bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of life in prostate cancer patients receiving particle radiotherapy: A review of the literature
Authors: Kawamura Hidemasa , Kubo Nobuteru , Sato Hiro , Miyasaka Yuhei , Matsui Hiroshi , Ito Kazuto , Suzuki Kazuhiro , Ohno Tatsuya
Published: September 2019

Proton and carbon ion radiotherapy for the treatment of prostate cancer is associated with a lower incidence of adverse events than conventional radiotherapy. There are few reports on the quality of life of patients treated with particle therapy, and limited patient‐reported outcomes. Analysis of quality of life is important for patients treated with radiotherapy alone or in combination with hormonal therapy, and long‐term results, dose fractionation and costs need to be included in the analysis. This information might help both clinical decision‐making and selection of appropriate treatments according to the individual needs of patients. This study reviews the literature on the quality of life and outcomes of patients treated with particle therapy, and discusses future directions.
Cardiac function modulation depends on the A‐kinase anchoring protein complex
Authors: Zhu Yan‐Rong , Jiang Xiao‐Xin , Zheng Yaguo , Xiong Jing , Wei Dongping , Zhang Dai‐Min
Published: September 2019

The A‐kinase anchoring proteins (AKAPs) are a group of structurally diverse proteins identified in various species and tissues. These proteins are able to anchor protein kinase and other signalling proteins to regulate cardiac function. Acting as a scaffold protein, AKAPs ensure specificity in signal transduction by enzymes close to their appropriate effectors and substrates. Over the decades, more than 70 different AKAPs have been discovered. Accumulative evidence indicates that AKAPs play crucial roles in the functional regulation of cardiac diseases, including cardiac hypertrophy, myofibre contractility dysfunction and arrhythmias. By anchoring different partner proteins (PKA, PKC, PKD and LTCCs), AKAPs take part in different regulatory pathways to function as regulators in the heart, and a damaged structure can influence the activities of these complexes. In this review, we highlight recent advances in AKAP‐associated protein complexes, focusing on local signalling events that are perturbed in cardiac diseases and their roles in interacting with ion channels and their regulatory molecules. These new findings suggest that AKAPs might have potential therapeutic value in patients with cardiac diseases, particularly malignant rhythm.
Practitioner Review: Treatment for suicidal and self‐harming adolescents – advances in suicide prevention care
Authors: Asarnow Joan Rosenbaum , Mehlum Lars
Published: September 2019

Background

Suicide is a leading cause of death globally in youths, and suicidal behavior and self‐harm are major clinical concerns. This article updates the previous practitioner review (2012) with the aims of integrating new research evidence, including that reported in this Special Issue.

Methods

The article reviews scientific evidence related to steps in the care pathway for identifying and treating youths with elevated suicide/self‐harm risk, specifically: (a) screening and risk assessment; (b) treatment; and (c) community‐level suicide prevention strategies.

Results

Review of current evidence indicates that major advances have been achieved in knowledge regarding clinical and preventive practices for reducing suicide and self‐harm risk in adolescents. The evidence supports the value of brief screeners for identifying youths with elevated suicide/self‐harm risk and the efficacy of some treatments for suicidal and self‐harm behavior. Dialectical behavior therapy currently meets Level 1 criteria (2 independent trials supporting efficacy) as the first well‐established treatment for self‐harm, and other approaches have shown efficacy in single randomized controlled trials. The effectiveness of some community‐based suicide prevention strategies for reducing suicide mortality and suicide attempt rates has been demonstrated.

Conclusions

Current evidence can guide practitioners in delivering effective care for youth suicide/self‐harm risk. Treatments and preventive interventions that address the psychosocial environment and enhance the ability of trusted adults to protect and support youths, while also addressing the psychological needs of youths appear to yield the greatest benefits. Although additional research is needed, our current challenge is to do our best to effectively utilize new knowledge to improve care and outcomes in our communities.
A New Statistic to Assess Fitness of Cubic‐Spline Postsmoothing
Authors: Kim Hyung Jin , Brennan Robert L. , Lee Won‐Chan
Published: September 2019

In equating, smoothing techniques are frequently used to diminish sampling error. There are typically two types of smoothing: presmoothing and postsmoothing. For polynomial log‐linear presmoothing, an optimum smoothing degree can be determined statistically based on the Akaike information criterion or Chi‐square difference criterion. For cubic‐spline postsmoothing, visual inspection has been an important tool in choosing such optimum degrees in operational settings. This study introduces a new statistic for assessing the fitness of the cubic‐spline postsmoothing method, which accommodates three conditions: (1) one standard error band, (2) deviation from unsmoothed equivalents, and (3) smoothness. A principal advantage of the new statistic proposed in this study is that an optimum degree of smoothing can be selected automatically by giving consistent amount of attention to deviation and smoothness across multiple equatings, whereas visual inspection may not be consistent.
Improvement of almond production usingBombus terrestris(Hymenoptera: Apidae) in Mediterranean conditions
Authors: Marqués Alicia , Juan Andreu , Ruíz Maurici , Traveset Anna , Leza Mar
Published: September 2019

Almond trees are one of the most important crops in the Balearic Islands. The pollination of almonds is limited to the activity of insects, and cross‐pollination is necessary for fruit development. Currently, honey bees and wild bee populations are declining considerably due to multiple causes, such as the use of pesticides, diseases and habitat loss. An alternative to increase the almond production is the use of commercial pollinators. In this long‐term (3 years) study, the effect of the introduction ofBombus terrestriscolonies on almond production was evaluated in two orchards. Two experimental designs were carried out to study the best management of this pollinator. For 2 years, all bumble bee colonies were placed in the middle of the plot and during the last year, the bumble bee colonies were distributed homogenously in the plot. Fruit set and the foraging behaviour of bumble bees during the blossoming period was determined, and the effect of different environmental variables on the visitation rate of bumble bees was assessed by means of a generalized linear mixed model (GLMM). Moreover, for the first time, the spatial distribution of fruit set was evaluated. Our results show that fruit set was significantly higher in the fields whereB. terrestrishad been introduced than in the control plots. This increased production resulted in a positive economic balance for the farmer. Moreover, bumble bees showed to prefer trees in a southwest orientation that were close to their colony. The activity of bumble bees showed to be significantly influenced by wind speed (the higher the speed the more flowers are visited byB. terrestris) and time after flowering (visitation rate decreased with days after flowering). In order to improve its management and obtain the highest possible almond production, it is important to understand the activity and behaviour of this pollinator.
“Some sort of fantasy land”: A qualitative investigation of appropriate prescribing in cancer care
Authors: Ghinea Narcyz , Wiersma Miriam , Kerridge Ian , Olver Ian , Pearson Sallie , Day Richard , Liauw Winston , Lipworth Wendy
Published: September 2019

Rationale, aims, and objectives

Increasing the appropriateness of prescribing has long been a focus of government, non‐government, and professional organizations. Progress towards this is made difficult by the fact appropriate prescribing remains inconsistently defined and is the subject of ongoing intense disagreement. In this study, we attempted to understand why this is the case within the context of oncology and haematology.

Methods

We performed a qualitative empirical analysis of semi‐structured interviews with 16 Australian oncologists and haematologists.

Results

We found that oncologists framed appropriate prescribing in terms of the following inter‐related, and at times opposed, values: civic mindedness, hope and compassion, realism, and virtue in motivation.

Conclusions

These values cannot be ranked a priori, and therefore, any definition of appropriate prescribing must be aligned with what communities want from their health system. When one value is privileged over another in any specific context, a compelling argument must be provided to justify the choice. In an era of shared decision making, patient rights, and high‐cost medicines, we need to reassess what we mean by appropriate prescribing in cancer care.
Characterization of the continuous skin fibroblastoid cell line, WE‐skin11f, from walleye (Sander vitreus)
Authors: Vo Nguyen T.K. , Katzenback Barbara A. , Kellendonk Calvin , Duong Tu , Curtis Theresa M. , Dixon Brian , Bols Niels C.
Published: September 2019

A walleye dermal fibroblastoid cell line, WE‐skin11f, was established and characterized. WE‐skin11f was immunocytochemically positive for two known dermal fibroblast protein markers: vimentin and collagen I. At passage 26, WE‐skin11f cultures contained both diploid and aneuploid populations. Ascorbic acid was required to produce extracellular collagen I fibres. Both of the skin fibroblastoid cell lines, WE‐skin11f and rainbow trout‐derived RTHDF, were not as good as the walleye caudal fin fibroblastoid cell line, WE‐cfin11f, at forming abundant dense extracellular collagen matrices. The thermobiology of WE‐skin11f was similar to that of other walleye cell lines with 26°C showing best temperature for growth and 4°C showing no growth but 100% viability. The transcript levels of b2m and mhIa genes of the major histocompatibility class I receptor in WE‐skin11f were largely similar at all temperatures examined (4, 14, 20 and 26°C). Cortisol had a variety of effects on WE‐skin11f cells: growth inhibition, morphological change from fibroblastoid to epithelioid, and enhancement of barrier function. Treatment of WE‐skin11f cells with the physiologically relevant concentration of 100 ng/ml cortisol inhibited collagen I synthesis and matrix formation. Thus, WE‐skin11f cell line could be useful in fish dermatology, endocrinology, and immunology research.
Modeling the effect of thermal combined with high‐pressure treatment on intramuscular lipid oxidation in pork
Authors: Huang Yechuan , Zhang Wen , Xiong Shuangli
Published: September 2019

The kinetics of lipid oxidation in pork during high‐pressure combined with thermal (HP‐T) treatment were studied within the condition range of 300–600 MPa and 20–60°C. Results showed that the lipid oxidation rate constants (k values) increased with increasing pressure or temperature. Lipid primary oxidation exhibited higher k values than secondary oxidation at each investigated pressure–temperature. At the studied pressure range, the temperature dependence (activation energy) of both primary lipid oxidation and secondary lipid oxidation rate constants decreased with increasing pressure; while the highest sensitivity of lipid oxidation rate constants to pressure (activation volume) was observed at 30°C for primary oxidation, and 40°C for secondary oxidation. Four kinetic models for lipid oxidation basing on Arrhenius and Eyring equation were established successfully.

Practical Applications

High pressure processing plays a more and more important role in food industry, however, the application of this technology in animal products is limited because of increased lipid oxidation due to high pressure treatment, the reason for which reported by different authors is inconsistent. To better understand the real causes of lipid oxidation induced by high pressure and control it purposefully, the kinetic models for lipid primary and secondary oxidation basing on Arrhenius and Eyring equation were established successfully in this article. In practice, the predetermined combinations of temperature and pressure during HP‐T treatment of pork could be evaluated by predicting the effect of these conditions on lipid oxidation using the models established in this study, and thereafter modifying and selecting the optimal treatment conditions. The models should be validated or modified when applied to other types of meat basing on a larger number of experiments.
The Cognitive Effects of Experiencing and Observing Subtle Racial Discrimination
Authors: Ozier Elise M. , Taylor Valerie Jones , Murphy Mary C.
Published: September 2019

Most research on the cognitive effects of subtle racial discrimination among racial and ethnic minorities focuses on direct experiences of it wherein stigmatized individuals are the targets of discriminatory treatment. However, it is not necessary for people to be the direct target of discriminatory behavior to experience the negative consequences associated with it. Although exposure to discriminatory behavior is increasingly common given the accessibility of smartphones and social media, we know relatively little about how this exposure affects people's executive functioning. Here, we provide a systematic, comparative review of the extant literature on the effects of (a) personally experiencing versus (b) observing instances of subtle racial discrimination toward others on three core executive functions: inhibition, shifting, and updating. We highlight where more work is needed to understand the cognitive consequences of observing discrimination and we provide initial evidence that observing subtle discrimination impairs updating—a previously unexplored relationship. Finally, we discuss the implications of executive function impairment due to observing and experiencing subtle discrimination for long‐term outcomes, such as academic achievement, employment, and mental health.
Identification of novel key lncRNAs involved in periodontitis by weighted gene co‐expression network analysis
Authors: Jin Su‐Han , Zhou Rui‐Hao , Guan Xiao‐Yan , Zhou Jian‐Guo , Liu Jian‐Guo
Published: September 2019

Background and Objective

Periodontitis is a multifactorial disease that can lead to the progressive destruction of dental support tissue. However, the detailed mechanisms and specific biomarkers involved in periodontitis remain to be further studied. Recently, long non‐coding RNAs (lncRNAs) have been found to play a more important role than other types of RNAs. In our study, we analysed the expression of lncRNAs in periodontitis by analysing GSE16134.

Material and Methods

We identified highly correlated genes by analysing GSE16134 with weighted gene co‐expression network analysis (WGCNA) and identified 50 hub lncRNAs that were dysregulated. Then, we used the Linear Models for Microarray Data (Limma) package to identify the hub lncRNAs that were differentially expressed (DElncRNAs). The ceRNA co‐expression network data were obtained from several sites, including miRcode, and were used to assess the potential WGCNA function of hub DElncRNAs in periodontitis. Besides, we divided the samples into LBX2‐AS1 high and low expression group by the expression level of LBX2‐AS1 and calculated DEG by Limma package. Furthermore, we performed GO function, KEGG pathway and GSEA enrichment of DEGs.

Results

In the analysis, we identified 50 hub lncRNAs that may play important roles in periodontitis. Then, we used the Limma package to identify 3 hub DElncRNAs (LINC00687, LBX2‐AS1 and LINC01566). We elucidated the potential function of the hub DElncRNA LBX2‐AS1 in periodontitis by constructing a co‐expression network of lncRNA‐miRNA‐mRNA interactions. Totally, 573 DEGs (354 up‐ and 219 downregulated) in periodontitis samples were identified. DEGs were enriched in different GO terms and pathways, such as neutrophil degranulation, neutrophil activation, neutrophil activation involved in immune response, neutrophil‐mediated immunity, antigen processing and presentation, JAK‐STAT signalling pathway, natural killer cell‐mediated cytotoxicity, EGFR tyrosine kinase inhibitor resistance, phosphatidylinositol signalling system and Vascular Endothelial Growth Factor (VEGF) signalling pathway.

Conclusion

In our study, we found that 3 hub DElncRNAs (LINC00687, LBX2‐AS1 and LINC01566) may be involved in the pathogenesis of periodontitis based on WGCNA and Limma analysis. Our study aimed to elucidate the mechanisms involved in periodontitis at the genetic and epigenetic levels by constructing a ceRNA network associated with lncRNA. Besides, identification DEGs of differential LBX2‐AS1 and functional annotation showed that LBX2‐AS1 might be associated with periodontitis.
Cortisol and adrenocorticotropic hormone concentrations in horses with systemic inflammatory response syndrome
Authors: Stewart Allison J. , Hackett Eileen , Bertin Francois‐Rene , Towns Taylor J.
Published: September 2019

Background

Plasma adrenocorticotropic hormone (ACTH) and serum cortisol concentrations increase with illness‐associated stress. Dynamics of plasma ACTH and serum cortisol concentrations in adult horses with systemic illness are undocumented.

Hypothesis/Objective

To determine whether ACTH and cortisol concentrations and the ACTH/cortisol ratio vary with survival, the presence of systemic inflammatory response syndrome (SIRS), or ischemic gastrointestinal lesions at admission, or throughout hospitalization.

Animals

One hundred fifty‐one adult horses.

Methods

Prospective study measuring serum cortisol and plasma ACTH at admission and on days 2, 4, and 6 of hospitalization. Horses were grouped by outcome (survival, SIRS status, number of SIRS criteria [SIRS score], SIRS severity group, and the presence of an ischemic lesion). Differences between groups and over time for ACTH, cortisol, and ACTH/cortisol ratio were investigated with a mixed effect model. Receiving operator characteristic curves and odds ratios were calculated for survival and ischemia.

Results

In all groups, ACTH, cortisol, and ACTH/cortisol ratio significantly decreased over time (P < .0001). ACTH, cortisol, and ACTH/cortisol ratio were higher at admission in nonsurvivors, and ACTH and cortisol were higher in horses with ischemic lesions (P < .01). Horses with ACTH above reference interval at admission were 6.10 (2.73‐13.68 [95% confidence interval]) times less likely to survive (P < .0001). No significant difference in ACTH, cortisol, and ACTH/cortisol ratio between horses with different SIRS status, scores, or groups were detected, although nonsurvivors had a higher SIRS score (P < .0001).

Conclusions and Clinical Importance

Pituitary and adrenal responses are altered in nonsurviving horses and those with an ischemic gastrointestinal lesion.
Phenotypic selection mosaic for flower length influenced by geographically varying hawkmoth pollinator proboscis length and abiotic environment
Authors: Soteras Florencia , Rubini Pisano Malén Aluhé , Bariles Julieta Belén , Moré Marcela , Cocucci Andrea Arístides
Published: September 2019

Biotic and abiotic context may affect the intensity of interspecific interactions and subsequently drive locally particular phenotypic selection patterns on interacting traits.

We evaluated the geographical variation of matching traits of the brush‐type flowers of Caesalpinia gilliesii and of the proboscis length of its guild of hawkmoth pollinators, as well as their relationship with environmental variables. We assessed the geographical variation of interacting traits (style and filament vs mean proboscis length of the guild of hawkmoths) across seven populations and estimated phenotypic selection on the plant side.

Interacting traits showed similar relationships with environmental variables. Phenotypic selection on the plant side was influenced by proboscis length and by environmental conditions. Mean proboscis length of the guild was shorter than previously recorded for the same study area, thus probably shifting the selective optima of flower length. We observed two presumptive coevolutionary cold spots where one‐sided negative directional selection is acting on style length. The lack of selection on the pollinator side should be further confirmed.

We provided joint evidence, mostly lacking, about the geographical variation of selective pressures on the plant side associated with both proboscis length and abiotic conditions. We suggest that recent environmental change may be shifting floral length optima.
Reproducibility of Natural Head Position assessed with stereophotogrammetry
Authors: Jakobsone Gundega , Vuollo Ville , Pirttiniemi Pertti
Published: September 2019

Objective

The aim of this study was to assess the stability of Natural Head Position (NHP) over time using the 3dMDface System.

Setting and sample population

This was an experimental study. Three‐dimensional facial images of 40 students were captured on two different occasions, with an interval of at least two weeks.

Materials and Methods

The images were taken using a stereophotogrammetric device (3dMD). The mirror positioned NHP was obtained in a standing position and then replicated in a sitting position for capturing. The self‐balanced NHP was taken in a sitting position. Rapidform 3D software was used for position angle calculations. The angle changes between the positions were calculated for rotations around the x‐, y‐ and z‐axes.

Results

The differences between NHP in the self‐balanced and mirror positions recorded on the first and second occasions were 2.43 and 1.75 degrees, respectively, around the x‐axis. The average changes in NHP around the x‐axis between the self‐balanced and mirror balanced positions exceeded 3 degrees at the two‐week interval. The differences were smaller for the rotations around the y‐ and z‐axes. Some subjects consistently tended to hold their heads in a more extended position when self‐balanced, while others did this when mirror balanced. There was no difference in the reproducibility of NHP between men and women.

Conclusion

The reproducibility of NHP for consecutive stereophotogrammetric captures is generally acceptable. The reproducibility of NHP using the mirror position was slightly better compared with NHP in the sitting self‐balanced position.
BRAND AGRICULTURE AND ECONOMIC GEOGRAPHY: WHEN ARE HIGHLY DIFFERENTIATED PRODUCTS SUSTAINABLE IN THE REMOTE PERIPHERY?
Authors: Fujita Masahisa , Hamaguchi Nobuaki
Published: September 2019

This paper presents a general equilibrium model of new economic geography, incorporating brand agriculture that produces differentiated agricultural products. Focusing on the core‐periphery space, we show that highly differentiated brand agriculture can be sustained in the periphery even when access to the core market is not particularly good. This result supports the promotion of innovative products in rural areas in order to avoid direct price competition in generic commodities markets under unfavorable conditions.
A flipped classroom in graduate medical education
Authors: Blair Rachel A , Caton Julia B , Hamnvik Ole‐Petter R
Published: September 2019

Background

The role of the flipped classroom model in graduate medical education (GME) is not yet defined. We set out to evaluate the feasibility, acceptability and outcomes of a flipped classroom instructional model in an internal medicine curriculum.

Methods

This pilot study was carried out in an academic medical centre in the USA with 43 second‐year internal medicine postgraduate trainees. Trainees watched videos on the pharmacological treatment of type 2 diabetes outside of the classroom, followed by an in‐class session in which they engaged in case‐based discussions. The intervention was evaluated using surveys and a knowledge test before, immediately after and 6 months after the intervention.

Results

The mean number of correct answers for a 10‐question knowledge test was 5.25 before the intervention, 8.00 in the immediate post‐intervention test, and 7.10 in the 6‐month follow‐up test (p < 0.001). Six months after the intervention, 57.1% of participants reported prescribing an antidiabetic medication discussed at the session. In a focus group, trainees reported their preference for interactive, case‐based learning, concern about the time required for preparation and interest in incorporating real patient cases.

Discussion

Trainees preferred the flipped classroom, which also resulted in increased knowledge and self‐reported prescribing changes; however, the required preparatory time may limit its feasibility in GME.
Full Thermal Simulation of an Arbitrary, Plane Axisymmetric Residual Stress Field
Authors: Parker Anthony P.
Published: September 2019

In this paper, numerical formulations are presented; these permit full thermal simulation of an arbitrary plane axisymmetric residual stress field encompassing hoop, radial, and axial stresses. Earlier formulations were based upon the determination of a temperature profile within the tube that could only replicate radial and hoop stresses; in general, axial stresses were incorrect. This new thermal simulation provides all three stresses and is achieved by incorporating orthotropic coefficients of thermal expansion that themselves vary with radius. Results are generally highly accurate. Crucial near-bore hoop and axial stresses can be replicated within 1%. Near-bore behavior is discussed in detail. These formulations will permit subsequent determination of stress intensity factors (SIF) for arbitrarily orientated cracks within pressure vessels in the presence of pre-existing residual stresses. Note that these thermal solutions mimic known, residual stress profiles; they do not predict residual stress profiles.
Effect of Vibrations on Thermal Performance of Miniature Loop Heat Pipe for Avionics Cooling: An Experimental Analysis
Authors: Kumar Prem , Khandekar Sameer , Maydanik Yuri F. , Bhattacharya Bishakh
Published: September 2019

A loop heat pipe (LHP) is an efficient passive, two-phase heat transfer device which can transport heat up to large distances (over ∼ 5 m) even in the anti-gravity mode. It is necessary to miniaturize the LHPs to make them suitable for space-constrained avionics applications. However, before incorporating these devices under high-vibrational environmental conditions such as those encountered in avionics applications, it is imperative to study their thermal performance under such loads. With the aim of understanding the effect of acceleration and frequency of imposed vibration on thermal performance of miniature LHP (mLHP), a contextual experimental study has been reported here using an ammonia charged mLHP (8 mm evaporator diameter; titanium wick) in the horizontal orientation for two cases: (a) without vibration and (b) with the transverse and longitudinal harmonic vibrations (1–4g, frequencies 15–45 Hz, and sine sweep 15–45 Hz in 1 s). With start-up loads between 5 W and 8 W, the LHP can transfer heat load of about 120 W at safe evaporation temperature of 70 °C. Results show that for the transverse vibration, acceleration rate and frequency of imposed vibrations do not affect the thermal performance of mLHP. For the longitudinal vibration, the device performance gets noticeably enhanced with increased acceleration. The decisive role of heat leak (from evaporator to the compensation chamber (CC)) with imposed vibrations is clearly observed, and its link to the internal fluid distribution can be discerned from data trends.
Reconfiguration of a 3-(rR)PS Metamorphic Parallel Mechanism Based on Complete Workspace and Operation Mode Analysis
Authors: Nurahmi Latifah , Gan Dongming
Published: September 2019

This paper focuses on the reconfiguration of a 3-(rR)PS metamorphic parallel mechanism based on complete workspace and operation mode analysis. The mechanism consists of three (rR)PS legs, and each (rR) joint is composed of two perpendicular revolute joints. One of the (rR) joint axes can be reconfigured continuously, which allows the mechanism to exhibit three distinct configurations. Initially, the constraint equations are derived by using algebraic geometry approach, and the primary decomposition is computed for the three configurations. It reveals that the 3-(rR)PS metamorphic parallel mechanism can exhibit one up to two operation modes among three configurations. When the second axes of the three (rR) joints intersect at a finite point and not coplanar, the 3-(rR)PS metamorphic parallel mechanism has only one operation mode. If the second axes of the three (rR) joints are coplanar, the 3-(rR)PS metamorphic parallel mechanism has two operation modes. It is shown that both operation modes have the same motion type, namely, 1T2R motion. However, to realize the same trajectories in both operation modes, the moving platform will have different orientations. Hence, the orientation workspaces of both operation modes are characterized and the axodes are used to compare the instantaneous motion of the moving platform when passing through the same trajectories. Based on these results, an identification approach is introduced to identify which operation mode a given mechanism pose belongs to and this provides a useful method for trajectory planning.
Vibratory Response Characteristics of High-Frequency Shape Memory Alloy Actuators
Authors: Kennedy Scott , Price Morgan , Zabala Michael , Perkins Edmon
Published: September 2019

This paper presents a shape memory alloy actuator design using a bimorph structure capable of high-speed actuation and low power consumption. Two active layers of shape memory alloy wires are separated by a passive layer of thermoplastic polyurethane. This structure results in a bending actuator when current is alternated between the two active shape memory alloy layers. Actuators of lengths 20, 25, 30, 35, and 40 mm were tested at peak current input of 110, 120, 130, and 140 mA. The 40-mm actuator was shown to have a natural frequency of 11.4 Hz with a bending displacement of 26.4 mm perpendicular to the neutral position and a power input of 0.78 W (140 mA peak current input). A relationship between the input current and the resulting vibratory characteristics was found. As the current increases, the natural frequency decreases and the damping ratio increases. The experimental results are compared with a finite element method (FEM) vibration analysis and an Euler–Bernoulli cantilever beam equations.
Accusations fly over threat to rarest great ape
Authors: Rochmyaningsih Dyna
Published: September 2019

A new dam on Sumatra poses an existential risk to the Tapanuli orangutan, scientists say.
Chinese ties don't faze European funders
Authors: Mervis Jeffrey
Published: September 2019

But in the United States and Australia, worries about China are affecting collaborations.
War of nerves
Authors: Servick Kelly
Published: September 2019

An emerging relationship between the nervous system and tumor growth suggests new therapies.
Machine Learning Interpretation of Extended Human Papillomavirus Genotyping by Onclarity in an Asian Cervical Cancer Screening Population
Authors: Wong Oscar G. W. , Ng Idy F. Y. , Tsun Obe K. L. , Pang Herbert H. , Ip Philip P. C. , Cheung Annie N. Y.
Published: September 2019

This study aimed (i) to compare the performance of the BD Onclarity human papillomavirus (HPV) assay with the Cobas HPV test in identifying cervical intraepithelial neoplasia 2/3 or above (CIN2/3+) in an Asian screening population and (ii) to explore improving the cervical cancer detection specificity of Onclarity by machine learning. We tested 605 stratified random archived samples of cervical liquid-based cytology samples with both assays.
Integrated prevention and management of non-communicable diseases, including musculoskeletal health: a systematic policy analysis among OECD countries
Authors: Briggs Andrew M , Persaud Jennifer G , Deverell Marie L , Bunzli Samantha , Tampin Brigitte , Sumi Yuka , Amundsen Olav , Houlding Elizabeth MG , Cardone Anontella , Hugosdottir Thora , Rogers Sophia , Pozsgai Miklós , Slater Helen
Published: September 2019

Introduction

Development and implementation of appropriate health policy is essential to address the rising global burden of non-communicable diseases (NCDs). The aim of this study was to evaluate existing health policies for integrated prevention/management of NCDs among Member States of the Organisation for Economic Co-operation and Development (OECD). We sought to describe policies’ aims and strategies to achieve those aims, and evaluate extent of integration of musculoskeletal conditions as a leading cause of global morbidity.

Methods

Policies submitted by OECD Member States in response to a World Health Organization (WHO) NCD Capacity Survey were extracted from the WHO document clearing-house and analysed following a standard protocol. Policies were eligible for inclusion when they described an integrated approach to prevention/management of NCDs. Internal validity was evaluated using a standard instrument (sum score: 0–14; higher scores indicate better quality). Quantitative data were expressed as frequencies, while text data were content-analysed and meta-synthesised using standardised methods.

Results

After removal of duplicates and screening, 44 policies from 30 OECD Member States were included. Three key themes emerged to describe the general aims of included policies: system strengthening approaches; improved service delivery; and better population health. Whereas the policies of most countries covered cancer (83.3%), cardiovascular disease (76.6%), diabetes/endocrine disorders (76.6%), respiratory conditions (63.3%) and mental health conditions (63.3%), only half the countries included musculoskeletal health and pain (50.0%) as explicit foci. General strategies were outlined in 42 (95.5%) policies—all were relevant to musculoskeletal health in 12 policies, some relevant in 27 policies and none relevant in three policies. Three key themes described the strategies: general principles for people-centred NCD prevention/management; enhanced service delivery; and system strengthening approaches. Internal validity sum scores ranged from 0 to 13; mean: 7.6 (95% CI 6.5 to 8.7).

Conclusion

Relative to other NCDs, musculoskeletal health did not feature as prominently, although many general prevention/management strategies were relevant to musculoskeletal health improvement.
‘Communities are attempting to tackle the crisis’: a scoping review on community plans to prevent and reduce opioid-related harms
Authors: Leece Pamela , Khorasheh Triti , Paul Nimitha , Keller-Olaman Sue , Massarella Susan , Caldwell Jayne , Parkinson Michael , Strike Carol , Taha Sheena , Penney Greg , Henderson Rita , Manson Heather
Published: September 2019

Objectives

We sought to understand the implementation of multifaceted community plans to address opioid-related harms.

Design

Our scoping review examined the extent of the literature on community plans to prevent and reduce opioid-related harms, characterise the key components, and identify gaps.

Data sources

We searched MEDLINE, Embase, PsycINFO, CINHAL, SocINDEX and Academic Search Primer, and three search engines for English language peer-reviewed and grey literature from the past 10 years.

Eligibility criteria

Eligible records addressed opioid-related harms or overdose, used two or more intervention approaches (eg, prevention, treatment, harm reduction, enforcement and justice), involved two or more partners and occurred in an Organisation for Economic Co-operation and Development country.

Data extraction and synthesis

Qualitative thematic and quantitative analysis was conducted on the charted data. Stakeholders were engaged through fourteen interviews, three focus groups and one workshop.

Results

We identified 108 records that described 100 community plans in Canada and the USA; four had been evaluated. Most plans were provincially or state funded, led by public health and involved an average of seven partners. Commonly, plans used individual training to implement interventions. Actions focused on treatment and harm reduction, largely to increase access to addiction services and naloxone. Among specific groups, people in conflict with the law were addressed most frequently. Community plans typically engaged the public through in-person forums. Stakeholders identified three key implications to our findings: addressing equity and stigma-related barriers towards people with lived experience of substance use; improving data collection to facilitate evaluation; and enhancing community partnerships by involving people with lived experience of substance use.

Conclusion

Current understanding of the implementation and context of community opioid-related plans demonstrates a need for evaluation to advance the evidence base. Partnership with people who have lived experience of substance use is underdeveloped and may strengthen responsive public health decision making.
Perspective of asylum-seeking caregivers on the quality of care provided by a Swiss paediatric hospital: a qualitative study
Authors: Brandenberger Julia , Sontag Katrin , Duchêne-Lacroix Cédric , Jaeger Fabienne Nicole , Peterhans Bernadette , Ritz Nicole
Published: September 2019

Objectives

This study investigated the perspective of asylum-seeking caregivers on the quality of healthcare delivered to their children in a qualitative in-depth interview study. The health of asylum-seeking children is of key interest for healthcare providers, yet knowledge of the perspective of asylum-seeking caregivers when accessing healthcare is limited.

Setting

The study took place in a paediatric tertiary care hospital in Basel, Switzerland.

Participants

Interviews were done with 13 asylum-seeking caregivers who had presented with their children at the paediatric tertiary care hospital. Nine female and four male caregivers from Tibet, Eritrea, Afghanistan, Syria, Iraq, Albania and Macedonia were included. A diverse sample was chosen regarding cultural and social background, years of residence in Switzerland and reasons for seeking care. A previously developed and pilot-tested interview guide was used for semistructured in-depth interviews between 36 and 92 min in duration. Data analysis and reporting was done according to Consolidated Criteria for Reporting Qualitative Research. The number of interviews was determined by saturation of data.

Results

The interviewees described a mismatch of personal competencies and external challenges. Communication barriers and unfamiliarity with new health concepts were reported as challenges. These were aggravated by isolation and concerns about their child’s health. The following factors were reported to strongly contribute to satisfaction of healthcare delivery: a respectful and trusting caregiver–provider relationship, the presence of interpreters and immediate availability of treatment.

Conclusions

A mismatch of personal competencies and external challenges importantly influences the caregiver–provider relationship. To overcome this mismatch establishment of confidence was identified as a key factor. This can be achieved by availability of interpreter services, sufficient consultation time and transcultural trainings for healthcare workers. Coordination between the family, the government’s asylum system and the medical system is required to facilitate this process.
Inequalities and stillbirth in the UK: a meta-narrative review
Authors: Kingdon Carol , Roberts Devender , Turner Mark A , Storey Claire , Crossland Nicola , Finlayson Kenneth William , Downe Soo
Published: September 2019

Objective

To review what is known about the relationship between stillbirth and inequalities from different disciplinary perspectives to inform stillbirth prevention strategies.

Design

Systematic review using the meta-narrative method.

Setting

Studies undertaken in the UK.

Data sources

Scoping phase: experts in field, exploratory electronic searches and handsearching. Systematic searches phase: Nine databases with no geographical or date restrictions. Non-English language studies were excluded.

Study selection

Any investigation of stillbirth and inequalities with a UK component.

Data extraction and synthesis

Three authors extracted data and assessed study quality. Data were summarised, tabulated and presented graphically before synthesis of the unfolding storyline by research tradition; and then of the commonalities, differences and interplays between narratives into resultant summary meta-themes.

Results

Fifty-four sources from nine distinctive research traditions were included. The evidence of associations between social inequalities and stillbirth spanned 70 years. Across research traditions, there was recurrent evidence of the social gradient remaining constant or increasing, fuelling repeated calls for action (meta-theme 1: something must be done). There was less evidence of an effective response to these calls. Data pertaining to socioeconomic, area and ethnic disparities were routinely collected, but not consistently recorded, monitored or reported in relation to stillbirth (meta-theme 2: problems of precision). Many studies stressed the interplay of socioeconomic status, deprivation or ethnicity with aggregated factors including heritable, structural, environmental and lifestyle factors (meta-theme 3: moving from associations towards intersectionality and intervention(s)). No intervention studies were identified.

Conclusion

Research investigating inequalities and stillbirth in the UK is underdeveloped. This is despite repeated evidence of an association between stillbirth risk and poverty, and stillbirth risk, poverty and ethnicity. A specific research forum is required to lead the development of research and policy in this area, which can harness the multiple relevant research perspectives and address the intersections between different policy areas.

PROSPERO registration number

CRD42017079228.
Hospital-level evaluation of the effect of a national quality improvement programme: time-series analysis of registry data
Authors: Stephens Timothy J , Peden Carol J , Haines Ryan , Grocott Mike P W , Murray Dave , Cromwell David , Johnston Carolyn , Hare Sarah , Lourtie Jose , Drake Sharon , Martin Graham P , Pearse Rupert M
Published: September 2019

Background and objectives

A clinical trial in 93 National Health Service hospitals evaluated a quality improvement programme for emergency abdominal surgery, designed to improve mortality by improving the patient care pathway. Large variation was observed in implementation approaches, and the main trial result showed no mortality reduction. Our objective therefore was to evaluate whether trial participation led to care pathway implementation and to study the relationship between care pathway implementation and use of six recommended implementation strategies.

Methods

We performed a hospital-level time-series analysis using data from the Enhanced Peri-Operative Care for High-risk patients trial. Care pathway implementation was defined as achievement of >80% median reliability in 10 measured care processes. Mean monthly process performance was plotted on run charts. Process improvement was defined as an observed run chart signal, using probability-based ‘shift’ and ‘runs’ rules. A new median performance level was calculated after an observed signal.

Results

Of 93 participating hospitals, 80 provided sufficient data for analysis, generating 800 process measure charts from 20 305 patient admissions over 27 months. No hospital reliably implemented all 10 processes. Overall, only 279 of the 800 processes were improved (3 (2–5) per hospital) and 14/80 hospitals improved more than six processes. Mortality risk documented (57/80 (71%)), lactate measurement (42/80 (53%)) and cardiac output guided fluid therapy (32/80 (40%)) were most frequently improved. Consultant-led decision making (14/80 (18%)), consultant review before surgery (17/80 (21%)) and time to surgery (14/80 (18%)) were least frequently improved. In hospitals using ≥5 implementation strategies, 9/30 (30%) hospitals improved ≥6 care processes compared with 0/11 hospitals using ≤2 implementation strategies.

Conclusion

Only a small number of hospitals improved more than half of the measured care processes, more often when at least five of six implementation strategies were used. In a longer term project, this understanding may have allowed us to adapt the intervention to be effective in more hospitals.
Detecting communities from networks based on their intrinsic properties
Authors: Yang Haijuan , Cheng Jianjun , Leng Mingwei , Su Xing , Zhang Wenbo , Chen Xiaoyun
Published: September 2019

Communities in networks expose some intrinsic properties, each of them involves some influential nodes as its cores, around which the entire community grows gradually; the more the common neighbors that exist between a pair of nodes, the larger the possibility of belonging to the same community; the more the neighbors of any one node belong to a community, the larger the possibility that node belongs to that community too. In this paper, we present a novel method, which makes full utilization of these intrinsic properties to detect communities from networks. We iteratively select the node with the largest degree from the remainder of the network as the first seed of a community, then consider its first- and second-order neighbors to identify other seeds of the community, then expand the community by attracting nodes whose large proportion of neighbors have been in the community to join. In this way, we obtain a series of communities. However, some of them might be too small to make sense. Therefore, we merge some of the initial communities into larger ones to acquire the final community structure. In the entire procedure, we try to keep nodes in every community to be consistent with the properties as possible as we can, this leads to a high-quality result. Moreover, the proposed method works with a higher efficiency, it does not need any prior knowledge about communities (such as the number or the size of communities), and does not need to optimize any objective function either. We carry out extensive experiments on both some artificial networks and some real-world networks to testify the proposed method, the experimental results demonstrate that both the efficiency and the community-structure quality of the proposed method are promising, our method outperforms the competitors significantly.
Key links identification for urban road traffic network based on temporal-spatial distribution of traffic congestion
Authors: Tian Zhao , She Wei , Li Shuang , Wang You-Wei , Liu Wei , Zai Guang-Jun , Jia Li-Min , Qin Yong , Dong Hong-Hui
Published: September 2019

Traffic congestion is now nearly ubiquitous in many urban areas. The improvement of road infrastructure is an effective way to ease traffic congestion, especially the key road links. So, it is a fundamental and important step to identify the key link for improving transportation efficiency. However, most approaches in the current literature use simulated data and need many assumption conditions. The result shows the low comprehensibility and the bad exactitude. This paper provides a new identification method of key links for urban road traffic network (URTN) based on temporal-spatial distribution of traffic congestion. The method involves identifying congestion state, computing time distribution of congestion state and determining key road link. By the cluster analysis of the history field data of URTN, the threshold to determine the traffic congestion of each link can be obtained. Then the time-interval of the traffic congestion can be computed by median filtering. At last, the time-interval coverage is defined and used to determine the target road link whether it is a key road link or not. The method is validated by a real-world case (Beijing road traffic network, BRTN). The result shows the feasibility and accuracy.