bluuebunny/crossref_metadata_2025 huggingface dataset:
Flightless scaly‐tailed squirrels never learned how to fly: A reappraisal of Anomaluridae phylogeny
Authors: Fabre Pierre‐Henri , Tilak Marie‐Ka , Denys Christiane , Gaubert Philippe , Nicolas Violaine , Douzery Emmanuel J. P. , Marivaux Laurent
Published: June 2018

Anomaluroidea, commonly known as the “scaly‐tailed squirrels,” are an emblematic group of tropical African mammals that includes gliding forms. The family Anomaluridae was until recently represented by three genera: the flying scaly‐tailed squirrels (Anomalurus), the flying mouse (Idiurus) and the flightless scaly‐tailed squirrels (Zenkerella). Idiurus and Zenkerella have long been grouped into the Zenkerellinae subfamily, and Zenkerella was interpreted as a rare case of evolutionary reversal to non‐gliding lifestyle. Recent studies have demonstrated that Zenkerella is sister to all other modern anomalurids, and represents in fact the monogeneric family Zenkerellidae. The Anomalurus genus was split into Anomalurus and Anomalurops, but no study has ever considered all Anomalurus species together in a phylogeny to test the status of Anomalurops. Here, we used mitogenomic next‐generation sequencing to infer the phylogenetic relationships among all extant anomalurids and to estimate their divergence ages. We found that the arboreal Zenkerella is the sister group of all extant gliding anomalurids (Idiurus and Anomalurus). We confirmed that Anomaluroidea only evolved the gliding adaptation once. A comparison based on morphological traits indicates that Zenkerella harbours several unique morphological features. We propose new morphological characters for the novel classification of modern Anomaluroidea, which includes the families Zenkerellidae and Anomaluridae. Using different calibration schemes, we demonstrated that classical dating methods relying only on mitogenomes provide rather young Miocene estimates between Zenkerellidae and the Anomaluridae. The use of published nuclear genes, internal calibrations and tip dating converged towards an Eocene split between gliding and non‐gliding scaly‐tailed squirrels, which is in agreement with the African fossil record. Finally, we provide the first exhaustive species‐level molecular phylogenetic inference for the genus Anomalurus. We found that Anomalurus beecrofti is the sister group of all other species of Anomalurus and branched off during the Miocene.
CLIMATE CHANGE AND CONFLICTING FUTURE VISIONS
Authors: Larrabee David A.
Published: June 2018

Dealing with the effects of climate change requires the consideration of multiple conflicting moral claims. The prioritization of these claims depends on the vision of a desired future, eschatology broadly defined. These visions, sometimes implicit rather than explicit, shape our decision making by influencing our sense of how things “ought to be.” The role of future visions in economics, technology, and preservation of nature are explored as secular eschatologies. Four aspects of such visions are especially relevant to climate change decisions: distributive justice, land use, the relationship among humans, and our relationship to the rest of nature. Effectively dealing with such wicked problems requires that we scrutinize our visions of how the future ought to be, both technically and morally. Finally, we must foster a dialogue between competing visions so that we can forge a path that strives for consent.
WHAT IS CLIMATE CHANGE DOING TO US AND FOR US?
Authors: Carr Paul H.
Published: June 2018

What are we doing to our climate? Emissions from fossil fuel burning have raised carbon dioxide concentrations 35 percent higher than in the past millions of years. This increase is warming our planet via the greenhouse effect. What is climate change doing to and for us? Dry regions are drier and wet ones wetter. Wildfires have increased threefold, hurricanes more violent, floods setting record heights, glaciers melting, and seas rising. Parts of Earth are increasingly uninhabitable. Climate change requires us to act as a global community. Climate justice enjoins emitters to pay the social‐environmental costs of fossil fuel burning. This would expedite green solar, wind, and next‐generation nuclear energy sources. Individuals should conserve resources, waste less food, and eat a plant‐rich diet.
CLIMATE CHANGE IN CONTEXT: STRESS, SHOCK, AND THE CRUCIBLE OF LIVINGKIND
Authors: van Pelt James Clement
Published: June 2018

An increasing number of environmentally knowledgeable observers and activists comprehend the situation faced by the emerging global civilization and its unsustainable systems, characterized by planet‐altering positive feedback loops arising from human activity. They perceive contemporary natural and cultural developments as the prelude to the imminent collapse of technological civilization and the cataclysmic end of the Anthropocene epoch via a forced passage through the population bottleneck of the impending extinction‐level event which only a remnant of the present biosphere is likely to survive. Should this understanding be accurate, our own time could become the occasion for the greatest choice ever made on Earth: whether to continue things as they are until humanity becomes the chief cause and the chief victim of the now‐unfolding mass extinction; or to make the necessary transition to the awakening of Planet Earth.
Distance restricted maximal covering model for pharmacy duty scheduling problem
Authors: Uncu Nuşin , Bulğurcu Berna , Kılıç Fatih
Published: June 2018

Pharmacies are considered as an integral part of health care systems for supplying medicine to patients. In order to access  medicine with ease, pharmacies locations in the context of distance and demand are important for patients. In the case of a few numbers of pharmacies may be on duty at nights or during holidays, pharmacies duty scheduling problem occur and can be associated with location models. In contrast to widely used p-median model which aims to minimize the demand-weighted distance, we maximize the demand covered over the distance between the patients and the pharmacies on duty. Main contribution of the proposed model is the restriction constraint for the distance between pharmacies on duty in order to ensure fairness in an organizational view of point. We propose a distance restricted maximal covering location model (DR-MCLM) in this study. This mathematical model is a mixed integer linear programming model and solved by Lingo optimization software. The distances between the pharmacies and the sites are obtained using Geographic Information Systems (GIS). The model is applied for the case in Adana, one of the biggest cities in Turkey. The results are given on the maps of the city, including the pharmacies on duty and their assignments to sites in each day of the period.
Effect of movement‐related pain on behaviour and corticospinal excitability changes associated with arm movement preparation
Authors: Neige Cécilia , Mavromatis Nicolas , Gagné Martin , Bouyer Laurent J. , Mercier Catherine
Published: June 2018

Key points

Experimental pain or its anticipation influence motor preparation processes as well as upcoming movement execution, but the underlying physiological mechanisms remain unknown.

Our results showed that movement‐related pain modulates corticospinal excitability during motor preparation.

In accordance with the pain adaptation theory, corticospinal excitability was higher when the muscle has an antagonist (vs. an agonist) role for the upcoming movement associated with pain.

Anticipation of movement‐related pain also affects motor initiation and execution, with slower movement initiation (longer reaction times) and faster movement execution compared to movements that do not evoke pain.

These results confirm the implementation of protective strategies during motor preparation known to be relevant for acute pain, but which may potentially have detrimental long‐term consequences and lead to the development of chronic pain.

When a movement repeatedly generates pain, we anticipate movement‐related pain and establish self‐protective strategies during motor preparation, but the underlying mechanisms remains poorly understood. The current study investigated the effect of movement‐related pain anticipation on the modulation of behaviour and corticospinal excitability during the preparation of arm movements. Participants completed an instructed‐delay reaction‐time (RT) task consisting of elbow flexions and extensions instructed by visual cues. Nociceptive laser stimulations (unconditioned stimuli) were applied to the lateral epicondyle during movement execution in a specific direction (CS+) but not in the other (CS−), depending on experimental group. During motor preparation, transcranial magnetic stimulation was used to measure corticospinal excitability in the biceps brachii (BB). RT and peak end‐point velocity were also measured. Neurophysiological results revealed an opposite modulation of corticospinal excitability in BB depending on whether it plays an agonist (i.e. flexion) or antagonist (i.e. extension) role for the CS+ movements (P < 0.001). Moreover, behavioural results showed that for the CS+ movements RT did not change relative to baseline, whereas the CS− movements were initiated more quickly (P = 0.023) and the CS+ flexion movements were faster relative to the CS− flexion movements (P < 0.001). This is consistent with the pain adaptation theory which proposes that in order to protect the body from further pain, agonist muscle activity is reduced and antagonist muscle activity is increased. If these strategies are initially relevant and lead to short‐term pain alleviation, they may potentially have detrimental long‐term consequences and lead to the development of chronic pain.
Acoustic landmarks contain more information about the phone string than other frames for automatic speech recognition with deep neural network acoustic model
Authors: He Di , Lim Boon Pang , Yang Xuesong , Hasegawa-Johnson Mark , Chen Deming
Published: June 2018

Most mainstream automatic speech recognition (ASR) systems consider all feature frames equally important. However, acoustic landmark theory is based on a contradictory idea that some frames are more important than others. Acoustic landmark theory exploits quantal nonlinearities in the articulatory-acoustic and acoustic-perceptual relations to define landmark times at which the speech spectrum abruptly changes or reaches an extremum; frames overlapping landmarks have been demonstrated to be sufficient for speech perception. In this work, experiments are conducted on the TIMIT corpus, with both Gaussian mixture model (GMM) and deep neural network (DNN)-based ASR systems, and it is found that frames containing landmarks are more informative for ASR than others. It is discovered that altering the level of emphasis on landmarks by re-weighting acoustic likelihood tends to reduce the phone error rate (PER). Furthermore, by leveraging the landmark as a heuristic, one of the hybrid DNN frame dropping strategies maintained a PER within 0.44% of optimal when scoring less than half (45.8% to be precise) of the frames. This hybrid strategy outperforms other non-heuristic-based methods and demonstrate the potential of landmarks for reducing computation.
Linezolid Kills Acid-Phase and Nonreplicative-Persister-Phase Mycobacterium tuberculosis in a Hollow-Fiber Infection Model
Authors: Drusano G. L. , Myrick Jenny , Maynard Michael , Nole Jocelyn , Duncanson Brandon , Brown David , Schmidt Stephan , Neely Michael , Scanga C. A. , Peloquin Charles , Louie Arnold
Published: June 2018

The therapy for treatment of
Mycobacterium tuberculosis
infections is long and arduous. It has been hypothesized that the therapy duration is driven primarily by populations of organisms in different metabolic states that replicate slowly or not at all (acid-phase and nonreplicative-persister [NRP]-phase organisms). Linezolid is an oxazolidinone antimicrobial with substantial activity against Log-phase
M. tuberculosis
. Here, we examined organisms in acid-phase growth and nonreplicative-persister-phenotype growth and determined the effect of differing clinically relevant exposures to linezolid in a hollow-fiber infection model (HFIM). The endpoints measured were bacterial kill over 29 days and whether organisms that were less susceptible to linezolid could be recovered during that period. In addition, we evaluated the effect of administration schedule on linezolid activity, contrasting daily administration with administration of twice the daily dose every other day. Linezolid demonstrated robust activity when administered daily against both acid-phase and NRP-phase organisms. We demonstrated a clear dose response, with 900 mg of linezolid daily generating ≥3 Log(CFU/ml) killing of acid-phase and NRP-phase
M. tuberculosis
over 29 days. Amplification of a population less susceptible to linezolid was not seen. Activity was reduced with every 48-h dosing, indicating that the minimum concentration (
C
min
)/MIC ratio drove the microbiological effect. We conclude that once-daily linezolid dosing has substantial activity against
M. tuberculosis
in acid-phase and NRP-phase metabolic states. Other studies have shown activity against Log-phase
M. tuberculosis
. Linezolid is a valuable addition to the therapeutic armamentarium for
M. tuberculosis
and has the potential for substantially shortening therapy duration.
Activities of Oxadiazole Antibacterials against Staphylococcus aureus and Other Gram-Positive Bacteria
Authors: Ceballos Sara , Kim Choon , Ding Derong , Mobashery Shahriar , Chang Mayland , Torres Carmen
Published: June 2018

The activities of four oxadiazoles were investigated with 210 methicillin-resistant
Staphylococcus aureus
(MRSA) strains. MIC
50
and MIC
90
values of 1 to 2 and 4 μg/ml, respectively, were observed.
In Vivo
Efficacy of Plazomicin Alone or in Combination with Meropenem or Tigecycline against Enterobacteriaceae Isolates Exhibiting Various Resistance Mechanisms in an Immunocompetent Murine Septicemia Model
Authors: Abdelraouf Kamilia , Kim Aryun , Krause Kevin M. , Nicolau David P.
Published: June 2018

Plazomicin is a novel aminoglycoside with potent
in vitro
activity against multidrug- and carbapenem-resistant
Enterobacteriaceae
. The objective of this study was to assess the efficacy of plazomicin exposure, alone and in combination with meropenem or tigecycline, against
Enterobacteriaceae
in the immunocompetent murine septicemia model.
The Murine Polyomavirus MicroRNA Locus Is Required To Promote Viruria during the Acute Phase of Infection
Authors: Burke James M. , Bass Clovis R. , Kincaid Rodney P. , Ulug Emin T. , Sullivan Christopher S.
Published: June 2018

MicroRNAs are expressed by diverse viruses, but for only a few is there any understanding of their
in vivo
function. PyVs can cause serious disease in immunocompromised hosts. Therefore, increased knowledge of how these viruses interact with the immune response is of clinical relevance. Here we show a novel activity for a viral miRNA locus in promoting virus shedding. This work indicates that in addition to any role for the PyV miRNA locus in long-term persistence, it also has biological activity during the acute phase. As this mutant phenotype is alleviated by infection of mice lacking an adaptive immune response, our work also connects the
in vivo
activity of the PyV miRNA locus to the immune response. Given that PyV-associated disease is associated with alterations in the immune response, our findings help to better understand how the balance between PyVs and the immune response becomes altered in pathogenic states.
Drug utilisation among Dutch adolescents: a pharmacy prescription records study
Authors: Kosse Richelle C , Koster Ellen S , de Vries Tjalling W , Bouvy Marcel L
Published: June 2018

Background

Studies on adolescent drug use are scarce as most studies do not distinguish between children and adolescents. Therefore, we assessed overall drug use in adolescents.

Methods

A retrospective cohort study was conducted using pharmacy dispensing records from 62 community pharmacies in the Netherlands. Dispensing records of the previous 5 years were extracted for adolescents (12–18 years).

Results

The study population consisted of 47 421 adolescents who collected at least one medication prescription during adolescence (mean age 15.5±1.8 years; 48.9% males). Half of them collected dermatologicals (46.2% males; 52.3% females), followed by drugs for the respiratory system (43.4% males; 40.3% females) and anti-infectives for systemic use (31.3% males; 39.1% females). The percentage of males using dermatologicals slightly increased, while the percentage of female users decreased with age. The most prescribed active ingredient was methylphenidate.

Conclusions

These insights into adolescent drug use help us to better understand adolescent healthcare use.

Trial registration number

Dutch trial register NTR5061.
Evaluation of keratoconus progression
Authors: Shajari Mehdi , Steinwender Gernot , Herrmann Kim , Kubiak Kate Barbara , Pavlovic Ivana , Plawetzki Elena , Schmack Ingo , Kohnen Thomas
Published: June 2018

Aim

To define variables for the evaluation of keratoconus progression and to determine cut-off values.

Methods

In this retrospective cohort study (2010–2016), 265 eyes of 165 patients diagnosed with keratoconus underwent two Scheimpflug measurements (Pentacam) that took place 1 year apart ±3 months. Variables used for keratoconus detection were evaluated for progression and a correlation analysis was performed. By logistic regression analysis, a keratoconus progression index (KPI) was defined. Receiver-operating characteristic curve (ROC) analysis was performed and Youden Index calculated to determine cut-off values.

Results

Variables used for keratoconus detection showed a weak correlation with each other (eg, correlation r=0.245 between RPImin and Kmax, p<0.001). Therefore, we used parameters that took several variables into consideration (eg, D-index, index of surface variance, index for height asymmetry, KPI). KPI was defined by logistic regression and consisted of a Pachymin coefficient of −0.78 (p=0.001), a maximum elevation of back surface coefficient of 0.27 and coefficient of corneal curvature at the zone 3 mm away from the thinnest point on the posterior corneal surface of −12.44 (both p<0.001). The two variables with the highest Youden Index in the ROC analysis were D-index and KPI: D-index had a cut-off of 0.4175 (70.6% sensitivity) and Youden Index of 0.606. Cut-off for KPI was −0.78196 (84.7% sensitivity) and a Youden Index of 0.747; both 90% specificity.

Conclusions

Keratoconus progression should be defined by evaluating parameters that consider several corneal changes; we suggest D-index and KPI to detect progression.
Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts
Authors: Stamatakis Emmanuel , Kelly Paul , Strain Tessa , Murtagh Elaine M , Ding Ding , Murphy Marie H
Published: June 2018

Background/objectives

Walking pace is associated with risk of premature mortality. However, whether this relationship is independent of total volume of physical activity and highest physical activity intensity remains unclear. We examined the associations between walking pace and cause-specific mortality, investigating the potential modifying effect of factors such as total physical activity volume, highest physical activity intensity, age, sex and body mass index (BMI).

Methods

Prospective pooled analysis of 11 population-based baseline surveys in England and Scotland between 1994 and2008 that were linked with mortality records. Multivariate-adjusted Cox proportional hazards models examined associations between walking pace (slow, average, brisk/fast) and all-cause, cancer and cardiovascular disease (CVD) mortality.

Results

50 225 walkers were entered in the core analyses. Among participants who did not experience an event in the first 2 years of follow-up (n=49 731), walking at an average or brisk/fast pace was associated with a reduced risk of all-cause (20% (95% CI 12% to 28%) and 24% (95% CI 13% to 33%), respectively) and CVD mortality (24% (95% CI 9% to 36%) and 21% (95% CI 1% to 38%), respectively), compared with reporting walking at a slow pace. In stratified analyses, such associations were evident among those over 50 years, those not meeting the physical activity recommendations and those who did not undertake vigorous-intensity activity. There were no interactions by sex or BMI. No associations were seen between pace and cancer mortality.

Conclusion

Walking benefits health. Assuming causality, these analyses suggest that increasing walking pace could reduce risk for all-cause and CVD mortality. Walking pace could be emphasised in public health messages, especially in situations when increase in walking volume or frequency is less feasible.
Walking on sunshine: scoping review of the evidence for walking and mental health
Authors: Kelly Paul , Williamson Chloë , Niven Ailsa G , Hunter Ruth , Mutrie Nanette , Richards Justin
Published: June 2018

Background/objectives

Walking has well-established positive relationships with, and effects on, physical health. In contrast, while poor mental health contributes substantially to global health burden, an overview of the benefits from walking has not previously been published. We aimed to scope the literature and present what is known, and highlight what is not known, about walking and mental health.

Methods

Design: Scoping review.

Data sources: Ovid (Medline), ProQuest, Web of Science.

Screening and reporting: 13 014 records were identified and screened by a team of researchers. Included full texts were analysed and reported according to mental health outcome.

Results

For the 8 mental health outcomes (identified a priori), there were a total of 5 systematic reviews and 50 individual papers included. Depression had the most evidence and existing systematic reviews were reported. Evidence for anxiety, psychological stress, psychological well-being, subjective well-being and social isolation and loneliness varied in volume and effectiveness, but no harmful effects were identified. There were no studies for walking and resilience. The setting and context of walking seems to be important variables.

Conclusion

The evidence base that suggests walking benefits mental health is growing, but remains fragmented and incomplete for some important outcomes. Policy and national guidelines should promote the known mental health benefits of increased walking and future research should directly address the gaps we have identified.
Quantifying patient preferences for symptomatic breast clinic referral: a decision analysis study
Authors: Quinlan Aisling , O’Brien Kirsty K , Galvin Rose , Hardy Colin , McDonnell Ronan , Joyce Doireann , McDowell Ronald D , Aherne Emma , Keogh Claire , O’Sullivan Katriona , Fahey Tom
Published: June 2018

Objectives

Decision analysis study that incorporates patient preferences and probability estimates to investigate the impact of women’s preferences for referral or an alternative strategy of watchful waiting if faced with symptoms that could be due to breast cancer.

Setting

Community-based study.

Participants

Asymptomatic women aged 30–60 years.

Interventions

Participants were presented with 11 health scenarios that represent the possible consequences of symptomatic breast problems. Participants were asked the risk of death that they were willing to take in order to avoid the health scenario using the standard gamble utility method. This process was repeated for all 11 health scenarios. Formal decision analysis for the preferred individual decision was then estimated for each participant.

Primary outcome measure

The preferred diagnostic strategy was either watchful waiting or referral to a breast clinic. Sensitivity analysis was used to examine how each varied according to changes in the probabilities of the health scenarios.

Results

A total of 35 participants completed the interviews, with a median age 41 years (IQR 35–47 years). The majority of the study sample was employed (n=32, 91.4%), with a third-level (university) education (n=32, 91.4%) and with knowledge of someone with breast cancer (n=30, 85.7%). When individual preferences were accounted for, 25 (71.4%) patients preferred watchful waiting to referral for triple assessment as their preferred initial diagnostic strategy. Sensitivity analysis shows that referral for triple assessment becomes the dominant strategy at the upper probability estimate (18%) of breast cancer in the community.

Conclusions

Watchful waiting is an acceptable strategy for most women who present to their general practitioner (GP) with breast symptoms. These findings suggest that current referral guidelines should take more explicit account of women’s preferences in relation to their GPs initial management strategy.
Patterns of smoking initiation during adolescence and young adulthood in South-West China: findings of the National Nutrition and Health Survey (2010–2012)
Authors: Zhang Qiang , Yu Bin , Chen Xinguang , Varma Deepthi S , Li Juanjuan , Zhao Jiang , Ruan Yuan , Han Xingmeng , Min Xiangdong , Liu Zhitao
Published: June 2018

Objective

This study aims to understand the age patterns of smoking initiation during adolescence and young adulthood in South-West China, where the prevalence of tobacco use is reported as the highest in the country.

Design

A cross-sectional study.

Setting

The data were derived from the China National Nutrition and Health Survey in Yunnan Province, South-West China (2010–2012).

Participants

A total of 4801 participants aged 15–65 years were included.

Primary outcome measures

A survival model was used to estimate the hazard of smoking initiation by age and log-rank test was used to compare the hazard curves across subgroups (men/women, urban/rural, Han Chinese/ethnic minority).

Results

The prevalence of current smoking among men and women were 60.4% (95% CI 58.2% to 62.6%) and 5.1% (95% CI 4.3% to 5.9%), respectively. Smoking was more prevalent among men and women of lower education and less income, as well as rural and ethnic minority women. Among the current smokers, cigarette (80.7%) was the most commonly used tobacco product, followed by waterpipe (10.8%) and pipe tobacco (8.5%). The hazards of smoking initiation were low for both men and women before the age of 15 years (1% for men and 0.05% for women); and the hazards increased quickly from age 15 years and peaked at 19years (21.5% for men and 1.0% for women). Rural and ethnic minority women were at higher risk of smoking initiation than their counterparts between 15 years and 19 years of age (χ2=44.8, p<0.01; χ2=165.2, p<0.01) and no such difference was found in men.

Conclusions

Findings of this study underscore the importance to implement tobacco prevention interventions among older teens and young adults in South-West China, especially for rural and ethnic minority women.
Interventional study to improve diabetic guidelines adherence using mobile health (m-Health) technology in Lahore, Pakistan
Authors: Hashmi Noreen Rahat , Khan Shazad Ali
Published: June 2018

Objective

To check if mobile health (m-Health) short message service (SMS) can improve the knowledge and practice of the American Diabetic Association preventive care guidelines (ADA guidelines) recommendations among physicians.

Methodology

Quasi-experimental pre–post study design with a control group.

Participants

The participants of the study were 62 medical officers/medical postgraduate trainees from two hospitals in Lahore, Pakistan. Pretested questionnaire was used to collect baseline information about physicians’ knowledge and adherence according to the ADA guidelines. All the respondents attended 1-day workshop about the guidelines. The intervention group received regular reminders by SMS about the ADA guidelines for the next 5 months. Postintervention knowledge and practice scores of 13 variables were checked again using the same questionnaire. Statistical analysis included χ2and McNemar’s tests for categorical variables and t-test for continuous variables. Pearson’s correlation analysis was done to check correlation between knowledge and practice scores in the intervention group. P values of <0.05 were considered statistically significant.

Results

The total number of participating physicians was 62. Fifty-three (85.5%) respondents completed the study. Composite scores within the intervention group showed statistically significant improvement in knowledge (p<0.001) and practice (p<0.001) postintervention. The overall composite scores preintervention and postintervention also showed statistically significant difference of improvement in knowledge (p=0.002) and practice (p=0.001) between non-intervention and intervention groups. Adherence to individual 13 ADA preventive care guidelines level was noted to be suboptimal at baseline. Statistically significant improvement in the intervention group was seen in the following individual variables: review of symptoms of hypoglycaemia and hyperglycaemia, eye examination, neurological examination, lipid examination, referral to ophthalmologist, and counselling about non-smoking.

Conclusion

m-Health technology can be a useful educational tool to help with improving knowledge and practice of diabetic guidelines. Future multicentre trials will help to scale this intervention for wider use in resource-limited countries.
A survey across four European countries to determine rheumatology health professionals’ awareness of physical activity measures in people with inflammatory joint diseases
Authors: Kennedy Norelee M , McKenna Sean G , O’Neill Aoife , Appel Esbensen Bente , Swinnen Thijs Willem , Nordgren Birgitta , Willemijns Sara , Hammer Nanna Maria , Brodin Nina
Published: June 2018

Objectives

The objectives of this study were to determine rheumatology health professionals' (HPs)' awareness of and confidence in using physical activity (PA) measures in people with inflammatory joint diseases (IJDs), their own self-reported PA levels and to identify HP-related educational needs.

Methods

Rheumatology HPs in Denmark, Sweden, Ireland and Belgium participated in an on-line survey. Descriptive statistics and latent class analysis (LCA) were undertaken SPSS (v21and SASv9.4) to describe data aggregates and range and to identify subclasses of groups with respect to use of PA measures.

Results

322 (n=322, 75.5% women) HPs responded from Denmark (n=50, 15.5%), Sweden (n=66, 20.5%), Ireland (n=28, 8.7%) and Belgium (n=178, 55.3%) and the majority of respondents (n=286, 91.7%) reported it was important to measure PA in people with IJDs. Only 28.2% of HPs used simple body worn sensors to measure PA levels in their patients. The majority were interested in on-line education on measuring PA (82.9%). LCA, used to generate classes of PA measures employed by HPs, revealed three distinct classes reflecting differences in self-reported PA levels, awareness of PA measures, further education requirements and professional background.

Conclusions

The majority of respondents reported that they considered measuring PA as important in people with IJDs; however, the majority lacked confidence in how to measure it. There was strong interest in further education around measuring PA. Three distinct respondent classes were identified to inform targeted education on how to measure PA.
Quantifying the incidence and burden of herpes zoster in New Zealand general practice: a retrospective cohort study using a natural language processing software inference algorithm
Authors: Turner Nikki M , MacRae Jayden , Nowlan Mary L , McBain Lynn , Stubbe Maria H , Dowell Anthony
Published: June 2018

Objective

To investigate the incidence of primary care presentations for herpes zoster (zoster) in a representative New Zealand population and to evaluate the utilisation of primary healthcare services following zoster diagnosis.

Design

A cross-sectional retrospective cohort study used a natural language processing software inference algorithm to identify general practice consultations for zoster by interrogating 22 million electronic medical record (EMR) transactions routinely recorded from January 2005 to December 2015. Data linking enabled analysis of the demographics of each case. The frequency of doctor visits was assessed prior to and after the first consultation diagnosing zoster to determine health service utilisation.

Setting

General practice, using EMRs from two primary health organisations located in the lower North Island, New Zealand.

Participants

Thirty-nine general practices consented interrogation of their EMRs to access deidentified records for all enrolled patients. Out-of-hours and practice nurse consultations were excluded.

Main outcome measures

The incidence of first and repeated zoster-related visits to the doctor across all age groups and associated patient demographics. To determine whether zoster affects workload in general practice.

Results

Overall, for 6 189 019 doctor consultations, the incidence of zoster was 48.6 per 10 000 patient-years (95% CI 47.6 to 49.6). Incidence increased from the age of 50 years to a peak rate of 128 per 10 000 in the age group of 80–90 years and was significantly higher in females than males (p<0.001). Over this 11-year period, incidence increased gradually, notably in those aged 80–85 years. Only 19% of patients had one or more follow-up zoster consultations within 12 months of a zoster index consultation. The frequency of consultations, for any reason, did not change between periods before and after the diagnosis.

Conclusions

Zoster consultations in general practice are rare, and the burden of these cases on overall general practice caseload is low.
Automated enumeration of lymphoid and plasma cells in bone marrow to establish normal reference ranges
Authors: Liang James , Malherbe Jacques A J , Fuller Kathryn A , Mirzai Bob , George Carly , Carter Tina L , Cole Catherine H , Guo Belinda B , Meehan Katie , Erber Wendy N
Published: June 2018

Aims

The number of precursor and mature lymphoid cells and plasma cells in normal bone marrow trephine (BMT) biopsies throughout the human lifespan is unknown. Reference ranges have been established from aspirated marrow, but due to haemodilution errors, these do not accurately reflect the native marrow milieu. We aimed to define age-specific, normal reference ranges for lymphoid and plasma cells in BMT biopsy specimens using a combined immunophenotyping and digital enumeration approach.

Methods

Morphologically normal BMT biopsy specimens (n=483) were obtained from patients aged 1 month to 90 years of age. Immunohistochemistry was performed to identify lymphoid progenitors , T-lymphocytes (CD3), B-lymphocytes (CD20) and plasma cells (CD138 and MUM1). Positive cells were counted using digital enumeration software, and the percent positivity for each antigen was determined per case. Mean values were generated for specific age groups, and age-defined reference ranges were determined for each antigen using normalised data.

Results

A mean of 16 609 cells (range: 7210–34 097) were counted per biopsy. Infant marrows showed a predominance of immature lymphoid progenitors and B cells. With increasing age, an increase in mean T cell and plasma cell numbers were observed. The results showed the same trends to flow cytometry references for aspirate material although the absolute values differed.

Conclusions

Combined immunohistochemistry and automated enumeration gives an accurate, reproducible number of antigen-positive cells and has generated normal reference ranges for these cell types in BMT biopsies. The method and ranges we have established have the potential to be applied in routine clinical practice.
PON1gene polymorphisms in patients with chronic obstructive pulmonary disease
Authors: Grdić Rajković Marija , Popović-Grle Sanja , Vukić Dugac Andrea , Rogić Dunja , Rako Ivana , Radić Antolić Margareta , Beriša Mirela , Rumora Lada
Published: June 2018

Aims

Chronic obstructive pulmonary disease (COPD) is characterised with oxidative stress. Paraoxonase 1 (PON1) is an enzyme, coded byPON1gene, with distinctive antiatherogenic and antioxidative roles. We aimed to investigate the frequencies of Q192R, L55M and −108C>T polymorphisms and association of those polymorphisms with paraoxonase and arylesterase activities in patients with COPD.

Methods

PON1genotype was determined by PCR–restriction fragment length polymorphism method. PON1 activity was measured by paraoxon and phenylacetate.

Results

Only −108C>T polymorphism resulted in significantly different distribution of genotypes and alleles, with higher frequency of TT genotype and T allele in patients compared with control subjects. Moreover, T allele (OR 2.29 (95% CI 1.54 to 3.41); p<0.001) as well as TT genotype (OR 5.00 (95% CI 2.19 to 11.43); p<0.001) showed an association with the disease. −108C>T polymorphism was suggested as a significant diagnostic predictor for the disease (OR (95% CI) 2.65 (1.53 to 4.59), p=0.001), with an area under the receiver operating characteristic curve of 0.90 (95% CI 0.84 to 0.93) and with 83.90% of correctly classified cases.

Conclusions

Higher frequency of TT genotype and T allele could contribute to the observed reduction of PON1 activity in patients with COPD. T allele and TT genotype are associated with COPD, and thePON1−108C>T polymorphism could be a potential predictor of the disease.
Medicine and the rise of the robots: a qualitative review of recent advances of artificial intelligence in health
Authors: Loh Erwin
Published: June 2018

Artificial intelligence (AI) has the potential to significantly transform the role of the doctor and revolutionise the practice of medicine. This qualitative review paper summarises the past 12 months of health research in AI, across different medical specialties, and discusses the current strengths as well as challenges, relating to this emerging technology. Doctors, especially those in leadership roles, need to be aware of how quickly AI is advancing in health, so that they are ready to lead the change required for its adoption by the health system. Key points: ‘AI has now been shown to be as effective as humans in the diagnosis of various medical conditions, and in some cases, more effective.’ When it comes to predicting suicide attempts, recent research suggest AI is better than human beings. ‘AI’s current strength is in its ability to learn from a large dataset and recognise patterns that can be used to diagnose conditions, putting it in direct competition with medical specialties that are involved in diagnostic tests that involve pattern recognition, such as pathology and radiology’. The current challenges in AI include legal liability and attribution of negligence when errors occur, and the ethical issues relating to patient choices. ‘AI systems can also be developed with, or learn, biases, that will need to be identified and mitigated’. As doctors and health leaders, we need to start preparing the profession to be supported by, partnered with, and, in future, potentially be replaced by, AI and advanced robotics systems.
Association between age and outcomes following thrombectomy for anterior circulation emergent large vessel occlusion is determined by degree of recanalisation
Authors: Jayaraman Mahesh V , Kishkovich Thomas , Baird Grayson L , Hemendinger Morgan L , Tung Eric L , Yaghi Shadi , Cutting Shawna , Saad Ali , Burton Tina M , Mac Grory Brian , Haas Richard A , Furie Karen L , McTaggart Ryan A
Published: June 2018

Background

Older patients undergoing thrombectomy for emergent large vessel occlusion have worse outcomes. However, complete or near-complete reperfusion (modified Thrombolysis in Cerebral Ischemia (mTICI) score of 2 c/3) is associated with improved outcomes compared with partial recanalisation (mTICI 2b).

Objective

To examine the relationship between outcomes and age separately for the mTICI 2c/3, 2b and 0-2a groups in patients undergoing thrombectomy for anterior circulation emergent large vessel occlusion.

Methods

Retrospective review of 157 consecutive patients undergoing thrombectomy at a single centre with an occlusion of the internal carotid artery (ICA), M1 or proximal M2 segments of the middle cerebral artery (MCA). Angiograms were graded in a blinded fashion. Patients were divided into three groups: mTICI 0-2a, mTICI 2b, and mTICI 2c/3. Demographics and workflow parameters were compared. Outcomes at 90 days were compared as a function of age, using both the conventional modified Rankin scale (mRs) and utility weighted mRs (UWmRs).

Results

There were 72, 61 and 24 patients in the mTICI 2c/3, 2b and 0-2a groups, respectively. Outcomes were significantly worse with increasing age for the mTICI 2b group, but not for the mTICI 0-2a and 2c/3 groups (P=0.0002). With increasing age, outcomes of the mTICI 2b group approached those of the mTICI 0-2a group. However, outcomes of the mTICI 2c/3 groups were similar for all ages. This association was present for both the original mRs and UWmRs.

Conclusion

Increasing age was associated with worse outcomes for those with partial (mTICI 2b) recanalisation, not in patients with complete (mTICI 2c/3) recanalisation.
Stochastic quantization and holographic Wilsonian renormalization group of free massive fermion
Authors: Moon Sung Pil
Published: June 2018

We examine a suggested relation between stochastic quantization and the holographic Wilsonian renormalization group in the massive fermion case on Euclidean AdS space. The original suggestion about the general relation between the two theories is posted in arXiv:1209.2242 . In the previous researches, it is already verified that scalar fields, U(1) gauge fields, and massless fermions are consistent with the relation. In this paper, we examine the relation in the massive fermion case. Contrary to the other case, in the massive fermion case, the action needs particular boundary terms to satisfy boundary conditions. We finally confirm that the proposed suggestion is also valid in the massive fermion case.
Influences of the coordinate dependent noncommutative space on charged and spin currents
Authors: Ren Ya-Jie , Ma Kai
Published: June 2018

We study the charged and spin currents on a coordinate dependent noncommutative space. Starting from the noncommutative extended relativistic equation of motion, the nonrelativistic approximation is obtained by using the Foldy–Wouthuysen transformation, and then the charged and spin currents are derived by using the extended Drude model. We find that the charged current is twisted by modifying the off-diagonal elements of the Hall conductivity, however, the spin current is not affected up to leading order of the noncommutative parameter.
Bifurcation Control and Complex Dynamics in Field-Oriented Control of a PMSM
Authors: Souhail W. , Khammari H. , Mimouni M. F.
Published: June 2018

The general purpose of this paper is to develop new aspects of bifurcation structures in a 3D parametric space. Identification of generic bifurcation structures in former studies was based on the arrangement of bifurcation curves in the parameter plane. So by analogy to such studies, we define the bifurcation surface in 3D parameter space as the main feature of the said generic structures. The implementation of this idea is made on the permanent magnet synchronous machine (PMSM) whose speed is regulated with a field-oriented control (FOC). Sufficient conditions are given for the existence of three main bifurcations: limit point (LP), Hopf (H) and Bogdanov–Takens (BT). Starting from bifurcation curves traced in a parameter plane and changing a third parameter, a qualitative bifurcation surface is constructed in a 3D parametric space. This led to underline the increasing complexity of the bifurcation structures when dealing with more than two parameters. This study put into evidence not only the complex behavior of PMSM, but stands as a starting point for a new formalism on the bifurcation structures in a 3D parametric space.
Dynamic Property Evaluation of a Long-Span Cable-Stayed Bridge (Sutong Bridge) by a Bayesian Method
Authors: Ni Yan-Chun , Zhang Qi-Wei , Liu Jian-Feng
Published: June 2018

Modal identification aims at identifying the dynamic properties including natural frequency, damping ratio, and mode shape, which is an important step in further structural damage detection, finite element model updating, and condition assessment. This paper presents the work on the investigation of the dynamic characteristics of a long-span cable-stayed bridge-Sutong Bridge by a Bayesian modal identification method. Sutong Bridge is the second longest cable-stayed bridge in the world, situated on the Yangtze River in Jiangsu Province, China, with a total length of 2 088[Formula: see text]m. A short-term nondestructive on-site vibration test was conducted to collect the structural response and determine the actual dynamic characteristics of the bridge before it was opened to traffic. Due to the limited number of sensors, multiple setups were designed to complete the whole measurement. Based on the data collected in the field tests, modal parameters were identified by a fast Bayesian FFT method. The first three modes in both vertical and transverse directions were identified and studied. In order to obtain modal parameter variation with temperature and vibration levels, long-term tests have also been performed in different seasons. The variation of natural frequency and damping ratios with temperature and vibration level were investigated. The future distribution of the modal parameters was also predicted using these data.
Master S-N Curve-Based Fatigue Life Assessment of Steel Bridges Using Finite Element Model and Field Monitoring Data
Authors: Ye X. W. , Su Y. H. , Jin T. , Chen B. , Han J. P.
Published: June 2018

The accuracy of fatigue life assessment for the welded joint in a steel bridge is largely dependent on an appropriate [Formula: see text]-[Formula: see text] curve. In this paper, a master [Formula: see text]-[Formula: see text] curve-based fatigue life assessment approach for the welded joint with an open-rib in orthotropic steel bridge deck is proposed based on the finite element model (FEM) and field monitoring data from structural health monitoring (SHM) system. The case studies on fatigue life assessment by use of finite element analysis (FEA) for constant-amplitude cyclic loading mode and field monitoring data under variable-amplitude cyclic loading mode are addressed. In the case of FEA, the distribution of structural stress at fatigue-prone weld toe is achieved using 4-node shell element model and then transformed into equivalent structural stress by fracture mechanics theory. The fatigue life of the welded joint is estimated with a single master [Formula: see text]-[Formula: see text] curve in the form of equivalent structural stress range versus the cycles to failure. In the case of monitoring data-based fatigue life assessment, the daily history of structural stress at diaphragm to U-rib is derived from the raw strain data measured by the instrumented fiber Bragg grating (FBG) sensors and transformed into equivalent structural stress. The fatigue life of the investigated welded joint is calculated by cyclic counting method and Palmgren–Miner linear damage cumulative rule. The master [Formula: see text]-[Formula: see text] curve method provides an effective fatigue life assessment process, especially when the nominal stress is hard to be defined. A single master [Formula: see text]-[Formula: see text] curve will facilitate to solve the difficulty in choosing a proper [Formula: see text]-[Formula: see text] curve which is required in the traditional fatigue life assessment methods.