hobiger Manuel , Fäh Donat
Published: April 2020

The difficulty and the high cost to assess the subsurface properties led to the development of several geophysical techniques. Generally, the focus of a site study is the reconstruction of the S-wave velocity profile down to few tens to hundreds of metres (e.g. 30–300 m), but not the investigation of deeper structures, such as the transition to the crystalline basement. However, such deeper structures are of interest when seismic hazard products have to relate to a reference rock-velocity profile, for example in regional seismic hazard assessment and microzonation studies. To estimate the S-wave velocity profiles down to several kilometres, we study the potential of Rayleigh and Love waves at low (down to 0.1 Hz) and high (up to 20 Hz) frequencies using two seismic arrays of increasing size. The small array, with a maximum inter-station distance of 900 m and a recording time of 3 hr, was aimed at constraining the shallow subsurface down to about 350–400 m, while the big one, with a maximum inter-station distance of more than 29 km and 23 hr of recording had the goal to constrain the deeper structure. The arrays were deployed in northern Switzerland (east of the village of Herdern) within the Swiss Molasse basin, a sedimentary basin north of the Alps stretching from Lake Constance to Lake Geneva; its thickness increases from 800 to 900 m in the northeast to more than 5 km in the southwest. The seismic data recorded by the two arrays were analysed using the techniques developed for the analysis of small-aperture arrays. The results were inverted for the S-wave velocity profile in two steps: first, the Rayleigh and Love wave phase dispersion curves were inverted together. Secondly, the previous dispersion curves were jointly inverted with the measured Rayleigh wave ellipticity angle. The resulting S-wave velocity profiles are similar and show agreement with the available geological and geophysical data, confirming the potential of surface waves to investigate deep structures. Moreover, our analysis proves the feasibility of site characterization techniques to large arrays and the possibility to estimate the P- and S-wave velocity profiles down to 5 km, deeper than the contrast between Molasse basin and crystalline rock at around 2.1 km.
Automatic microseismic event picking via unsupervised machine learning
Authors: Chen Yangkang
Published: April 2020

Effective and efficient arrival picking plays an important role in microseismic and earthquake data processing and imaging. Widely used short-term-average long-term-average ratio (STA/LTA) based arrival picking algorithms suffer from the sensitivity to moderate-to-strong random ambient noise. To make the state-of-the-art arrival picking approaches effective, microseismic data need to be first pre-processed, for example, removing sufficient amount of noise, and second analysed by arrival pickers. To conquer the noise issue in arrival picking for weak microseismic or earthquake event, I leverage the machine learning techniques to help recognizing seismic waveforms in microseismic or earthquake data. Because of the dependency of supervised machine learning algorithm on large volume of well-designed training data, I utilize an unsupervised machine learning algorithm to help cluster the time samples into two groups, that is, waveform points and non-waveform points. The fuzzy clustering algorithm has been demonstrated to be effective for such purpose. A group of synthetic, real microseismic and earthquake data sets with different levels of complexity show that the proposed method is much more robust than the state-of-the-art STA/LTA method in picking microseismic events, even in the case of moderately strong background noise.
Automatic high-resolution microseismic event detection via supervised machine learning
Authors: Qu Shan , Guan Zhe , Verschuur Eric , Chen Yangkang
Published: April 2020

Microseismic methods are crucial for real-time monitoring of the hydraulic fracturing dynamic status during the development of unconventional reservoirs. However, unlike the active-source seismic events, the microseismic events usually have low signal-to-noise ratio (SNR), which makes its data processing challenging. To overcome the noise issue of the weak microseismic events, we propose a new workflow for high-resolution microseismic event detection. For the preprocessing, fix-sized segmentation with a length of 2*wavelength is used to divide the data into segments. Later on, 191 features have been extracted and used as the input data to train the support vector machine (SVM) model. These features include 63 1-D time/spectral-domain features, and 128 2-D texture features, which indicate the continuity, smoothness, and irregularity of the events/noise. The proposed feature extraction maximally exploits the limited information of each segment. Afterward, we use a combination of univariate feature selection and random-forest-based recursive feature elimination for feature selection to avoid overfitting. This feature selection strategy not only finds the best features, but also decides the optimal number of features that are needed for the best accuracy. Regarding the training process, SVM with a Gaussian kernel is used. In addition, a cross-validation (CV) process is implemented for automatic parameter setting. In the end, a group of synthetic and field microseismic data with different levels of complexity show that the proposed workflow is much more robust than the state-of-the-art short-term-average over long-term-average ratio (STA/LTA) method and also performs better than the convolutional-neural-networks (CNN), for this case where the amount of training data sets is limited. A demo for the synthetic example is available: https://github.com/shanqu91/ML_event_detection_microseismic.
Prevalence and Factors Associated With Virological Treatment Failure Among Children and Adolescents on Antiretroviral Therapy Attending HIV/AIDS Care and Treatment Clinics in Dodoma Municipality, Central Tanzania
Authors: Bitwale Niyonziza Z , Mnzava David P , Kimaro Francisca D , Jacob Theopista , Mpondo Bonaventura C T , Jumanne Shakilu
Published: April 2020

Background

As the World Health Organization (WHO) and its joint partners such as USAIDS target achieving 90% sustained virological suppression among children and adolescents living with Human Immunodeficience Virus (HIV)/AIDS, it is imperative to elucidate the current prevalence and factors associated with virological treatment failure for formulation of appropriate strategies. This study was conducted determine the prevalence and factors associated with virological treatment failure among children and adolescents with HIV/AIDS on antiretroviral therapy (ART) attending HIV/AIDS care clinics in Dodoma, Central Tanzania.

Methods

This was a cross-sectional study of children aged 1–19 years attending 3 HIV/AIDS care clinics in Dodoma (central Tanzania) from November 2018 to February 2019. Sociodemographic and clinical factors were documented, HIV viral load and CD4+ T lymphocytes were evaluated for children on ART for ≥6 months. The primary outcomes were the prevalence and factors associated with viralogic treatment failure.

Results

Of 300 children enrolled, 102 (34%) had virological treatment failure. Poor adherence to ART (adjusted odds ratio [AOR] = 3.221; 95% confidence interval [CI], 1.867–5.558; P = .032), nevirapine regimen (AOR = 3.185; 95% CI, 1.473–6.886; P ≤ .001), not using cotrimoxazole prophylaxis (AOR = 25.56; 95% CI, 3.15–27.55; P = .002) and nondisclosure of HIV status to others (AOR = 7.741; 95% CI, 2.351–25.489; P = .001) were independently associated with virological treatment failure.

Conclusions

Current prevalence of virological treatment failure among children and adolescents living with HIV on ART remain high. Factors such as ART adherence, nevirapine based regimen, HIV status disclosure to those caring for the child need to be addressed to achieve sustained virological suppression.
Phenotypes Associated with 16p11.2 Copy Number Gains and Losses at a Single Institution
Authors: Chu Caleb , Wu Haotian , Xu Fangling , Ray Joseph W , Britt Allison , Robinson Sally S , Lupo Pamela J , Murphy Christine R C , Dreyer Charles F , Lee Phillip D K , Hu Peter C , Dong Jianli
Published: April 2020

Chromosome 16p11.2 is one of the susceptible sites for recurrent copy number variations (CNVs) due to flanking near-identical segmental duplications. Five segmental duplications, named breakpoints 1 to 5 (BP1–BP5), have been defined as recombination hotspots within 16p11.2. Common CNVs on 16p11.2 include a proximal ~593 kb between BP4 and BP5, and a distal ~220 kb between BP2 and BP3. We performed a search for patients carrying 16p11.2 CNVs, as detected using chromosome microarray (CMA), in the Molecular Diagnostic Laboratory at the University of Texas Medical Branch (UTMB), in Galveston. From March 2013 through April 2018, a total of 1200 CMA results were generated for germline testing, and 14 patients tested positive for 16p11.2 CNVs, of whom 7 had proximal deletion, 2 had distal deletion, 4 had proximal duplication, and 1 had distal duplication. Herein, we provide detailed phenotype data for these patients. Our study results show that developmental delay, abnormal body weight, behavioral problems, and hypotonia are common phenotypes associated with 16p11.2 CNVs.