bluuebunny/crossref_metadata_2025 huggingface dataset:
Multivariate Posterior Inference for Spatial Models with the Integrated Nested Laplace Approximation
Authors: Gómez-Rubio Virgilio , Palmí-Perales Francisco
Published: June 2018

The integrated nested Laplace approximation (INLA) is a convenient way to obtain approximations to the posterior marginals for parameters in Bayesian hierarchical models when the latent effects can be expressed as a Gaussian Markov random field. In addition, its implementation in the R-INLA package for the R statistical software provides an easy way to fit models using the INLA in practice in a fraction of the time that other computer-intensive methods (e.g. Markov chain Monte Carlo methods) take to fit the same model. Although the INLA provides a fast approximation to the marginals of the model parameters, it is difficult to use it with models that are not implemented in R-INLA. It is also difficult to make multivariate posterior inference on the parameters of the model as the INLA focuses on the posterior marginals and not the joint posterior distribution. We describe how to use the INLA within the Metropolis–Hastings algorithm to fit complex spatial models and to estimate the joint posterior distribution of a small number of parameters. We illustrate the benefits of this new method with two examples. In the first, a spatial econometrics model with two auto-correlation parameters (for the response and the error term) is considered. This model is not currently available in R-INLA, and multivariate inference is often required to assess dependence between the two spatial auto-correlation parameters in the model. Furthermore, the estimation of spillover effects is based on the joint posterior distribution of a spatial auto-correlation parameter and a covariate coefficient. In the second example, a multivariate spatial model for several diseases is proposed for disease mapping. This model includes a shared specific spatial effect as well as disease-specific spatial effects. Dependence on the shared spatial effect is modulated via disease-specific weights. By inspecting the joint posterior distribution of these weights it is possible to assess which diseases have a similar spatial pattern.
Field and laboratory comparative evaluation of a LAMP assay for the diagnosis of urogenital schistosomiasis in Cubal, Central Angola
Authors: Gandasegui Javier , Fernández‐Soto Pedro , Dacal Elena , Rodríguez Esperanza , Saugar José María , Yepes Edward , Aznar‐Ruiz‐de‐Alegría María Luisa , Espasa Mateu , Ninda Arlette , Bocanegra Cristina , Salvador Fernando , Sulleiro Elena , Moreno Milagros , Vicente Belén , López‐Abán Julio , Muro Antonio
Published: June 2018

Objective

To evaluate the performance of Rapid‐Heat LAMPellet assay in field conditions for diagnosis of urogenital schistosomiasis in an endemic area in Cubal, Angola, and to assess the reproducibility in a reference laboratory.

Methods

A total of 172 urine samples from school‐age children were tested for microhaematuria, microscopic detection of Schistosoma haematobium eggs and LAMP for DNA detection. Urine samples were stored in a basic equipped laboratory. Field‐LAMP tests were performed with and without prior DNA extraction from urine samples, and the results were read by turbidity and by colour change. When field procedures were finished, samples were sent to a reference laboratory to be reanalysed by LAMP.

Results

A total of 83 of 172 (48.3%) were positive for microhaematuria, 87/172 (50.6%) were microscopy‐positive for S. haematobium eggs detection, and 127/172 (73.8%) showed LAMP‐positive results for detecting S. haematobium using purified DNA and 109/172 (63.4%) without prior DNA extraction. MacNemar's test showed a statistical significant relation between LAMP results and microscopy‐detected S. haematobium infections and microhaematuria (P < 0.001 in both cases), respectively. When samples of purified DNA were reanalysed in a reference laboratory in Spain using the same LAMP methodology, the overall reproducibility achieved 72.1%.

Conclusions

The ease of use, simplicity and feasibility demonstrated by LAMP assay in field conditions together with the acceptable level of reproducibility achieved in a reference laboratory support the use of LAMP assay as an effective test for molecular diagnosis of urogenital schistosomiasis in endemic remote areas.
Impact of prestorage leucoreduction of autologous whole blood on length of hospital stay with a subgroup analysis in bilateral hip arthroplasty
Authors: Sawamura Y. , Ohto H. , Ikeda K. , Kanno T. , Suzuki Y. , Gonda K. , Tasaki T. , Nollet K. E. , Takahashi H. , Aota S.
Published: June 2018

Background

Although prestorage leucoreduction (LR) of blood components for transfusion has gained favour around the world, evidence of its beneficial clinical effects is ambiguous.

Study design and methods

To reveal whether leucocytes and/or platelets in transfused blood are related to transfusion‐related adverse effects, a prospective randomized crossover study was performed on patients who donated autologous blood prior to elective surgery. Among 1487 primary enrolees, a total of 192 patients undergoing two‐stage, bilateral total hip arthroplasty were randomized to receive autologous blood that was either prestorage leucoreduced, or not, for the first procedure. For the second procedure, each patient was crossed over to receive alternatively processed autologous blood. Length of hospital stay served as a primary end‐point, with perioperative infectious/thrombotic complications, pre‐ and postoperative laboratory values, and body temperature serving as secondary endpoints.

Results

No significant differences emerged between prestorage LR and non‐LR cohorts in length of hospital stay, as well as perioperative infectious/thrombotic complications, postoperative body temperature and duration of fever. Postoperative laboratory values including white blood cell counts and C‐reactive protein levels had no significant differences.

Conclusion

This study could not prove any superiority of prestorage LR over non‐LR for autologous whole blood among patients who underwent total hip arthroplasty.
Modelling the sprouting capacity from underground buds of the perennial weed Sonchus arvensis
Authors: Taab A , Andersson L , Boström U
Published: June 2018

Sonchus arvensis is a problematic perennial weed species causing problems in many crops. Control measures often rely on soil tillage or mowing; both methods are used to exhaust the root system. This approach fails during periods of restrictions in sprouting capacity or shoot regrowth. The aim of this study was to develop a simulation model for prediction of shoot sprouting capacity in underground buds of S. arvensis. We hypothesised restricted regrowth to be induced as a function of photoperiod and temperature sum and released as a function of cold temperature sum. The model was parameterised and calibrated against observations of shoot regrowth from an experiment on intact roots of S. arvensis. Subsequently, it was validated against observations of regrowth from another experiment on intact roots and sprouting from fragmented roots from a third experiment. Restriction in regrowth was attributed to reduction in the photoperiod, observed when the day length decreased below a threshold of 16.5 h, but also to a daily mean temperature below 16.8°C. Resumed regrowth occurred in late autumn at a daily mean temperature threshold of 4.7°C. The pattern of changes over time in shoot regrowth from an intact root system was well predicted by the model. The temporal change in sprouting capacity from buds on fragmented roots followed the same pattern, but with a quantitative difference between the model prediction and the observed sprouting capacity. We conclude that the model can be used to predict the pattern over time of sprouting capacity in intact roots of S. arvensis.
You cannot fight fire with fire: a demographic model suggests alternative approaches to manage multiple herbicide‐resistant Avena fatua
Authors: Burns E E , Lehnhoff E A , Mckenzie S C , Maxwell B D , Dyer W E , Menalled F D
Published: June 2018

Multiple herbicide‐resistant (MHR) weed populations pose significant agronomic and economic threats and demand the development and implementation of ecologically based tactics for sustainable management. We investigated the influence of nitrogen fertiliser rate (56, 112, 168, or 224 kg N ha−1) and spring wheat seeding density (67.3 kg ha−1 or 101 kg ha−1) on the demography of one herbicide susceptible and two MHR Avena fatua populations under two cropping systems (continuous cropping and crop‐fallow rotation). To represent a wide range of environmental conditions, data were obtained in field conditions over 3 years (2013–2015). A stochastic density‐dependent population dynamics model was constructed using the demographic data to project A. fatua populations. Elasticity analysis was used to identify demographic processes with negative impacts on population growth. In both cropping systems, MHR seedbank densities were negatively impacted by increasing nitrogen fertilisation rate and wheat density. Overall, MHR seedbank densities were larger in the wheat‐fallow compared with the continuous wheat cropping system and seedbank densities stabilised near zero in the high nitrogen and high spring wheat seeding rate treatment. In both cropping systems, density‐dependent seed production was the most influential parameter impacting population growth rate. This study demonstrated that while the short‐term impact of weed management tactics can be investigated by field experiments, evaluation of long‐term consequences requires the use of population dynamics models. Demographic models, such as the one constructed here, will aid in selecting ecologically based weed management tactics, such as appropriate resource availability and modification to crop competitive ability to reduce the impact of MHR.
Academicians’ Burnout, Vigor and Occupational Satisfactions in the Department of Fine Arts Education: A Sample of Uludag University
Authors: Demirbatır Rasim Erol , Engür Doruk
Published: June 2018

The success of an educational institution is heavily based on instructors’ occupational satisfaction and their happiness at their workplace. Therefore, determining the case of the instructors’ wellbeing in order to improve working standards is really important to sustain high quality in education. In this sense, this study set out to identify state of academicians in terms of their level of burnout, vigor and occupational satisfaction at a department of Fine Arts Education at Uludag University. All 42 academician participants attended the study. To determine the level of burnout and vigor, Shirom-Melamed Burnout Measure was employed, and to learn participants’ occupational satisfaction levels, a questionnaire developed by authors was used. The results show that burnout and vigor have negative correlation and occupational satisfaction has negatively correlated with emotional exhaustion, which is a sub-dimension of burnout but positively correlated with physical strength, which is a sub-dimension of vigor. Moreover, it is determined that the academicians who go to the doctor less frequently have higher occupational satisfaction and the academicians who are facing health issues have higher level of burnout. The results confirm that health status significantly affects one sub-dimension of burnout, which is physical fatigue.
Examining Mathematics Pre-service Teachers’ Experiences of School Practicum
Authors: Gökçek Tuba
Published: June 2018

This article presents findings from research about a practice teaching course designed to help mathematics pre-service teachers to learn from the practices of school teachers and supervisors. For this reason, the aim of this study is to research the contribution of the practicum course to the teacher candidates understanding of the teaching process. The participants in this study were 61 pre-service teachers, enrolled in a required six-hour teaching practicum course taught in the last year of the mathematics education program at a large state university located on the north coast of Turkey. To answer the research question, information was primarily obtained from reflection reports prepared by the supervisor. Content analysis was completed to reveal the emerging themes and codes. The results indicate that practicum contributed in several ways to novice teachers’ view of teaching. These include preparing for the profession; application of theory-practice; getting to know students and being aware of the difficulties.
Preventing carbon contamination of Ge (001) during atomic layer deposition with a barium-based Zintl layer
Authors: Hu Shen , Ekerdt John G.
Published: June 2018

Carbon contamination of the clean Ge (001) 2 × 1 surface occurs during atomic layer deposition (ALD) of perovskite oxides and introduces impurities that can affect device performance. Zintl layers are formed by exposing a bare Ge (001) 2 × 1-reconstructed surface to 0.5-monolayers of elemental Ba, with the Ba atoms occupying the fourfold sites between Ge-dimer rows. The bare Ge (001) and Ba-Zintl layer surfaces feature a 2 × 1-reconstructed structure. Exposure of bare 2 × 1-reconstructed Ge (001) to 0.5 monolayers of elemental Sr leads to an 8 × 1- or 9 × 1-reconstructed Ge (001) surface. Bare Ge (001) and Ba-Zintl layer Ge (001), and 0.5-monolayer Sr-dosed Ge (001) surfaces were exposed to background molecules in the ALD chamber at 225 °C. Bare Ge (001) and Ba-Zintl layer Ge (001) were also exposed to barium bis(triisopropylcyclopentadienyl) at 225 °C and changes in the surface composition were monitored with x-ray photoelectron spectroscopy. The 2 × 1-reconstructed Ba-Zintl surface protects Ge (001) from carbon accumulation associated with ALD background molecules and cyclopentadienyl-based ligands originating from the ALD precursor. Surface structure is important in protecting Ge (001); the 8 × 1- or 9 × 1-reconstructed Ge (001) surface formed from 0.5-monolayers of Sr does not prevent carbon accumulation.
Binaural rendering of Ambisonic signals by head-related impulse response time alignment and a diffuseness constraint
Authors: Zaunschirm Markus , Schörkhuber Christian , Höldrich Robert
Published: June 2018

Binaural rendering of Ambisonic signals is of great interest in the fields of virtual reality, immersive media, and virtual acoustics. Typically, the spatial order of head-related impulse responses (HRIRs) is considerably higher than the order of the Ambisonic signals. The resulting order reduction of the HRIRs has a detrimental effect on the binaurally rendered signals, and perceptual evaluations indicate limited externalization, localization accuracy, and altered timbre. In this contribution, a binaural renderer, which is computed using a frequency-dependent time alignment of HRIRs followed by a minimization of the squared error subject to a diffuse-field covariance matrix constraint, is presented. The frequency-dependent time alignment retains the interaural time difference (at low frequencies) and results in a HRIR set with lower spatial complexity, while the constrained optimization controls the diffuse-field behavior. Technical evaluations in terms of sound coloration, interaural level differences, diffuse-field response, and interaural coherence, as well as findings from formal listening experiments show a significant improvement of the proposed method compared to state-of-the-art methods.
The Chinese import ban and its impact on global plastic waste trade
Authors: Brooks Amy L. , Wang Shunli , Jambeck Jenna R.
Published: June 2018

For decades China imported much of the world’s plastic waste; but a recent import ban requires new ideas and systemic change.
The ERBB network facilitates KRAS-driven lung tumorigenesis
Authors: Kruspig Björn , Monteverde Tiziana , Neidler Sarah , Hock Andreas , Kerr Emma , Nixon Colin , Clark William , Hedley Ann , Laing Sarah , Coffelt Seth B. , Le Quesne John , Dick Craig , Vousden Karen H. , Martins Carla P. , Murphy Daniel J.
Published: June 2018

G12 mutant KRAS requires tonic ERBB network activity for initiation and maintenance of lung cancer.
A molecular warning system for invasive pneumococcus
Authors: Langelier Chaz
Published: June 2018

A genome-wide association study of
Streptococcus pneumoniae
identifies and validates bacterial loci associated with invasive infection.
Improving “gut feelings” for poorly water-soluble drugs
Authors: Shen Keyue
Published: June 2018

A nanocarrier system self-assembled in the intestine significantly improves oral availability of poorly water-soluble drugs.
In Vitro
Susceptibility of Burkholderia cepacia Complex Isolated from Cystic Fibrosis Patients to Ceftazidime-Avibactam and Ceftolozane-Tazobactam
Authors: Van Dalem A. , Herpol M. , Echahidi F. , Peeters C. , Wybo I. , De Wachter E. , Vandamme P. , Piérard D.
Published: June 2018

We tested the
in vitro
susceptibility of ceftazidime-avibactam and ceftolozane-tazobactam and 13 other antibiotics against 91
Burkholderia cepacia
complex (BCC) strains isolated from cystic fibrosis patients since 2012. The highest susceptibility (82%) was found for trimethoprim-sulfamethoxazole.
CRISPR/Cas9 Genome Editing To Demonstrate the Contribution of Cyp51A Gly138Ser to Azole Resistance in Aspergillus fumigatus
Authors: Umeyama Takashi , Hayashi Yuta , Shimosaka Hisaki , Inukai Tatsuya , Yamagoe Satoshi , Takatsuka Shogo , Hoshino Yasutaka , Nagi Minoru , Nakamura Shigeki , Kamei Katsuhiko , Ogawa Kenji , Miyazaki Yoshitsugu
Published: June 2018

A pan-azole-resistant
Aspergillus fumigatus
strain with the
cyp51A
mutations Gly138Ser and Asn248Lys was isolated from a patient receiving long-term voriconazole treatment. PCR fragments containing
cyp51A
with the mutations were introduced along with the Cas9 protein and single guide RNA into the azole-resistant/susceptible strains.
Draft Genome Sequence of Serratia sp. Strain S1B, Isolated from Mercury-Contaminated Soil
Authors: Pathak Ashish , Jaswal Rajneesh , Xu Xiaoyu , Chauhan Ashvini
Published: June 2018

We report here the draft genome sequence of
Serratia
sp. strain S1B, comprising 7,710,841 bases, 7,075 coding sequences, a G+C content of 45.9%, and 138 RNAs. Notably, a repertoire of biodegradative genes, several occurring on genomic islands, was also identified, which enhances our understanding of the environmental relevance of
Serratia
spp.
Draft Genome Sequence of Bifidobacterium longum UMA026, Isolated from Holstein Dairy Cow Feces
Authors: Albert Korin , Sela David A.
Published: June 2018

The draft genome sequence of an isolate identified as
Bifidobacterium longum
is communicated herein. This strain was isolated from the feces of a 1-week-old Holstein dairy cow. The draft genome of this
Bifidobacterium longum
isolate is 2.39 Mb in length, with a G+C content of 60.1%.
Complete Genome Sequences of Four Novel Human Gammapapillomavirus Types, HPV-219, HPV-220, HPV-221, and HPV-222, Isolated from Penile Skin Swabs from South African Men
Authors: Murahwa Alltalents T. , Meiring Tracy L. , Mbulawa Zizipho Z. A. , Williamson Anna-Lise
Published: June 2018

Four novel human gammapapillomaviruses were characterized from penile specimens using genome amplification, cloning, and sequencing. The HPV-219 L1 gene showed 87% nucleotide identity to that of HPV-213 of species gamma-13, HPV-220 had 72% identity to L1 of HPV-212 (gamma-17), HPV-221 had 80% identity to L1 of HPV-142 (gamma-10), and HPV-222 had 73% nucleotide identity to L1 of HPV-162 (gamma-19).
Identification of Biomarkers for Differentiation of Hypervirulent Klebsiella pneumoniae from Classical K. pneumoniae
Authors: Russo Thomas A. , Olson Ruth , Fang Chi-Tai , Stoesser Nicole , Miller Mark , MacDonald Ulrike , Hutson Alan , Barker Jason H. , La Hoz Ricardo M. , Johnson James R. , Backer Martin , Bajwa Rajinder , Catanzaro Andrew T. , Crook Derrick , de Almeda Kleper , Fierer Joshua , Greenberg David E. , Klevay Michael , Patel Payal , Ratner Adam , Wang Jin-Town , Zola Jaroslaw
Published: June 2018

A hypervirulentKlebsiella pneumoniae(hvKp) pathotype is undergoing global dissemination. In contrast to the usual health care-associated epidemiology of classicalK. pneumoniae(cKp) infections, hvKp causes tissue-invasive infections in otherwise healthy individuals from the community, often involving multiple sites.
Structural Basis for the Broad, Antibody-Mediated Neutralization of H5N1 Influenza Virus
Authors: Lin Qingshan , Li Tingting , Chen Yixin , Lau Siu-Ying , Wei Minxi , Zhang Yuyun , Zhang Zhenyong , Yao Qiaobin , Li Jinjin , Li Zhihai , Wang Daning , Zheng Qingbing , Yu Hai , Gu Ying , Zhang Jun , Chen Honglin , Li Shaowei , Xia Ningshao
Published: June 2018

Infection by highly pathogenic avian influenza A virus remains a threat to public health. Our broadly neutralizing antibody, 13D4, is capable of neutralizing all representative H5N1 viruses and protecting mice against lethal challenge. Structural analysis revealed that 13D4 uses heavy-chain complementarity-determining region 3 (HCDR3) to fit the receptor binding site (RBS) via conformational rearrangement. Four conserved residues within the RBS are critical for the broad potency of 13D4. Importantly, polymorphism of Lys193 on the RBS may be associated with the antigenicity shift from H5N1 to other newly emerging viruses, such as H5N6 and H5N8. Our findings may pave the way for highly pathogenic avian influenza virus vaccine development and therapeutic RBS inhibitor design.
Bacterial Small RNAs in Mixed Regulatory Networks
Authors: Brosse Anaïs , Guillier Maude
Published: June 2018

Small regulatory RNAs are now recognized as key regulators of gene expression in bacteria. They accumulate under specific conditions, most often because their synthesis is directly controlled by transcriptional regulators, including but not limited to alternative sigma factors and response regulators of two-component systems. In turn, small RNAs regulate, mostly at the posttranscriptional level, expression of multiple genes, among which are genes encoding transcriptional regulators. Small RNAs are thus embedded in mixed regulatory circuits combining transcriptional and posttranscriptional controls, and whose properties are discussed here.
Detailed genetic characteristics of an international large cohort of patients with Stargardt disease: ProgStar study report 8
Authors: Fujinami Kaoru , Strauss Rupert W , Chiang John (Pei-Wen) , Audo Isabelle S , Bernstein Paul S , Birch David G , Bomotti Samantha M , Cideciyan Artur V , Ervin Ann-Margret , Marino Meghan J , Sahel José-Alain , Mohand-Said Saddek , Sunness Janet S , Traboulsi Elias I , West Sheila , Wojciechowski Robert , Zrenner Eberhart , Michaelides Michel , Scholl Hendrik P N ,   ProgStar Study Group
Published: June 2018

Background/aims

To describe the genetic characteristics of the cohort enrolled in the international multicentre progression of Stargardt disease 1 (STGD1) studies (ProgStar) and to determine geographic differences based on the allele frequency.

Methods

345 participants with a clinical diagnosis of STGD1 and harbouring at least one disease-causing ABCA4 variant were enrolled from 9 centres in the USA and Europe. All variants were reviewed and
in silico
analysis was performed including allele frequency in public databases and pathogenicity predictions. Participants with multiple likely pathogenic variants were classified into four national subgroups (USA, UK, France, Germany), with subsequent comparison analysis of the allele frequency for each prevalent allele.

Results

211 likely pathogenic variants were identified in the total cohort, including missense (63%), splice site alteration (18%), stop (9%) and others. 50 variants were novel. Exclusively missense variants were detected in 139 (50%) of 279 patients with multiple pathogenic variants. The three most prevalent variants of these patients with multiple pathogenic variants were p.G1961E (15%), p.G863A (7%) and c.5461-10 T>C (5%). Subgroup analysis revealed a statistically significant difference between the four recruiting nations in the allele frequency of nine variants.

Conclusions

There is a large spectrum of ABCA4 sequence variants, including 50 novel variants, in a well-characterised cohort thereby further adding to the unique allelic heterogeneity in STGD1. Approximately half of the cohort harbours missense variants only, indicating a relatively mild phenotype of the ProgStar cohort. There are significant differences in allele frequencies between nations, although the three most prevalent variants are shared as frequent variants.
Comparison of the efficacy and acceptability of Chinese herbal medicine in adult patients with heart failure and reduced ejection fraction: study protocol for a systematic review and network meta-analysis
Authors: Liu Jing , Lu Jin-Jin , Zhou Kun , Wan Jie , Li Yan , Cui Xiao-Yun , Gao Qun , Huang Yan-Chao , Li Si-Nai , Dong Qiao-Zhi , Lin Qian
Published: June 2018

Introduction

Heart failure with reduced ejection fraction (HFrEF) is defined as the clinical diagnosis of heart failure (HF) and ejection fraction (EF) ≤40%, which is a severe public healthcare issue and brings a heavy social and economic burden for patients with HFrEF. Chinese herbal medicine (CHM) has a long history in treating HF. Questions concerning the efficacy and acceptability of CHM-related interventions in adult patients with HFrEF led us to use the method of systematic review and network meta-analysis to integrate direct and indirect evidence to create hierarchies for all CHM.

Methods and analysis

Nine medical databases, including PubMed, EMBASE (OVID), the Cochrane Library, Google Scholar, Web of Science, CNKI, VIP, Wanfang Database and CBM will be searched from the date of database inception to June 2015 (updated to March 2017) without language and publication status restriction. Completely randomised controlled trials (RCTs) comparing CHM or CHM plus routine treatment with CHM, CHM plus routine treatment, routine treatment, no treatment or placebo for adults with HFrEF will be examined. Our primary outcomes will include all-cause mortality, HF-related death, all-cause rehospitalisation, HF-related rehospitalisation and acceptability (discontinuation due to any adverse events during treatment). Secondary outcomes will include response rate, mean value or mean difference from baseline of surrogate indexes. We will perform the Bayesian network meta-analyses (NMA) for the most frequently reported primary or secondary outcome and the acceptability outcome, if available. Meta-regression, subgroup analyses and sensitivity analyses will be conducted based on prespecified effect modifiers to assess the robustness of the findings.

Dissemination

The results of this NMA will provide useful information about the effectiveness and acceptability of CHM in adults with HFrEF, which will also have implications for clinical practice and further research. Findings will be disseminated through peer-reviewed journal publication and conference presentations.

PROSPERO registration number

CRD42016053854.
Validation of discharge diagnosis codes to identify serious infections among middle age and older adults
Authors: Wiese Andrew D , Griffin Marie R , Stein C Michael , Schaffner William , Greevy Robert A , Mitchel Jr Edward F , Grijalva Carlos G
Published: June 2018

Objectives

Hospitalisations for serious infections are common among middle age and older adults and frequently used as study outcomes. Yet, few studies have evaluated the performance of diagnosis codes to identify serious infections in this population. We sought to determine the positive predictive value (PPV) of diagnosis codes for identifying hospitalisations due to serious infections among middle age and older adults.

Setting and participants

We identified hospitalisations for possible infection among adults >=50 years enrolled in the Tennessee Medicaid healthcare programme (2008–2012) using International Classifications of Diseases, Ninth Revision diagnosis codes for pneumonia, meningitis/encephalitis, bacteraemia/sepsis, cellulitis/soft-tissue infections, endocarditis, pyelonephritis and septic arthritis/osteomyelitis.

Design

Medical records were systematically obtained from hospitals randomly selected from a stratified sampling framework based on geographical region and hospital discharge volume.

Measures

Two trained clinical reviewers used a standardised extraction form to abstract information from medical records. Predefined algorithms served as reference to adjudicate confirmed infection-specific hospitalisations. We calculated the PPV of diagnosis codes using confirmed hospitalisations as reference. Sensitivity analyses determined the robustness of the PPV to definitions that required radiological or microbiological confirmation. We also determined inter-rater reliability between reviewers.

Results

The PPV of diagnosis codes for hospitalisations for infection (n=716) was 90.2% (95% CI 87.8% to 92.2%). The PPV was highest for pneumonia (96.5% (95% CI 93.9% to 98.0%)) and cellulitis (91.1% (95% CI 84.7% to 94.9%)), and lowest for meningitis/encephalitis (50.0% (95% CI 23.7% to 76.3%)). The adjudication reliability was excellent (92.7% agreement; first agreement coefficient: 0.91). The overall PPV was lower when requiring microbiological confirmation (45%) and when requiring radiological confirmation for pneumonia (79%).

Conclusions

Discharge diagnosis codes have a high PPV for identifying hospitalisations for common, serious infections among middle age and older adults. PPV estimates for rare infections were imprecise.
Enhancing recognition of obstetric anal sphincter injuries in six maternity units in Palestine: an interventional quality improvement study
Authors: Ali-Masri Hadil , Hassan Sahar , Ismail Khaled , Zimmo Kaled , Zimmo Mohammed , Fosse Erik , Vikanes Åse , Laine Katariina
Published: June 2018

Objective

To explore the impact of a training intervention on obstetric anal sphincter injuries’ (OASIS) detection rate.

Design

Prospective quality improvement interventional study.

Setting

Six secondary and tertiary maternity units in Palestine.

Population

Women having singleton vaginal births ≥23 weeks’ gestation or babies weighing ≥500 g (n=22 922). Caesarean births (n=5431), multiple gestations (n=443) and vaginal births of unregistered perineum status (n=800) were excluded.

Interventions

Training programme for enhancing OASIS detection was conducted between 31 January and 31 December 2015. International experts delivered 2-day standardisation workshop teaching OASIS diagnosis and repair to each maternity unit. They also provided additional training to three research fellows employed in three of the maternity units. This was followed by 13-week period of data collection (phase 1). Research fellows then delivered training intervention over 15-week interval (phase 2), including theoretical teaching and ‘onsite’ training in perineal trauma assessment within the six maternity units. Finally, 13-week postintervention observation (phase 3) followed.

Primary outcome measure

OASIS rates were used as surrogate for OASIS recognition. OASIS rates were compared between different phases and between the two maternity unit groups (research fellow and non-research fellow based) using Pearson’s χ² test.

Results

A total 22 922 women were included. Among primiparous women, OASIS rate was higher in phase 2 (2.8%, p<0.001) and phase 3 (3.1%, p<0.001) than phase 1 (0.5%). However, no significant differences were detected in the rates of severe OASIS (third-degree 3c and fourth-degree tears) between phase 1 and 2 (0.5% vs 0.3%), because this would have required at least 103 women with severe OASIS to be included in each phase. Among parous women, OASIS rate was significantly higher in phase 2 (0.6%, p=0.002) but not in phase 3 (0.4%, p=0.071) compared with phase 1 (0.2%). Research fellows’ maternity units showed higher OASIS rates among primiparous women in phase 2 (3.6% vs 1.4%, p=0.001) and phase 3 (4.3% vs 0.8%, p<0.001) than non-research fellows’ maternity units.

Conclusions

This work is basically an epidemiological study which has identified the prevalence of perineal lacerations and their severity on a large sample of women representative of an entire geographical ethnic region. The quality improvement intervention improved OASIS detection mainly in the research fellows’ maternity units. Regular mandatory national programmes in obstetric perineal trauma assessment and management by local champions are essential to mitigate the risk of missing significant degrees of trauma.
Interventions for mental health problems in children and adults with severe intellectual disabilities: a systematic review
Authors: Vereenooghe Leen , Flynn Samantha , Hastings Richard P , Adams Dawn , Chauhan Umesh , Cooper Sally-Ann , Gore Nick , Hatton Chris , Hood Kerry , Jahoda Andrew , Langdon Peter E , McNamara Rachel , Oliver Chris , Roy Ashok , Totsika Vasiliki , Waite Jane
Published: June 2018

Objective

Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatment options have received little attention. The aim of this study was to identify and evaluate the effectiveness of pharmacological and psychological interventions in the treatment of mental health problems in children and adults with severe and profound intellectual disabilities, given their difficulties in accessing standard mental health interventions, particularly talking therapies, and difficulties reporting drug side effects.

Design

A systematic review using electronic searches of PsycINFO, PsycTESTS, EMBASE, MEDLINE, CINAHL, ERIC, ASSIA, Science Citation Index, Social Science Citation Index and CENTRAL was conducted to identify eligible intervention studies. Study selection, data extraction and quality appraisal were performed by two independent reviewers.

Participants

Study samples included at least 70% children and/or adults with severe or profound intellectual disabilities or reported the outcomes of this subpopulation separate from participants with other levels of intellectual disabilities.

Interventions

Eligible intervention studies evaluated a psychological or pharmacological intervention using a control condition or pre-post design.

Outcomes

Symptom severity, frequency or other quantitative dimension (e.g., impact), as assessed with standardised measures of mental health problems.

Results

We retrieved 41 232 records, reviewed 573 full-text articles and identified five studies eligible for inclusion: three studies evaluating pharmacological interventions, and two studies evaluating psychological interventions. Study designs ranged from double-blind placebo controlled crossover trials to single-case experimental reversal designs. Quality appraisals of this very limited literature base revealed good experimental control, poor reporting standards and a lack of follow-up data.

Conclusions

Mental ill health requires vigorous treatment, yet the current evidence base is too limited to identify with precision effective treatments specifically for children or adults with severe and profound intellectual disabilities. Clinicians therefore must work on the basis of general population evidence, while researchers work to generate more precise evidence for people with severe and profound intellectual disabilities.

PROSPERO registration number

CRD 42015024469.
Does perceived organisational support influence career intentions? The qualitative stories shared by UK early career doctors
Authors: Scanlan Gillian Marion , Cleland Jennifer , Walker Kim , Johnston Peter
Published: June 2018

Introduction

The wish to quit or take time out of medical training appears to be related, at least in part, to a strong desire for supportive working and learning environments. However, we do not have a good understanding of what a supportive culture means to early career doctors, and how perceptions of support may influence career decision making. Our aim was to explore this in UK Foundation doctors.

Methods

This was a qualitative study using semistructured interviews incorporating a narrative inquiry approach for data collection. Interview questions were informed by the literature as well as data from two focus groups. Interviews were carried out in two UK locations. Initial data coding and analysis were inductive, using thematic analysis. We then used the lens of Perceived Organizational Support (POS) to group themes and aid conceptual generalisability.

Results

Twenty-one interviews were carried out. Eleven interviewees had applied for specialty training, while ten had not. Support from senior staff and colleagues influenced participants’ job satisfaction and engagement. Positive relationships with senior staff and colleagues seemed to act as a buffer, helping participants cope with challenging situations. Feeling valued (acknowledgement of efforts, and respect) was important. Conversely, perceiving a poor level of support from the organisation and its representatives (supervisors and colleagues) had a detrimental impact on participants’ intentions to stay working within the National Health Service (NHS).

Conclusion

Overall, this is the first study to explore directly how experiences in early postgraduate training have a critical impact on the career intentions of trainee/resident doctors. We found perceived support in the early stages of postgraduate training was critical to whether doctors applied for higher training and/or intended to stay working in the NHS. These findings have transferable messages to other contexts struggling to recruit and retain junior doctors.
Should all medical research be published? The moral responsibility of medical journal editors
Authors: Ploug Thomas
Published: June 2018

This article reinvigorates a key question in publication ethics: Is there research that it is permissible to conduct but that ought not to be published? The article raises the question in relation to two recent medical studies. It is argued (1) that the publication of these studies may cause significant harm to individuals, (2) that editors of medical journals have a moral responsibility for such harm, (3) that denial of publication is inadequate as an instrument to fulfil this moral responsibility and (4) that internationally acknowledged publication ethics codes should incorporate this aspect of editors’ moral responsibility.
Increased capillary density in skeletal muscle is not associated with impaired insulin sensitivity induced by bed rest in healthy young men
Authors: Montero David , Oberholzer Laura , Haider Thomas , Breenfeldt-Andersen Andreas , Dandanell Sune , Meinild-Lundby Anne-Kristine , Maconochie Hannah , Lundby Carsten
Published: June 2018

Physical inactivity alters glucose homeostasis in skeletal muscle, potentially developing into overt metabolic disease. The present study sought to investigate the role of skeletal muscle capillarization in glucose tolerance and insulin sensitivity (IS) using a classic human model of physical inactivity. Thirteen healthy males (age = 23 ± 2 years) underwent 4 days of full-time supervised and diet-controlled bed rest. Oral glucose tolerance test, indices of IS (quantitative insulin sensitivity check index (QUICKI), Matsuda index), as well as skeletal muscle biopsies with measurement of fiber type distribution, fiber cross-sectional area (FCSA), capillary-to-fiber ratio (C/F ratio), and capillary density (CD) were assessed prior to and after bed rest. Body weight and composition were unaltered by bed rest. Fasting glucose/insulin ratio (G0/I0ratio) (−25%, P = 0.016), QUICKI (−7%, P = 0.023), and Matsuda index (−24%, P = 0.003) diminished with bed rest. Skeletal muscle FCSA decreased (−737.4 ± 763.2 μm−2(−12%), P = 0.005) while C/F ratio was preserved, resulting in augmented CD (+93.9 ± 91.5 capillaries·mm−2(+37%), P = 0.003) with bed rest. No association was detected between changes in skeletal muscle variables and metabolic outcomes. Independently of bed rest-induced effects, a positive linear relationship was detected between C/F ratio and G0/I0ratio (β = 17.09, P = 0.021). In conclusion, impaired glucose homeostasis with bed rest is not prevented nor associated with enhanced skeletal muscle capillarization in healthy individuals.
A Review on Self-Healing and Self-Organizing Techniques for Wireless Sensor Networks
Authors: Diaz Sergio , Mendez Diego , Kraemer Rolf
Published: June 2018

We present the state-of-the-art related to self-organizing and self-healing techniques. On the one hand, self-organization is the nodes’ ability to construct a network topology without any human intervention and any previous topology knowledge. On the other hand, self-healing is the network’s ability to recover from failures by using hardware and software redundancies. By using both techniques, Wireless Sensor Networks (WSNs) can be deployed in unattended and harsh environments where on-site technical service is unfeasible. In the last few years, a large amount of work has been done in these two research areas, but these different techniques occur at different layers and with no general classification or effort to consolidate them. One of the contributions of this paper is the consolidation of the most significant and relevant mechanisms in these two areas, and additionally, we made an effort to organize and classify them. In this review, we explain in detail the two stages of self-organization, namely topology construction and management. Moreover, we present a comprehensive study of the four steps in a self-healing technique, namely, information collection, fault detection, fault classification and fault recovery. By introducing relevant work, comparative tables, and future trends, we provide the reader with a complete picture of the state-of-the-art. Another contribution is the proposal of a unified framework that employs self-organizing and self-healing mechanisms to achieve a fault-tolerant network.
FRACTAL APPROXIMATION OF JACKSON TYPE FOR PERIODIC PHENOMENA
Authors: NAVASCUÉS M. A. , JHA SANGITA , CHAND A. K. B. , SEBASTIÁN M. V.
Published: June 2018

The reconstruction of an unknown function providing a set of Lagrange data can be approached by means of fractal interpolation. The power of that methodology allows us to generalize any other interpolant, both smooth and nonsmooth, but the important fact is that this technique provides one of the few methods of nondifferentiable interpolation. In this way, it constitutes a functional model for chaotic processes. This paper studies a generalization of an approximation formula proposed by Dunham Jackson, where a wider range of values of an exponent of the basic trigonometric functions is considered. The trigonometric polynomials are then transformed in close fractal functions that, in general, are not smooth. For suitable election of this parameter, one obtains better conditions of convergence than in the classical case: the hypothesis of continuity alone is enough to ensure the convergence when the sampling frequency is increased. Finally, bounds of discrete fractal Jackson operators and their classical counterparts are proposed.
Text Mining: Techniques, Applications, and Challenges
Authors: Justicia de la Torre C. , Sánchez D. , Blanco I. , Martín-Bautista M. J.
Published: June 2018

This work presents an overview of the text mining area, considering the most common techniques, and including proposals based on the application of fuzzy sets. Besides, some of the most frequent text mining applications are mentioned. We discuss the existing approaches, which we call text data mining, in relation to the recently proposed paradigm of text knowledge mining, and we conclude that both are different and complementary, in the sense that they are able to extract different knowledge pieces from text by using different reasoning mechanisms. Future challenges related to text knowledge mining are also briefly outlined.
Some Interval-Valued Intuitionistic Fuzzy Zhenyuan Aggregation Operators and Their Application to Multi-Attribute Decision Making
Authors: Mu Zhimin , Zeng Shouzhen , Liu Qingbing
Published: June 2018

This paper develops some new decision making methods for multi-attribute decision making (MADM) problems, in which the attribute weights take the form of crisp numbers, and attribute values take the form of interval-valued intuitionistic fuzzy information. First, based on the Zhenyuan integral, an interval-valued intuitionistic fuzzy Zhenyuan averaging (IVIFZA) operator and an interval-valued intuitionistic fuzzy Zhenyuan geometric (IVIFZG) operator are introduced to facilitate aggregation of interval-valued intuitionistic fuzzy information. The proposed operators allow one to fully consider the importance of different combinations of attributes and, therefore, are highly suitable to handle problems involving inter-dependent or interactive attributes. We further proceed by exploring some desirable properties of the IVIFZA and IVIVZG operators. By employing the proposed operators, a MADM approach based on intervalvalued intuitionistic fuzzy information is proposed. Finally, an illustrative example is presented to verify the developed approach and to demonstrate its practicality and effectiveness.
Effect of Added Mass on Wind-Induced Vibration of a Circular Flat Membrane by Wind Tunnel Tests
Authors: Zhou Yi , Li Yuanqi , Yoshida Akihito
Published: June 2018

Flexible roof structures, such as membranes, are sensitive to wind action due to their flexibility and light weight. Previously, the effect of added mass on the vibration frequency of membrane structures has been experimentally tested. However, the effect of added mass on wind-induced vibration remains unclear. The purpose of this paper is to investigate the effect of added mass on the wind-induced vibration of a circular flat membrane based on wind tunnel tests. First, wind tunnel tests were conducted to obtain wind pressure distribution from the rigid model and wind-induced vibration from the aeroelastic model of a circular flat membrane. Secondly, a dynamic finite element analysis for the proposed added mass model was conducted to obtain the wind-induced vibration of the membrane structure. Then, with the wind pressure distribution obtained from the rigid model tests, dynamic analysis was conducted either with or without consideration of the effect of added mass. According to the dynamic analysis results and the wind tunnel test results, it is clear that considering the effect of added mass in dynamic analysis can significantly improve the accuracy of a wind-induced response. Such an effect is more significant at the windward than the central zone. The inclusion of added mass can result in a larger displacement response as wind velocity increases but a smaller response as the prestress level increases.
L1 Regularized Model Updating for Structural Damage Detection
Authors: Wu Yu-Han , Zhou Xiao-Qing
Published: June 2018

Model updating methods based on structural vibration data have been developed and applied to detecting structural damages in civil engineering. Compared with the large number of elements in the entire structure of interest, the number of damaged elements which are represented by the stiffness reduction is usually small. However, the widely used [Formula: see text] regularized model updating is unable to detect the sparse feature of the damage in a structure. In this paper, the [Formula: see text] regularized model updating based on the sparse recovery theory is developed to detect structural damage. Two different criteria are considered, namely, the frequencies and the combination of frequencies and mode shapes. In addition, a one-step model updating approach is used in which the measured modal data before and after the occurrence of damage will be compared directly and an accurate analytical model is not needed. A selection method for the [Formula: see text] regularization parameter is also developed. An experimental cantilever beam is used to demonstrate the effectiveness of the proposed method. The results show that the [Formula: see text] regularization approach can be successfully used to detect the sparse damaged elements using the first six modal data, whereas the [Formula: see text] counterpart cannot. The influence of the measurement quantity on the damage detection results is also studied.