bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcium in drinking water: effect on iron stores in Danish blood donors—results from the Danish Blood Donor Study
Authors: Rigas Andreas S. , Ejsing Benedikte H. , Sørensen Erik , Pedersen Ole B. , Hjalgrim Henrik , Erikstrup Christian , Ullum Henrik
Published: March 2018

BACKGROUND

Studies confirm that calcium inhibits iron absorption. Danish tap water comes from groundwater, which contains varying amounts of calcium depending on the subsoil. We investigated the association of calcium in drinking water with iron levels in Danish blood donors.

STUDY DESIGN AND METHODS

We used data on Danish blood donors including dietary and lifestyle habits, blood donation history, and physiologic characteristics including measures of ferritin levels along with information on area of residence from The Danish Blood Donor Study. Data on calcium levels in groundwater (“water hardness”) were obtained through the Geological Survey of Denmark and Greenland. We performed multiple linear and logistic regression analyses to evaluate the effect of water hardness on ferritin levels and risk of having iron deficiency (defined as ferritin levels <15 ng/mL), stratified by sex.

RESULTS

There was a significant negative association between water hardness and ferritin levels in both men and women. Risk of iron deficiency was correspondingly increased in both men (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.14‐2.12) and women (OR, 1.20; 95% CI, 1.03‐1.40) with increasing water hardness. In analyses restricted to individuals who received supplemental iron tablets no significant association between groundwater hardness and ferritin levels was observed.

CONCLUSIONS

As measured by ferritin levels, residential drinking water calcium content is associated with blood donors‐ iron levels and risk of iron deficiency. However, effect sizes are small.
Reproducibility, stability, and biological variability of thrombin generation using calibrated automated thrombography in healthy dogs
Authors: Cuq Benoît , Blois Shauna L. , Wood R. Darren , Monteith Gabrielle , Abrams‐Ogg Anthony C. , Bédard Christian , Wood Geoffrey A.
Published: March 2018

Background

Thrombin plays a central role in hemostasis and thrombosis. Calibrated automated thrombography (CAT), a thrombin generation assay, may be a useful test for hemostatic disorders in dogs.

Objectives

To describe CAT results in a group of healthy dogs, and assess preanalytical variables and biological variability.

Animals

Forty healthy dogs were enrolled.

Methods

Lag time (Lag), time to peak (ttpeak), peak thrombin generation (peak), and endogenous thrombin potential (ETP) were measured. Direct jugular venipuncture and winged‐needle catheter‐assisted saphenous venipuncture were used to collect samples from each dog, and results were compared between methods. Sample stability at −80°C was assessed over 12 months in a subset of samples. Biological variability of CAT was assessed via nested ANOVA using samples obtained weekly from a subset of 9 dogs for 4 consecutive weeks.

Results

Samples for CAT were stable at −80°C over 12 months of storage. Samples collected via winged‐needle catheter venipuncture showed poor repeatability compared to direct venipuncture samples; there was also poor agreement between the 2 sampling methods. Intra‐individual variability of CAT parameters was below 25%; inter‐individual variability ranged from 36.9% to 78.5%.

Conclusions

Measurement of thrombin generation using CAT appears to be repeatable in healthy dogs, and samples are stable for at least 12 months when stored at −80°C. Direct venipuncture sampling is recommended for CAT. Low indices of individuality suggest that subject‐based reference intervals are more suitable when interpreting CAT results.
Nitride etching with hydrofluorocarbons. II. Evaluation of C4H9F for tight pitch Si3N4 patterning applications
Authors: Marchack Nathan , Miyazoe Hiroyuki , Bruce Robert L. , Tsai Hsinyu , Nakamura Masahiro , Suzuki Takefumi , Ito Azumi , Matsumoto Hirokazu , Engelmann Sebastian U. , Joseph Eric A.
Published: March 2018

A novel etch chemistry, C4H9F was evaluated for highly selective patterning of SiN using both organic and SiOx masks for line/space and cylindrical geometries. Patterning of 80 nm of SiN using 65 nm of the organic planarization layer (OPL) mask with a C4H9F:O2:CF4 admixture yielded line edge roughness (LER) and line width roughness (LWR) values of 1.9 and 2.8 nm on sub-25 nm critical dimension (CD) SiN lines at 50 nm pitch, with >50 nm mask retention up to 40% overetch values. The LER and LWR values were 60% and 66% lower than features patterned using a CF4:CHF3 admixture, which also exhibited complete OPL mask loss and nitride erosion of 27 nm even at the endpointed etch condition. Using 20 nm of SiOx as a mask and removing CF4 from the chemistry admixture, LER and LWR values of 2.7 and 3.3 nm were achieved with nearly full SiOx retention for features of identical dimensions. At smaller mask pitches (21 and 24 nm) formed by directed self-assembly of high-χ block copolymers, the highly selective nature of C4H9F to organic masks facilitated SiN pattern transfer where CF4 based admixtures failed, achieving line CDs of ∼12 nm with LWR and LER of 1.6 and 2.2 nm. Applied to alternate geometry, hole patterning in SiN at ∼30 nm CD and 60 nm pitch was demonstrated. A subsequent image reversal process yielded pillars by filling the hole pattern with OPL and etching back the surrounding SiN layer, reaffirming the extremely high selectivity of C4H9F to organic masks.
Extrapolation of rotating sound fields
Authors: Carley Michael
Published: March 2018

A method is presented for the computation of the acoustic field around a tonal circular source, such as a rotor or propeller, based on an exact formulation which is valid in the near and far fields. The only input data required are the pressure field sampled on a cylindrical surface surrounding the source, with no requirement for acoustic velocity or pressure gradient information. The formulation is approximated with exponentially small errors and appears to require input data at a theoretically minimal number of points. The approach is tested numerically, with and without added noise, and demonstrates excellent performance, especially when compared to extrapolation using a far-field assumption.
Geometry and topology of the space of sonar target echos
Authors: Robinson Michael , Fennell Sean , DiZio Brian , Dumiak Jennifer
Published: March 2018

Successful synthetic aperture sonar target classification depends on the “shape” of the scatterers within a target signature. This article presents a workflow that computes a target-to-target distance from persistence diagrams, since the “shape” of a signature informs its persistence diagram in a structure-preserving way. The target-to-target distances derived from persistence diagrams compare favorably against those derived from spectral features and have the advantage of being substantially more compact. While spectral features produce clusters associated to each target type that are reasonably dense and well formed, the clusters are not well-separated from one another. In rather dramatic contrast, a distance derived from persistence diagrams results in highly separated clusters at the expense of some misclassification of outliers.
Kingella kingae Surface Polysaccharides Promote Resistance to Human Serum and Virulence in a Juvenile Rat Model
Authors: Muñoz Vanessa L. , Porsch Eric A. , St. Geme Joseph W.
Published: March 2018

Kingella kingaeis a Gram-negative coccobacillus that is increasingly being recognized as an important cause of invasive disease in young children. The pathogenesis ofK. kingaedisease begins with colonization of the oropharynx, followed by invasion of the bloodstream, survival in the intravascular space, and dissemination to distant sites. Recent studies have revealed thatK. kingaeproduces a number of surface factors that may contribute to the pathogenic process, including a polysaccharide capsule and an exopolysaccharide. In this study, we observed thatK. kingaewas highly resistant to the bactericidal effects of human serum complement. Using mutant strains deficient in expression of capsule, exopolysaccharide, or both in assays with human serum, we found that elimination of both capsule and exopolysaccharide was required for efficient binding of IgG, IgM, C4b, and C3b to the bacterial surface and for complement-mediated killing. Abrogation of the classical complement pathway using EGTA-treated human serum restored survival to wild-type levels by the mutant lacking both capsule and exopolysaccharide, demonstrating that capsule and exopolysaccharide promote resistance to the classical complement pathway. Consistent with these results, loss of both capsule and exopolysaccharide eliminated invasive disease in juvenile rats with an intact complement system but not in rats lacking complement. Based on these observations, we conclude that the capsule and the exopolysaccharide have important redundant roles in promoting survival ofK. kingaein human serum. Each of these surface factors is sufficient by itself to fully prevent serum opsonin deposition and complement-mediated killing ofK. kingae, ultimately facilitating intravascular survival and promotingK. kingaeinvasive disease.
The Light Chain Defines the Duration of Action of Botulinum Toxin Serotype A Subtypes
Authors: Pellett Sabine , Bradshaw Marite , Tepp William H. , Pier Christina L. , Whitemarsh Regina C. M. , Chen Chen , Barbieri Joseph T. , Johnson Eric A.
Published: March 2018

Botulinum neurotoxin (BoNT) is the causative agent of botulism and a widely used pharmaceutical to treat a variety of neurological diseases. BoNTs are 150-kDa protein toxins organized into heavy chain (HC) and light chain (LC) domains linked by a disulfide bond. The HC selectively binds to neurons and aids cell entry of the enzymatically active LC. There are seven immunological BoNT serotypes (A to G); each serotype includes genetic variants, termed subtypes. Only two subtypes, BoNT/A1 and BoNT/B1, are currently used as therapeutics. BoNT serotype A (BoNT/A) subtypes A2 to A8 show distinct potency, duration of action, and pathology relative to BoNT/A1. Specifically, BoNT/A3 possesses shorter duration of action and elicits distinct symptoms in mice at high toxin doses. In this report, we analyzed the roles of LC and HC of BoNT/A3 for duration of action, neuronal cell entry, and mouse pathology by using clostridium-derived recombinant hybrid BoNTs consisting of reciprocal LC and HC (BoNTA1/A3 and BoNTA3/A1). Hybrid toxins were processed in their expression host to a dichain BoNT consisting of LC and HC linked via a disulfide bond. The LC and HC defined BoNT potency in mice and BoNT toxicity for cultured neuronal cells, while the LC defined the duration of BoNT action in cell and mouse models. Protein alignment identified a previously unrecognized region within the LC subtype A3 (LC/A3) relative to the other LC serotype A (LC/A) subtypes (low primary acid homology [LPH]) that correlated to intracellular LC localization. This study shows the utility of recombinant hybrid BoNTs with new therapeutic potential, while remaining sensitive to antitoxins and therapies to native BoNT.

IMPORTANCE
Botulinum neurotoxins are the most potent protein toxins for humans and potential bioterrorism threats, but they are also widely used as pharmaceuticals. Within the large family of BoNTs, only two subtypes are currently used as pharmaceuticals, with a large number of BoNT subtypes remaining as untapped potential sources for unique pharmaceuticals. Here, two recombinant hybrid toxins were engineered, consisting of domains from two BoNT subtypes that possess distinct duration of action and activity in human neurons and mice. We define the functional domains responsible for BoNT action and demonstrate creation of functional hybrid BoNTs with new therapeutic potential, while remaining sensitive to antitoxins and therapies to native BoNT.
Concurrent Host-Pathogen Transcriptional Responses in a
Clostridium perfringens
Murine Myonecrosis Infection
Authors: Low Lee-Yean , Harrison Paul F. , Gould Jodee , Powell David R. , Choo Jocelyn M. , Forster Samuel C. , Chapman Ross , Gearing Linden J. , Cheung Jackie K. , Hertzog Paul , Rood Julian I.
Published: March 2018

To obtain an insight into host-pathogen interactions in clostridial myonecrosis, we carried out comparative transcriptome analysis of both the bacterium and the host in a murine
Clostridium perfringens
infection model, which is the first time that such an investigation has been conducted. Analysis of the host transcriptome from infected muscle tissues indicated that many genes were upregulated compared to the results seen with mock-infected mice. These genes were enriched for host defense pathways, including Toll-like receptor (TLR) and Nod-like receptor (NLR) signaling components. Real-time PCR confirmed that host TLR2 and NLRP3 inflammasome genes were induced in response to
C. perfringens
infection. Comparison of the transcriptome of
C. perfringens
cells from the infected tissues with that from broth cultures showed that host selective pressure induced a global change in
C. perfringens
gene expression. A total of 33% (923) of
C. perfringens
genes were differentially regulated, including 10 potential virulence genes that were upregulated relative to their expression
in vitro
. These genes encoded putative proteins that may be involved in the synthesis of cell wall-associated macromolecules, in adhesion to host cells, or in protection from host cationic antimicrobial peptides. This report presents the first successful expression profiling of coregulated transcriptomes of bacterial and host genes during a clostridial myonecrosis infection and provides new insights into disease pathogenesis and host-pathogen interactions.

IMPORTANCE
Clostridium perfringens
is the causative agent of traumatic clostridial myonecrosis, or gas gangrene. In this study, we carried out transcriptional analysis of both the host and the bacterial pathogen in a mouse myonecrosis infection. The results showed that in comparison to mock-infected control tissues, muscle tissues from
C. perfringens
-infected mice had a significantly altered gene expression profile. In particular, the expression of many genes involved in the innate immune system was upregulated. Comparison of the expression profiles of
C. perfringens
cells isolated from the infected tissues with those from equivalent broth cultures identified many potential virulence genes that were significantly upregulated
in vivo
. These studies have provided a new understanding of the range of factors involved in host-pathogen interactions in a myonecrosis infection.
The Sole DEAD-Box RNA Helicase of the Gastric Pathogen
Helicobacter pylori
Is Essential for Colonization
Authors: El Mortaji Lamya , Aubert Sylvie , Galtier Eloïse , Schmitt Christine , Anger Karine , Redko Yulia , Quentin Yves , De Reuse Hilde
Published: March 2018

Present in every kingdom of life, generally in multiple copies, DEAD-box RNA helicases are specialized enzymes that unwind RNA secondary structures. They play major roles in mRNA decay, ribosome biogenesis, and adaptation to cold temperatures. Most bacteria have multiple DEAD-box helicases that present both specialized and partially redundant functions. By using phylogenomics, we revealed that the
Helicobacter
genus, including the major gastric pathogen
H. pylori
, is among the exceptions, as it encodes a sole DEAD-box RNA helicase. In
H. pylori
, this helicase, designated RhpA, forms a minimal RNA degradosome together with the essential RNase, RNase J, a major player in the control of RNA decay. Here, we used
H. pylori
as a model organism with a sole DEAD-box helicase and investigated the role of this helicase in
H. pylori
physiology, ribosome assembly, and during
in vivo
colonization. Our data showed that RhpA is dispensable for growth at 37°C but crucial at 33°C, suggesting an essential role of the helicase in cold adaptation. Moreover, we found that a Δ
rhpA
mutant was impaired in motility and deficient in colonization of the mouse model. RhpA is involved in the maturation of 16S rRNA at 37°C and is associated with translating ribosomes. At 33°C, RhpA is, in addition, recruited to individual ribosomal subunits. Finally, via its role in the RNA degradosome, RhpA directs the regulation of the expression of its partner, RNase J. RhpA is thus a multifunctional enzyme that, in
H. pylori
, plays a central role in gene regulation and in the control of virulence.

IMPORTANCE
We present the results of our study on the role of RhpA, the sole DEAD-box RNA helicase encoded by the major gastric pathogen
Helicobacter pylori
. We observed that all the
Helicobacter
species possess such a sole helicase, in contrast to most free-living bacteria. RhpA is not essential for growth of
H. pylori
under normal conditions. However, deletion of
rhpA
leads to a motility defect and to total inhibition of the ability of
H. pylori
to colonize a mouse model. We also demonstrated that this helicase encompasses most of the functions of its specialized orthologs described so far. We found that RhpA is a key element of the bacterial adaptation to colder temperatures and plays a minor role in ribosome biogenesis. Finally, RhpA regulates transcription of the
rnj
gene encoding RNase J, its essential partner in the minimal
H. pylori
RNA degradosome, and thus plays a crucial role in the control of RNA decay.
The Tripod for Bacterial Natural Product Discovery: Genome Mining, Silent Pathway Induction, and Mass Spectrometry-Based Molecular Networking
Authors: Trivella Daniela B. B. , de Felicio Rafael
Published: March 2018

Natural products are the richest source of chemical compounds for drug discovery. Particularly, bacterial secondary metabolites are in the spotlight due to advances in genome sequencing and mining, as well as for the potential of biosynthetic pathway manipulation to awake silent (cryptic) gene clusters under laboratory cultivation.
In Search of Model Ecological Systems for Understanding Specialized Metabolism
Authors: Pessotti Rita C. , Hansen Bridget L. , Traxler Matthew F.
Published: March 2018

Microbes occupy diverse habitats, forming interconnected, dynamic communities. Elucidating the principles of microbial community function is a grand challenge for microbiology, and it will entail experiments that engage microbiomes across multiple levels of complexity.
Optical coherence tomography angiography in comparison with other multimodal imaging techniques in punctate inner choroidopathy
Authors: Pohlmann Dominika , Pleyer Uwe , Joussen Antonia M , Winterhalter Sibylle
Published: March 2018

Aims

To characterise punctate lesions and choroidal neovascularisation (CNV) in eyes with punctate inner choroidopathy (PIC) using current standard multimodal imaging techniques and optical coherence tomography angiography (OCTA).

Methods

In our prospective, single-centre study, 20 individuals with PIC underwent imaging with spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), indocyanine green angiography, fundus autofluorescence, fundus colour photography and OCTA.

Results

Thirty-two eyes of 20 patients were affected. Eight (20%) eyes revealed typical punctate lesions, while 24 (60%) eyes had confirmed CNV on SD-OCT and FA in addition to punctate lesions. Of these 24 eyes with CNV, a reoccurrence of active CNV was detected in 5 (21%) eyes, a residual fluid in 3 (13%) eyes, while 16 (67%) eyes were defined as being stable. On OCTA, CNV was classified as having ‘lacy wheel’, ‘pruned large-trunk’ and ‘dead tree aspect’ vessel shapes with or without areas of non-perfusion. The disease activity was dependent on several predictors in the regression analysis such as intraretinal fluid (p=0.0014), CNV type (p=0.0199), leakage (p<0.0001) and hypoperfusion/non-perfusion (p<0.0001) on OCTA.

Conclusion

OCTA offers additional valuable insight into the current standard multimodal imaging techniques used for characterisation of PIC. This imaging technique can be a useful tool for analysis of disease activity.
Anthropology in public health emergencies:what is anthropology good for?
Authors: Stellmach Darryl , Beshar Isabel , Bedford Juliet , du Cros Philipp , Stringer Beverley
Published: March 2018

Recent outbreaks of Ebola virus disease (2013–2016) and Zika virus (2015–2016) bring renewed recognition of the need to understand social pathways of disease transmission and barriers to care. Social scientists, anthropologists in particular, have been recognised as important players in disease outbreak response because of their ability to assess social, economic and political factors in local contexts. However, in emergency public health response, as with any interdisciplinary setting, different professions may disagree over methods, ethics and the nature of evidence itself. A disease outbreak is no place to begin to negotiate disciplinary differences. Given increasing demand for anthropologists to work alongside epidemiologists, clinicians and public health professionals in health crises, this paper gives a basic introduction to anthropological methods and seeks to bridge the gap in disciplinary expectations within emergencies. It asks: ‘What can anthropologists do in a public health crisis and how do they do it?’ It argues for an interdisciplinary conception of emergency and the recognition that social, psychological and institutional factors influence all aspects of care.
Care home services at the vanguard: a qualitative study exploring stakeholder views on the development and evaluation of novel, integrated approaches to enhancing healthcare in care homes
Authors: Stocker Rachel , Bamford Claire , Brittain Katie , Duncan Rachel , Moffatt Suzanne , Robinson Louise , Hanratty Barbara
Published: March 2018

Objectives

To explore stakeholders’ understanding of novel integrated approaches to enhancing care in care homes (a care home ‘vanguard’) and identify priorities for evaluation.

Design

A qualitative study, using semistructured interviews with commissioners and service providers to/within care homes, and third sector organisations with thematic analysis.

Setting

A Clinical Commissioning Group (CCG) area in England.

Participants

Thirty interviewees from care homes, the National Health Service (NHS; England) and local authority, third sector (10 care home managers, 5 general practitioners, 4 CCG employees, 4 local authority employees, 1 national (NHS England) vanguard lead, 2 specialist nurses, 2 geriatricians, 1 third sector and 1 health manager).

Results

Four higher level themes emerged from the data: understanding of proposed changes, communication, evaluation of outcome measures of success, and trust and complexity. The vision for the new programme was shared by stakeholders, with importance attached to equitable access to high-quality care. Support for the programme was described as being ‘the right thing to do’, inferring a moral imperative. However, the practical implications of key aspects, such as integrated working, were not clearly understood and the programme was perceived by some as being imposed, top down, from the health service. Barriers and facilitators to change were identified across themes of communication, outcomes, trust and complexity. Importance was attached to the measurement of intangible aspects of success, such as collaboration. Interviewees understood that outcome-based commissioning was one element of the new programme, but discussion of their aspirations and practices revealed values and beliefs more compatible with a system based on trust.

Conclusions

Innovation in service delivery requires organisations to adopt common priorities and share responsibility for success. The vanguard programme is working to ensure health and local authorities have this commitment, but engaging care homes that may feel isolated from the welfare system needs sustained dialogue over the longer term. Evaluation of the programme needs to measure what is important to stakeholders, and not focus too closely on resource consumption.
A cross-sectional study of all clinicians’ conflict of interest disclosures to NHS hospital employers in England 2015-2016
Authors: Feldman Harriet Ruth , DeVito Nicholas J , Mendel Jonathan , Carroll David E , Goldacre Ben
Published: March 2018

Objective

We set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees.

Design

Cross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers.

Setting

NHS Trusts (secondary/tertiary care organisations) in England.

Participants

236 Trusts were contacted, of which 217 responded.

Main outcome measures

We assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency.

Results

185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria.

Conclusion

Overall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees’ conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US ‘Sunshine Act’.
Validation of an algorithm to identify heart failure hospitalisations in patients with diabetes within the veterans health administration
Authors: Presley Caroline A , Min Jea Young , Chipman Jonathan , Greevy Robert A , Grijalva Carlos G , Griffin Marie R , Roumie Christianne L
Published: March 2018

Objectives

We aimed to validate an algorithm using both primary discharge diagnosis (International Classification of Diseases Ninth Revision (ICD-9)) and diagnosis-related group (DRG) codes to identify hospitalisations due to decompensated heart failure (HF) in a population of patients with diabetes within the Veterans Health Administration (VHA) system.

Design

Validation study.

Setting

Veterans Health Administration—Tennessee Valley Healthcare System

Participants

We identified and reviewed a stratified, random sample of hospitalisations between 2001 and 2012 within a single VHA healthcare system of adults who received regular VHA care and were initiated on an antidiabetic medication between 2001 and 2008. We sampled 500 hospitalisations; 400 hospitalisations that fulfilled algorithm criteria, 100 that did not. Of these, 497 had adequate information for inclusion. The mean patient age was 66.1 years (SD 11.4). Majority of patients were male (98.8%); 75% were white and 20% were black.

Primary and secondary outcome measures

To determine if a hospitalisation was due to HF, we performed chart abstraction using Framingham criteria as the referent standard. We calculated the positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity for the overall algorithm and each component (primary diagnosis code (ICD-9), DRG code or both).

Results

The algorithm had a PPV of 89.7% (95% CI 86.8 to 92.7), NPV of 93.9% (89.1 to 98.6), sensitivity of 45.1% (25.1 to 65.1) and specificity of 99.4% (99.2 to 99.6). The PPV was highest for hospitalisations that fulfilled both the ICD-9 and DRG algorithm criteria (92.1% (89.1 to 95.1)) and lowest for hospitalisations that fulfilled only DRG algorithm criteria (62.5% (28.4 to 96.6)).

Conclusions

Our algorithm, which included primary discharge diagnosis and DRG codes, demonstrated excellent PPV for identification of hospitalisations due to decompensated HF among patients with diabetes in the VHA system.
Study protocol for a self-controlled cluster randomised trial of the Alert Program to improve self-regulation and executive function in Australian Aboriginal children with fetal alcohol spectrum disorder
Authors: Wagner Bree , Fitzpatrick James P , Mazzucchelli Trevor G , Symons Martyn , Carmichael Olson Heather , Jirikowic Tracy , Cross Donna , Wright Edie , Adams Emma , Carter Maureen , Bruce Kaashifah , Latimer Jane
Published: March 2018

Introduction

While research highlights the benefits of early diagnosis and intervention for children with fetal alcohol spectrum disorders (FASD), there are limited data documenting effective interventions for Australian children living in remote communities.

Methods and analysis

This self-controlled cluster randomised trial is evaluating the effectiveness of an 8-week Alert Program school curriculum for improving self-regulation and executive function in children living in remote Australian Aboriginal communities. Children in grades 1–6 attending any of the eight participating schools across the Fitzroy Valley in remote North-West Australia (N≈ 363) were invited to participate. Each school was assigned to one of four clusters with clusters randomly assigned to receive the intervention at one of four time points. Clusters two, three and four had extended control conditions where students received regular schooling before later receiving the intervention. Trained classroom teachers delivered the Alert Program to students in discrete, weekly, 1-hour lessons. Student outcomes were assessed at three time points. For the intervention condition, data collection occurred 2 weeks immediately before and after the intervention, with a follow-up 8 weeks later. For control conditions in clusters two to four, the control data collection matched that of the data collection for the intervention condition in the preceding cluster. The primary outcome is change in self-regulation. FASD diagnoses will be determined via medical record review after the completion of data collection. The results will be analysed using generalised linear mixed modelling and reported in accordance with Consolidated Standards of Reporting Trials (CONSORT) guidelines.

Ethics and dissemination

Ethical approval was obtained from the University of Western Australia (WA) (RA/4/1/7234), WA Aboriginal Health Ethics Committee (601) and WA Country Health Service (2015:04). The Kimberley Aboriginal Health Planning Forum Research Sub-Committee and WA Department of Education also provided approval. The results will be disseminated through peer-reviewed journals, conference presentations, the media and at forums.

Trial registration number

ACTRN12615000733572; Pre-results.
Socioeconomic inequalities in child vaccination in low/middle-income countries: what accounts for the differences?
Authors: Hajizadeh Mohammad
Published: March 2018

Background

Socioeconomic inequalities in child vaccination continue to be a global public health concern. This study aimed to measure and identify factors associated with socioeconomic inequalities in full immunisation coverage against the four core vaccine-preventable diseases (ie, bacille Calmette-Guérin, diphtheria-tetanus-pertussis (three doses), polio (three doses) and measles vaccines) in 46 low/middle-income countries.

Methods

The most recent nationally representative samples of children (aged 10–59 months, n=372 499) collected through the Demographic Health Surveys were used to measure vaccination rates. The concentration index (C) was used to quantify socioeconomic inequalities in vaccination coverage. Furthermore, meta-regression analyses were used to determine factors affecting socioeconomic inequalities in vaccination coverage across countries.

Results

Results suggested that immunisation coverage was pro-rich in most countries (median C=0.161, IQR 0.131). Gambia (C=−0.146, 95% CI −0.223 to −0.069), Namibia (C=−0.093, 95% CI −0.145 to −0.041) and Kyrgyz Republic (C=−0.227, 95% CI −0.304 to −0.15) were the only countries where children who belong to higher socioeconomic status group were less likely to receive all the four core vaccines than their lower socioeconomic status counterparts. Meta-regression analyses suggested that, across countries, the concentration of antenatal care visits among wealthier mothers was positively associated with the concentration of vaccination coverage among wealthier children (coefficient=0.606, 95% CI 0.301 to 0.911).

Conclusions

Pro-rich distribution of child vaccination in most low/middle-income countries remains an important public health policy concern. Policies aimed to improve antenatal care visits among mothers in lower socioeconomic groups may mitigate socioeconomic inequalities in vaccination coverage in low/middle-income countries.
Ultrasound is More Reliable than Inflammatory Parameters to Evaluate Disease Activity in Patients with Ra Receiving Tocilizumab Therapy
Authors: Chiu Wen-Chan , Lai Han-Ming , Ko Chi-Hua , Chen Jia-Feng , Hsu Chung-Yuan , Chen Ying-Chou
Published: March 2018

The target of treatment for rheumatoid arthritis (RA) is to keep low disease activity or remission. Tocilizumab can fully inhibit interleukin-6 and C reactive protein (CRP) production. The goal of the study is to search whether tocilizumab treatment compared with adalimumab treatment had the similar effect on sonography and inflammatory parameters in patients with RA. We compared ultrasound scores and inflammatory parameters between patients with RA receiving tocilizumab therapy and those receiving adalimumab therapy. Power Doppler (PD) ultrasound and grayscale synovial hypertrophy on bilateral radiocarpal joints were performed. Inflammatory mediators and ultrasound scores were compared by independent t-test between the adalimumab and tocilizumab groups. 65 patients with RA (32 tocilizumab and 33 adalimumab) were included. Between the two groups, there were no significant differences in age, gender, rheumatoid factors and anticyclic citrullinated peptide antibody. Following biological therapy, the ultrasound score was 2.33 in the tocilizumab group and 2.08 in the adalimumab group (p=0.570), while the erythrocyte sedimentation rate, CRP and Disease Activity Score in 28 joints (DAS28) were lower in the tocilizumab group. So ultrasound scores between the two groups were not significantly different, but the laboratory parameters and DAS28 were lower in the tocilizumab group than in the adalimumab group. Hence, to assess disease activity cannot be based only on clinical evaluations, so we suggest PD ultrasound to be used for all patients on tocilizumab therapy and reflect the true disease activity in these patients.
Environmental cadmium exposure is associated with elevated risk of chronic otitis media in adults
Authors: Lee Dong-Wook , Oh Seung-Ha , Park Moo-Kyun , Lim Youn-Hee , Hong Yun-Chul
Published: March 2018

Objectives

Chronic otitis media (COM) is caused by an infection of the middle ear, although it may also be associated with environmental pollutants. Recent reports found that cadmium exposure could be toxic to middle ear cell lines, but the role of cadmium in the development of COM in humans has not been examined to date. We hypothesised that environmental cadmium exposure was associated with an increased risk of COM in the general population.

Methods

We analysed cross-sectional data for 5331 adults of 20 years of age or above, obtained from the Korea National Health and Nutrition Examination Survey 2010–2012. We examined the association between blood cadmium levels and COM diagnosed by an otolaryngologist.

Results

The highest quartile group of cadmium blood concentration was associated with an OR of 3.33 (95% CI 1.78 to 7.53) for COM, after adjusting for potential confounding factors. Doubling blood cadmium concentration resulted in an OR of 1.58 (95% CI 1.19 to 2.08) for COM. These associations were robust on sensitivity analyses after excluding current smokers and former smokers and after excluding subjects with a potential history of occupational exposure to cadmium.

Conclusions

The results of our study suggest that environmental cadmium exposure is associated with increased risk of COM, and further studies are warranted to understand the pathogenetic mechanism by which COM is caused by cadmium exposure.
Sudden death following dystocia and peritoneal contamination with a polyethylene polymer‐based obstetrical lubricant in an alpaca
Authors: Anderson David E , DiCarlo Caroline , Whitlock Brian Keith
Published: March 2018

A four‐year‐old alpaca suffered muscle tremors, weakness and rear limb paresis following transvaginal correction of dystocia with the aid of a polyethylene oxide polymer (PEP) obstetrical lubricant. A large volume of serosanguinous fluid containing a viscous substance consistent with the PEP lubricant was found in the abdomen. The alpaca died 5.5 hours after dystocia and postmortem examination confirmed multiple uterine tears and presence of a large volume of PEP in the abdomen. The onset of clinical signs and death are consistent with that reported after intraperitoneal instillation of PEP‐based lubricants in horses and cows. Veterinarians should exercise caution when using PEP‐based lubricants based on the risk of death if intra‐abdominal contamination with PEP occurs.
Origin of the Piché Structural Complex and implications for the early evolution of the Archean crustal-scale Cadillac – Larder Lake Fault Zone, Canada
Authors: Bedeaux Pierre , Mathieu Lucie , Pilote Pierre , Rafini Silvain , Daigneault Réal
Published: March 2018

The Piché Structural Complex (PSC) extends over 150 km within the Cadillac – Larder Lake Fault Zone (CLLFZ), a gold-endowed, east-trending, and high-strain corridor located along the southern edge of the Archean Abitibi Subprovince. The PSC consists of discontinuous units of volcanic rocks (<1 km thick) that host multiple gold deposits. It is spatially associated with molasse-type Timiskaming sedimentary basins. This study describes and interprets the origin of structures and lithologies within the poorly understood PSC to unravel the tectonic evolution of the CLLFZ. Field mapping, chemical analyses, as well as interpretations of cross-sections from drill-hole data, were used to interpret the geometry and structure of the PSC. The PSC is subdivided into six homogeneous fault-bounded segments or slivers. These slivers consist mostly of ultramafic to intermediate volcanic rocks and include some felsic volcanic flows and intrusions. Volcanic facies, chemical compositions, and isotopic ages confirm that these slivers are derived from the early volcanic units of the southern Abitibi greenstone belt, which are located north of the CLLFZ. Cross-cutting relationships between volcanic rocks of the PSC and the Timiskaming-aged intrusions suggest that the slivers were inserted into the CLLFZ during the early stages of the accretion-related deformation (<2686 Ma) and prior to Timiskaming sedimentation and ductile deformation (>2676 Ma). The abundant ultramafic rocks located within the CLLFZ may have focused strain, thereby facilitating the nucleation of the fault as well as the displacements along this crustal-scale structure.
RE-MEASUREMENT OF SHORT-TERM INTERNATIONAL CAPITAL FLOWS AND ITS APPLICATION: EVIDENCE FROM CHINA
Authors: SHI JUNYI
Published: March 2018

In this paper, we use the improved direct method and improved residual method to re-measure the annual scale and to measure the quarterly scale of the short-term international capital flows based on the Chinese Balance of Payment table. At the same time, we use the residual method to estimate the monthly scale of the Chinese short-term international capital flows as well. Then we explain and test these calculated results. Next we apply the results to the lead–lag analysis of macro-economy. To judge whether the short-term international capital flow is a leading indicator, we apply the Kullback–Leibler information method and cross-correlation analysis method to analyze the lead–lag relationship between the short-term international capital flows and macro-economy by selecting some representative macroeconomic indicators as a reference. Our empirical analysis shows that in China, the short-term international capital flow is a leading indicator to macro-economy and a coincident indicator to Purchasing Managers’ Index. In the end, we give some conclusions and policy proposals.
Research on ion implantation in MEMS device fabrication by theory, simulation and experiments
Authors: Bai Minyu , Zhao Yulong , Jiao Binbin , Zhu Lingjian , Zhang Guodong , Wang Lei
Published: March 2018

Ion implantation is widely utilized in microelectromechanical systems (MEMS), applied for embedded lead, resistors, conductivity modifications and so forth. In order to achieve an expected device, the principle of ion implantation must be carefully examined. The elementary theory of ion implantation including implantation mechanism, projectile range and implantation-caused damage in the target were studied, which can be regarded as the guidance of ion implantation in MEMS device design and fabrication. Critical factors including implantations dose, energy and annealing conditions are examined by simulations and experiments. The implantation dose mainly determines the dopant concentration in the target substrate. The implantation energy is the key factor of the depth of the dopant elements. The annealing time mainly affects the repair degree of lattice damage and thus the activated elements’ ratio. These factors all together contribute to ions’ behavior in the substrates and characters of the devices. The results can be referred to in the MEMS design, especially piezoresistive devices.
Geometrical optics for scalar, electromagnetic and gravitational waves on curved spacetime
Authors: Dolan Sam R.
Published: March 2018

The geometrical-optics expansion reduces the problem of solving wave equations to one of the solving transport equations along rays. Here, we consider scalar, electromagnetic and gravitational waves propagating on a curved spacetime in general relativity. We show that each is governed by a wave equation with the same principal part. It follows that: each wave propagates at the speed of light along rays (null generators of hypersurfaces of constant phase); the square of the wave amplitude varies in inverse proportion to the cross-section of the beam; and the polarization is parallel-propagated along the ray (the Skrotskii/Rytov effect). We show that the optical scalars for a beam, and various Newman–Penrose scalars describing a parallel-propagated null tetrad, can be found by solving transport equations in a second-order formulation. Unlike the Sachs equations, this formulation makes it straightforward to find such scalars beyond the first conjugate point of a congruence, where neighboring rays cross, and the scalars diverge. We discuss differential precession across the beam which leads to a modified phase in the geometrical-optics expansion.
Millisecond pulsars modeled as strange quark stars admixed with condensed dark matter
Authors: Panotopoulos Grigoris , Lopes Ilídio
Published: March 2018

We study for the first time how a new class of stars could impact an ensemble of pulsars with known masses and spin-periods. These new compact objects are strange stars admixed with condensed dark matter (DM). In this exploratory theoretical work, our goal is to determine how the basic parameters of pulsars are modified for such a new class of compact objects. In particular, we consider three different scenarios that correspond to a DM mass fraction of [Formula: see text], [Formula: see text] and [Formula: see text]. Within each scenario with fixed parameters, we predict theoretically other properties of the pulsars, such as the radius, the compactness, the moment of inertia, as well as the angular momentum. Our numerical results are summarized in tables and also shown graphically for better visualization, where a comparison between the different scenarios can be made.
Multiple-Stage Policies for a Server System with Illegal Access
Authors: Imaizumi Mitsuhiro , Kimura Mitsutaka
Published: March 2018

As the Internet technology has developed, the demands for the improvement of the reliability and security of the system connected with the Internet have increased. Although various services are performed on the Internet, illegal access on the Internet has become a problem in recent years. This paper formulates stochastic models for a system with illegal access. The server has the function of IDS, and illegal access is checked in multiple stages which consist of simple check, detailed check and dynamic check. We apply the theory of Markov renewal processes to a system with illegal access, and derive the mean time and the expected checking number until a server system becomes faulty. Further, optimal policies which minimize the expected cost are discussed. Finally, numerical examples are given.
Optimal Shelf-Inspection Policies of Self-Service Retailers
Authors: Ito Kodo , Higuchi Yoshiyuki , Ohta Masao , Liu Xiaoyuan
Published: March 2018

In Japan, the annual sales share of supermarkets and convenience stores increased around 2000. Both self-servicing and delivering a wide variety of products are denominators of these stores, and they have an advantage in retail business competitions because self-service stores can reduce labor costs by engaging consumers with the provision of services and the productivity of these stores is higher than specialty stores. In case of self-service stores, miscellaneous jobs such as cash registering, goods arranging, and shelf reviewing, have to be performed by limited number of clerks and efficient operation methods are required. The inventory management of store shelves for avoiding out-of-stock is an important issue and the AHM-Model which is a famous periodic monitoring inventory utilizing dynamic programming was proposed.

In this paper, store shelves are monitored periodically and are replenished when the total amount of goods is below a threshold. Total expected cost rates are defined and optimal thresholds are discussed utilizing the cumulative damage model analytically.
Discontinuous Legendre Wavelet Element Method for Reaction–Diffusion Equation from Mathematical Chemistry
Authors: Zheng Xiaoyang , Wei Zhengyuan
Published: March 2018

This paper presents discontinuous Legendre wavelet element (DLWE) approach for solving nonlinear reaction–diffusion equation (RDE) arising in mathematical chemistry. Firstly, weak formulation of the RDE and corresponding numerical fluxes are devised by utilizing the advantages of both Legendre wavelet and discontinuous Galerkin (DG) approach. Secondly, stability and error estimates of the proposed method have been addressed. Finally, numerical experiments demonstrate the validity and utility of the DLWE method, which is also applicable to solving some other kinds of partial differential equations.
A general family of congruences for Bernoulli numbers
Authors: Rosen Julian
Published: March 2018

We prove a general family of congruences for Bernoulli numbers whose index is a polynomial function of a prime, modulo a power of that prime. Our family generalizes many known results, including the von Staudt–Clausen theorem and Kummer’s congruence.