bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensitivity Study on the Effects of Nondestructive Examinations on Failure Probabilities of Reactor Pressure Vessels
Authors: Arai Kensaku , Katsuyama Jinya , Li Yinsheng
Published: October 2018

Reactor pressure vessels (RPVs) in nuclear power plants are important components that prevent non-ductile fracture considering neutron irradiation embrittlement as aging degradation and several types of transients. An analysis code called PASCAL for assessing failure frequencies of RPVs based on probabilistic fracture mechanics has been developed by the Japan Atomic Energy Agency. In failure frequency analyses, flaw size distribution in RPVs is one of the most important parameters, and it is determined by considering possible flaws generated during fabrication and the flaw-detection capabilities of nondestructive examinations (NDEs). Flaw-detection capabilities of NDEs are represented as probability of detection (POD) curves related to flaw sizes.

In this study, the effects of NDEs on failure frequencies of RPVs are evaluated using PASCAL considering simplified POD curves in terms of minimum detectable flaw size, the smallest probability of non-detection (PND), and flaw size where POD value reaches the smallest PND.
Revision to Stress Intensity Factor Equations for ASME Section XI Appendix C-4000: Determination of Failure Mode
Authors: Hojo Kiminobu , Xu Steven
Published: October 2018

In ASME Section XI Appendix C for analytical evaluation of flaws in piping, a screening procedure is prescribed to determine the failure mode and analysis method for the flawed pipe. The end-of-evaluation period flaw dimensions, temperature, material properties, and pipe loadings are considered in the screening procedure. Equations necessary to calculate components of the screening criteria (SC) include stress intensity factor (K) equations. The K-equation for a pipe with a circumferential inside surface flaw in the 2017 Edition Section XI Appendix C-4000 is for a fan-shaped flaw. Real surface flaws are closer to semi-elliptical shape. As part of Section XI Working Group on Pipe Flaw Evaluation (WGPFE) activities, revision to stress intensity factor equations for circumferential surface flaws in Appendix C-4000 has been proposed. The proposed equations include closed-form equations for stress intensity influence coefficients G0 for membrane stress and Ggb for global bending stress for circumferential inside surface flaws. The rationale for the Code changes and technical basis for the proposed stress intensity factor equations are provided in this paper.
Numerical Calculation of Fatigue Crack Growth for the Structures of Elbow and Tee Pipe Based on RCC-MR A16 Code
Authors: Tang Peng , Luo Jiacheng , Li Pengzhou , Sun Lei , Luo Juan
Published: October 2018

As the transport artery for the reactor coolant, high-energy piping systems are the links that maintain the normal operation of each system and play a crucial role in ensuring the normal operation and safety of the reactor in nuclear power plants. During the long-term operation of the reactor, stress concentration may be induced at the weak links in the pipeline systems, such as the elbow and the tee pipe structures, under the loads of high temperature, high pressure, flow-induced vibration and so on, and finally resulting in crack defects. Due to the continuous fatigue load during the lifetime, the defects in the inner surface of the pipes may propagate rapidly and even penetrate through the wall thickness, leading to the leakage of coolant and seriously affecting the safe operation of the reactor. In order to ensure the normal function of the pipeline system and meet the service requirements, this paper studies the fatigue crack propagation problems in elbows and tee pipe in the reactor pipe systems to ensure the safe operation of the pipeline. According to the RCC-MR A16 code, the fatigue crack propagation calculation program is compiled for the elbow and tee pipe made of austenitic steel to study the fatigue crack growth process and the influencing factors of crack propagation.
Creep and Creep-Fatigue Deformation and Life Assessment of Ni-Based Alloy 740H and Alloy 617
Authors: Zhang Shengde , Takahashi Yukio
Published: October 2018

This paper presents creep and creep-fatigue deformations and lives of both Ni-based alloys, Alloy 740H and Alloy 617. Creep tests were performed using solid bar specimens at 650°C-800°C, and effect of cyclic loading on creep deformation and rupture was discussed. Strain controlled creep-fatigue tests were also performed under triangular and trapezoidal waveforms at 700°C. Alloy 740H showed stronger creep-fatigue resistance compared to Alloy 617. Creep-fatigue lives in trapezoidal waveform were smaller than those in the pure fatigue test and the creep-fatigue lives decreased as the hold time increased. Applicability of four representative creep-fatigue life prediction methods was discussed.
Assessment of Weld Quality Using Control Chart and Frequency Domain Analysis
Authors: Thekkuden Dinu Thomas , I. Mourad Abdel-Hamid , Christy John Victor , Idrisi Amir Hussain
Published: October 2018

Two novel techniques are proposed in this work to distinguish instantly the weld quality. The first technique is based on the recorded voltage during welding while the other is based on the recorded sound. Both voltage and sound are recorded using data acquisition system having 8 KHz sampling frequency and sound recorder respectively. The recorded data are analyzed immediately after welding process using control chart for voltage-based technique and frequency domain analysis for sound-based technique. The result of the first approach revealed that the sample points in the standard deviation or mean control chart scatter beyond the control limits for an unstable process at the defected region whereas they locate within the control limits for stable process. This prominent technique identifies the arc instability caused by the formation of internal minute porosities. The presence of these porosities is confirmed by the radiographic test. For the second technique, the frequency domain analysis of the welding sound proved to have peak magnitude at 216 Hz consistently for the quality welds. Multiple frequencies with significant absolute magnitude away from 216 Hz were the distinct feature observed for the unstable welds. The two methods are found to be highly adaptable for instant monitoring of the quality of the weld.
Gate-induced superconductivity in a monolayer topological insulator
Authors: Sajadi Ebrahim , Palomaki Tauno , Fei Zaiyao , Zhao Wenjin , Bement Philip , Olsen Christian , Luescher Silvia , Xu Xiaodong , Folk Joshua A. , Cobden David H.
Published: October 2018

A monolayer of many talents

Superconductors with a topologically nontrivial band structure have been predicted to exhibit exotic properties. However, such materials are few and far between. Now, two groups show that the monolayer of the material tungsten ditelluride (WTe
2
)—already known to be a two-dimensional topological insulator—can also go superconducting. Fatemi
et al.
and Sajadi
et al.
varied the carrier density in the monolayer by applying a gate voltage and observed a transition from a topological to a superconducting phase. The findings may lead to the fabrication of devices in which local gating enables topological and superconducting phases to exist in the same material.

Science
, this issue p.
926
, p.
922
Use of Translational Pharmacokinetic/Pharmacodynamic Infection Models To Understand the Impact of Neutropenia on the Efficacy of Tedizolid Phosphate
Authors: Xiao Jianying , Gill Charles , Liang Lianzhu , Liu Jenny , Wu Jin , Feng Hwa-Ping , Flanagan Shawn , Tan Christopher , Flattery Amy
Published: October 2018

Tedizolid phosphate, the prodrug of the active antibiotic tedizolid, is an oxazolidinone for the treatment of acute bacterial skin and skin structure infections. Studies in a mouse thigh infection model demonstrated that tedizolid has improved potency and pharmacokinetics/pharmacodynamics (PK/PD) compared with those of linezolid.
Spontaneous Mutational Frequency and
FKS
Mutation Rates Vary by Echinocandin Agent against
Candida glabrata
Authors: Shields Ryan K. , Kline Ellen G. , Healey Kelley R. , Kordalewska Milena , Perlin David S. , Nguyen M. Hong , Clancy Cornelius J.
Published: October 2018

Echinocandins are front-line agents for treatment of invasive candidiasis. There are no reported agent-specific differences in
Candida
mutational frequency of resistance or propensity to develop
FKS
mutations.
Preclinical Characterization of NVR 3-778, a First-in-Class Capsid Assembly Modulator against Hepatitis B Virus
Authors: Lam Angela M. , Espiritu Christine , Vogel Robert , Ren Suping , Lau Vincent , Kelly Mollie , Kuduk Scott D. , Hartman George D. , Flores Osvaldo A. , Klumpp Klaus
Published: October 2018

NVR 3-778 is the first capsid assembly modulator (CAM) that has demonstrated antiviral activity in hepatitis B virus (HBV)-infected patients. NVR 3-778 inhibited the generation of infectious HBV DNA-containing virus particles with a mean antiviral 50% effective concentration (EC
50
) of 0.40 µM in HepG2.2.15 cells.
Inhibition Studies with 2-Bromoethanesulfonate Reveal a Novel Syntrophic Relationship in Anaerobic Oleate Degradation
Authors: Salvador A. F. , Cavaleiro A. J. , Paulo A. M. S. , Silva S. A. , Guedes A. P. , Pereira M. A. , Stams A. J. M. , Sousa D. Z. , Alves M. M.
Published: October 2018

In anaerobic treatment of complex wastewater containing fat, oils, and grease, high long-chain fatty acid (LCFA) concentrations may inhibit microbial communities, particularly those of methanogens. Here, we investigated if anaerobic degradation of LCFAs can proceed when methanogens are inhibited and in the absence of typical external electron acceptors, such as nitrate, iron, or sulfate. Inhibition studies were performed with the methanogenic inhibitor 2-bromoethanesulfonate (BrES). We noticed that, after autoclaving, BrES underwent partial hydrolysis and turned out to be a mixture of two sulfonates (BrES and isethionate). We found out that LCFA conversion proceeded faster in the assays where methanogenesis was inhibited, and that it was dependent on the utilization of isethionate. In this study, we report LCFA degradation coupled to desulfonation. Our results also showed that BrES can be utilized by anaerobic bacteria.
Genus-Wide Assessment of Antibiotic Resistance in
Lactobacillus
spp
Authors: Campedelli Ilenia , Mathur Harsh , Salvetti Elisa , Clarke Siobhán , Rea Mary C. , Torriani Sandra , Ross R. Paul , Hill Colin , O’Toole Paul W.
Published: October 2018

Lactobacillus
species are generally considered to be nonpathogenic and are used in a wide variety of foods and products for humans and animals. However, many of the species examined in this study have antibiotic resistance levels which exceed those recommended by the EFSA, suggesting that these cutoff values should be reexamined in light of the genetic basis for resistance discussed here. Our data provide evidence for rationally revising the regulatory guidelines for safety assessment of lactobacilli entering the food chain as starter cultures, food preservatives, or probiotics and will facilitate comprehensive genotype-based assessment of strains for safety screening.
Diagnostic value of a combination of next-generation sequencing, chorioretinal imaging and metabolic analysis: lessons from a consanguineous Chinese family with gyrate atrophy of the choroid and retina stemming from a novel OAT variant
Authors: Huang Junting , Fu Jiewen , Fu Shangyi , Yang Lisha , Nie Kailai , Duan Chengxia , Cheng Jingliang , Li Yumei , Lv Hongbin , Chen Rui , Liu Longqian , Fu Junjiang
Published: October 2018

Background/Aim

Gyrate atrophy of the choroid and retina (GACR) is an extremely rare autosomal recessive inherited disorder characterised by progressive vision loss. To identify the disease-causing gene in a consanguineous Chinese pedigree with GACR, we aimed to accurately diagnose patients with GACR through a combination of next-generation sequencing (NGS) genetic diagnosis, clinical imaging and amino acid metabolic analysis.

Methods

A consanguineous Chinese pedigree with GACR, including two patients, was recruited and a comprehensive ophthalmological evaluation was performed. DNA was extracted from a proband and her family members, and the sample from the proband was analysed using targeted NGS. Variants ‎detected by NGS were confirmed by Sanger sequencing and subjected to segregation analysis. Tandem mass spectrometry (MS/MS) was subsequently performed for metabolic assessment.

Results

We identified a ‎novel, deleterious, homologous ornithine aminotransferase (
OAT
) variant, c.G248A: p.S83N, which contributes to ‎the progression of GACR in patients. Our results showed that the p.S83N autosomal recessive ‎variant of OAT is most likely ‎pathogenic, with changes in protein stability drastically decreasing functionality. MS/MS verified that ornithine levels in patients were significantly elevated.

Conclusions

Recruitment of a third-degree first cousin consanguineous marriage family with GACR allowed us to identify a novel pathogenic
OAT
variant in the Chinese population, broadening the mutation spectrum. Our findings reported the diagnostic value of a combination of NGS, retinal imaging and metabolic analysis of consanguineous marriage pedigrees in low-income/middle-income and low-incidence countries, including China, and may help to guide accurate diagnosis and ‎treatment of this disease.
Recent advances in genetically modified animal models of glaucoma and their roles in drug repositioning
Authors: Harada Chikako , Kimura Atsuko , Guo Xiaoli , Namekata Kazuhiko , Harada Takayuki
Published: October 2018

Glaucoma is one of the leading causes of vision loss in the world. Currently, pharmacological intervention for glaucoma therapy is limited to eye drops that reduce intraocular pressure (IOP). Recent studies have shown that various factors as well as IOP are involved in the pathogenesis of glaucoma, especially in the subtype of normal tension glaucoma. To date, various animal models of glaucoma have been established, including glutamate/aspartate transporter knockout (KO) mice, excitatory amino acid carrier 1 KO mice, optineurin E50K knock-in mice, DBA/2J mice and experimentally induced models. These animal models are very useful for elucidating the pathogenesis of glaucoma and for identifying potential therapeutic targets. However, each model represents only some aspects of glaucoma, never the whole disease. This review will summarise the benefits and limitations of using disease models of glaucoma and recent basic research in retinal protection using existing drugs.
Systematic review of interventions targeting sickness absence among pregnant women in healthcare settings and workplaces
Authors: Pedersen Pernille , Labriola Merete , Nielsen Claus Vinther , Maimburg Rikke Damkjær , Nohr Ellen Aagaard , Momsen Anne-Mette
Published: October 2018

Objectives

The high rate of sickness absence from work during pregnancy is recognised as a problem, and may be higher than necessary from a health perspective. The aim was to evaluate the effectiveness of interventions in healthcare settings and workplaces targeting sickness absence among pregnant women.

Methods

Studies were eligible if they included pregnant women participating in any intervention in healthcare settings or workplaces. The outcome was length of sickness absence in days or number of episodes. Study design had to be either randomised controlled trials (RCTs) or quasi-experimental studies.

The search for studies was conducted in PubMed, Scopus, CINAHL, PsycINFO, ClinicalTrials.gov and WHO trial registry. Risk of bias was assessed by the Joanna Briggs Institute standardised quality assessment instrument.

Results

A total of nine studies were quality assessed and of these, four were excluded due to insufficient methodological quality. Five RCTs conducted in healthcare settings in Sweden and Norway were included. Due to heterogeneity, meta-analysis was not performed.

Two RCTs examined complementary and alternative medicine and three RCTs the effect of physical exercise. In general, the frequency of women on sickness absence was lower in the intervention groups than the control groups, however, only among pregnant women who participated in a 12-week exercise programme, the frequency was significantly lower (22% vs 30%, p=0.04).

Conclusion

The evidence of interventions targeting sickness absence among pregnant women in healthcare settings is sparse, and no studies were conducted at workplaces.

Future interventions including physical activity provided in collaboration with healthcare settings and workplaces are requested. Studies should measure sickness absence based on valid methods, measure compliance to the intervention and provide transparency of statistical methods.

PROSPERO registration number

CRD42018084802.
Loss of horizontal macular ganglion cell complex asymmetry: an optical coherence tomography indicator of chiasmal compression
Authors: Jørstad Øystein Kalsnes , Wigers Andreas Reidar , Marthinsen Pål Bache , Moe Morten Carstens , Evang Johan Arild
Published: October 2018

Objective

To estimate the macular ganglion cell complex (GCC) asymmetry in patients with suprasellar tumours, to compare its diagnostic performance to the nasal GCC thickness and visual field (VF) and to investigate how the parameters correlate with magnetic resonance imaging (MRI) findings.

Methods and analysis

Cross-sectional study of patients with suprasellar tumours affecting the optic chiasm. Macular optical coherence tomography (OCT) scans were evaluated for nasal GCC sector thinning and loss of normal GCC asymmetry between corresponding nasal-temporal sectors. Equivalently, VFs were analysed for defects compatible with chiasm dysfunction. The relationship between optic chiasm and tumour was measured on MRI.

Results

Thirty-three eyes of 33 patients were included. There were OCT findings in 14 eyes. Nasal GCC thinning was found in 9 eyes and loss of GCC asymmetry in 12 eyes; the two parameters were not significantly different with respect to number of positive findings (p=0.45). Loss of GCC asymmetry, however, occurred in 5 eyes among 24 without GCC thinning (proportion 0.21; 95% confidence interval 0.071 to 0.42). In 8 eyes, VF indicated pathology; of these, 7 had concurring OCT findings. The prevalence of OCT and VF findings increased significantly with suprasellar tumour extension on MRI.

Conclusion

The diagnostic capabilities of nasal GCC thinning and loss of GCC asymmetry were comparable, whilst their complementary performances increased the proportion of eyes in which OCT suggested compression. The prevalence of both OCT and VF findings grew with suprasellar tumour extension. In several cases, however, structural findings on OCT preceded detectable VF deficits.
Faecal immunochemical testing implementation to increase colorectal cancer screening in primary care
Authors: Bakhai Smita , Ahluwalia Gaurav , Nallapeta Naren , Mangat Amanpreet , Reynolds Jessica L
Published: October 2018

Colorectal cancer (CRC) is the second leading cause of cancer death in USA, and CRC screening remains suboptimal. The aim of this quality improvement was to increase CRC screening in the internal medicine clinic (IMC) patients, between the ages of 50–75 years, from a baseline rate of 50%–70% over 12 months with the introduction of faecal immunochemical test (FIT) testing. We used the Plan–Do–Study–Act (PDSA) method and performed a root cause analysis to identify barriers to acceptance of CRC screening. The quality improvement team created a driver diagram to identify and prioritise change ideas. We developed a process flow map to optimise opportunities to improve CRC screening. We performed eight PDSA cycles. The major components of interventions included: (1) leveraging health information technology; (2) optimising team work, (3) education to patient, physicians and IMC staff, (4) use of patient navigator for tracking FIT completion and (5) interactive workshops for the staff and physicians to learn motivational interview techniques. The outcome measure included CRC screening rates with either FIT or colonoscopy. The process measures included FIT order and completion rates. Data were analysed using a statistical process control and run charts. Four hundred and seven patients visiting the IMC were offered FIT, and 252 (62%) completed the test. Twenty-two (8.7%) of patients were FIT positive, 14 of those (63.6%) underwent a subsequent diagnostic colonoscopy. We achieved 75% CRC screening with FIT or colonoscopy within 12 months and exceeded our goal. Successful strategies included engaging the leadership, the front-line staff and a highly effective multidisciplinary team. For average-risk patients, FIT was the preferred method of screening. We were able to sustain a CRC screening rate of 75% during the 6-month postproject period. Sustainable annual FIT is required for successful CRC screening.
Effect of data validation audit on hospital mortality ranking and pay for performance
Authors: Haviari Skerdi , Chollet François , Polazzi Stéphanie , Payet Cecile , Beauveil Adrien , Colin Cyrille , Duclos Antoine
Published: October 2018

Background

Quality improvement and epidemiology studies often rely on database codes to measure performance or impact of adjusted risk factors, but how validity issues can bias those estimates is seldom quantified.

Objectives

To evaluate whether and how much interhospital administrative coding variations influence a typical performance measure (adjusted mortality) and potential incentives based on it.

Design

National cross-sectional study comparing hospital mortality ranking and simulated pay-for-performance incentives before/after recoding discharge abstracts using medical records.

Setting

Twenty-four public and private hospitals located in France

Participants

All inpatient stays from the 78 deadliest diagnosis-related groups over 1 year.

Interventions

Elixhauser and Charlson comorbidities were derived, and mortality ratios were computed for each hospital. Thirty random stays per hospital were then recoded by two central reviewers and used in a Bayesian hierarchical model to estimate hospital-specific and comorbidity-specific predictive values. Simulations then estimated shifts in adjusted mortality and proportion of incentives that would be unfairly distributed by a typical pay-for-performance programme in this situation.

Main outcome measures

Positive and negative predictive values of routine coding of comorbidities in hospital databases, variations in hospitals’ mortality league table and proportion of unfair incentives.

Results

A total of 70 402 hospital discharge abstracts were analysed, of which 715 were recoded from full medical records. Hospital comorbidity-level positive predictive values ranged from 64.4% to 96.4% and negative ones from 88.0% to 99.9%. Using Elixhauser comorbidities for adjustment, 70.3% of hospitals changed position in the mortality league table after correction, which added up to a mean 6.5% (SD 3.6) of a total pay-for-performance budget being allocated to the wrong hospitals. Using Charlson, 61.5% of hospitals changed position, with 7.3% (SD 4.0) budget misallocation.

Conclusions

Variations in administrative data coding can bias mortality comparisons and budget allocation across hospitals. Such heterogeneity in data validity may be corrected using a centralised coding strategy from a random sample of observations.
HbA1c: a review of non-glycaemic variables
Authors: Campbell Leon , Pepper Tessa , Shipman Kate
Published: October 2018

Identification of the correlation between HbA1c and diabetic complications has yielded one of the most clinically useful biomarkers. HbA1c has revolutionised the diagnosis and monitoring of diabetes mellitus. However, with widespread adoption of HbA1c has come increasing recognition that non-glycaemic variables can also affect HbA1c, with varying clinical significance. Furthermore, the identification of a discrepancy between predicted and measured HbA1c in some individuals, the so-called ‘glycation gap’, may be clinically significant. We aimed to review the current body of evidence relating to non-glycaemic variables to quantify any significance and provide subsequent suggestions. A PubMed-based literature search was performed, using a variety of search terms, to retrieve articles detailing the non-glycaemic variables suggested to affect HbA1c. Articles were reviewed to assess the relevance of any findings in clinical practice and where possible guidance is given. A range of non-glycaemic variables have statistically significant effects on HbA1c. While the clinical implications are generally irrelevant, a small number of non-glycaemic variables do have clinically significant effects and alternative biomarkers should be considered instead of, or in addition to, HbA1c. There are a small number of non-glycaemic variables which have a clinically significant effect on HbA1c, However, the vast majority of non-glycaemic variables have no clinical relevance. While clinicians should have an awareness of those non-glycaemic variables with clinical significance, in the vast majority of clinical scenarios HbA1c should continue to be used with confidence.
Experimental study of the inhibition effect of CXCL12/CXCR4 in malignant pleural mesothelioma
Authors: Li Jianshuang , Li Tong , Li Shuo , Xie Lipeng , Yang Yi-Lin , Lin Qiang , Kadoch Orli , Li Hui , Hou Shengcai , Xu Zhidong
Published: October 2018

Previous studies have demonstrated that CXCL12/CXCR4 axis is closely related to tumors such as malignant pleural mesothelioma (MPM). This research was conducted in order to detect whether CXCL12/CXCR4 inhibitors could restrain MPM and have a synergistic effect with chemotherapy, also to investigate the relationship of CXCL12/CXCR4 with other gene expressions in MPM. Forty mice were injected MPM cells and randomly divided into four groups: the PBS (control group), AMD3100 (CXCR4-CXCL12 antagonist), pemetrexed and AMD3100 plus pemetrexed. The mice were treated respectively for duration of 3 weeks. The size, bioluminescence and weight of tumors were measured. The differences between gene expressions in each group were analyzed. The tumor weights of each treatment group were lower than that of the control group (p<0.05). The bioluminescence of the tumor of the AMD3100 treatment group and the AMD3100 plus pemetrexed treatment group were lower than that of the control group (p<0.05), and AMD3100 was shown to have synergistic effects with pemetrexed (p<0.05). Among the 2.5 billion genes, several hundreds of genes expressed differently between groups. Results show that AMD3100 and pemetrexed can inhibit the growth of MPM in vivo, also that there is a better result if both are used together. Our findings suggest that CXCL12/CXCR4 axis affects a certain amount of gene expression in MPM.
Repeat Radiographic Imaging in Patients with Long Bone Fractures Transferred to a Pediatric Trauma Center
Authors: Mangus Courtney W , Klein Bruce L , Miller Marlene , Stewart Dylan , Ryan Leticia M
Published: October 2018

This study sought to determine the proportion of children with long bone fractures who undergo duplicate radiographic imaging after transfer to a pediatric trauma center (PTC) for further management. The secondary objective was to explore provider rationale and diagnostic yield of repeat X-rays. This was a single-site, retrospective cohort study conducted at a PTC. All patients, aged 0–21 years, who were transferred to the PTC for management of a long bone fracture were included. Electronic medical records were reviewed to determine the proportion of children who had repeat radiographic imaging and the provider rationale for obtaining this. T-test and Χ2 analyses were used to compare patients who had repeat X-rays with those who did not. During the study period, 309 patients (63% male, mean age 7.2±4.3 years) were transferred from 30 referring hospitals. Of these, 43% (n=133) underwent repeat radiographs. Patient age (p=0.9), gender (p=0.7), fracture location (p=0.19), and type of referring emergency department (pediatric vs general, p=0.3) were not significantly associated with repeat imaging. Rationale for repeat imaging could be ascertained in 31% of cases (n=41); the most common reasons were request by orthopedist (17%, n=23) and suboptimal original imaging (10%, n=13). Repeat imaging at the PTC did not reveal new or additional diagnoses in any case. Nearly half of the children in our study population undergo repeat and likely unnecessary imaging. Strategies to reduce repeat radiographs should be developed, as redundant imaging exposes patients to additional radiation and increases medical expense.
Behavioural and trait changes in parkinsonian patients with impulse control disorder after switching from dopamine agonist to levodopa therapy: results of REIN-PD trial
Authors: Lee Jee-Young , Jeon Beomseok , Koh Seong-Beom , Yoon Won Tae , Lee Ho-Won , Kwon Oh Dae , Kim Jae Woo , Kim Jong-Min , Ma Hyeo-Il , Kim Hee-Tae , Baik Jong Sam , Cho Jinwhan ,   (REIN-PD Investigators)
Published: October 2018

Objective

In this multicentre open-label trial, we compared behavioural and neuropsychiatric symptoms in Parkinson’s disease (PD) patients with impulse control disorders (ICD) treated with dopamine agonists before and 12 weeks after substituting dopamine agonists with an equivalent dose of levodopa/carbidopa slow-release formulation.

Methods

Baseline characteristics of 50 PD patients with ICD were compared with those of 60 medicated and 40 drug-naive PD control groups. Neuropsychiatric trait changes in the PD-ICD group were investigated 12 weeks after the intervention. ICD behaviours were assessed via modified Minnesota Impulsive Disorders Interview (mMIDI), whereas parkinsonian severity and neuropsychiatric characters were systematically assessed with the Unified PD Rating Scale (UPDRS) and a predefined neuropsychological assessment battery.

Results

At baseline, ICD patients showed higher scores in the Neuropsychiatric Inventory and anxiety, anger and obsessive-compulsive traits compared with both PD control groups. In contrast, the three PD groups showed indifference in the impulsivity scales. At 12 weeks post intervention, ICD behaviours significantly improved (p<0.001, Δ modified MIDI score=‒5.27 ± 5.75) along with the UPDRS II daily activity scores (p=0.02, Δ=‒2.07 ± 4.53). Behavioural disinhibition tended to improve (p=0.06), although no significant changes were observed in the Neuropsychiatric Inventory and personality trait scores. Dopamine agonist withdrawal syndrome developed in 5.3% of the PD-ICD group.

Conclusions

This study provides class IV evidence suggesting that switching from dopamine agonists to levodopa/carbidopa slow-release formulations alleviated ICD behaviours in PD patients leading to improvement in daily activities whereas neuropsychiatric traits associated with ICD persisted after the 12-week therapy.

Trial registration number

NCT01683253.
Ambient concentrations of NO2 and hospital admissions for schizophrenia
Authors: Bai Lijun , Zhang Xulai , Zhang Yanwu , Cheng Qiang , Duan Jun , Gao Jiaojiao , Xu Zihan , Zhang Heng , Wang Shusi , Su Hong
Published: October 2018

Objectives

Schizophrenia is a chronic and severe mental disorder affecting more than 21 million people worldwide. Short-term exposure to nitrogen dioxide (NO2) has been associated with hospital admissions (HAs) for mental disorders, but no study has evaluated the specific association of NO2 and schizophrenia. Additionally, the shape of the concentration–response (C–R) curve has not yet been assessed at present. This study aims to investigate the relationship between short-term exposure to NO2 and HAs for schizophrenia in Hefei, from 2014 to 2016. We also attempt to explore the C–R and the underlying effect modifiers of the association.

Methods

Daily number of HAs for schizophrenia was derived from the computerised medical record system of Anhui Mental Health Center. We used a time-series Poisson generalised linear regression combined with distributed lag non-linear models to model the NO2–schizophrenia relationship.

Results

A total of 11 373 HAs were identified during the study period. An increase in levels of NO2 was significantly associated with elevated schizophrenia HAs. The estimated relative risk per IQR increase in NO2 at lag 01 was 1.10 (95% CI 1.01 to 1.18). Greater association was observed in young patients (relative risk: 1.11, 95% CI 1.02 to 1.19). The modelled C–R curves of the NO2–schizophrenia relationship suggested possible threshold effects of NO2 for all ages combined, young patients, men and both seasons.

Conclusions

Short-term exposure to NO2 may be associated with increased schizophrenia HAs. Findings indicated potential threshold effects of NO2, which has important implications for health-based risk assessments.
High prevalence of undiagnosed COPD among patients evaluated for suspected myocardial ischaemia
Authors: Jönsson Andreas , Fedorowski Artur , Engström Gunnar , Wollmer Per , Hamrefors Viktor
Published: October 2018

Objective

Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of global morbidity and mortality. Despite the well-known comorbidity between COPD and CAD, the presence of COPD may be overlooked in patients undergoing coronary evaluation. We aimed to assess the prevalence of undiagnosed COPD among outpatients evaluated due to suspected myocardial ischemia.

Methods

Among 500 outpatients who were referred to myocardial perfusion imaging due to suspected stable myocardial ischaemia, 433 patients performed spirometry. Of these, a total of 400 subjects (age 66 years; 45% women) had no previous COPD diagnosis and were included in the current study. We compared the prevalence of previously undiagnosed COPD according to spirometry criteria from The Global Initiative for Chronic Obstructive Lung Disease (GOLD) or lower limit of normal (LLN) and reversible myocardial ischaemia according to symptoms and clinical factors.

Results

A total of 134 (GOLD criteria; 33.5 %) or 46 patients (LLN criteria; 11.5%) had previously undiagnosed COPD, whereas 55 patients (13.8 %) had reversible myocardial ischaemia. The presenting symptoms (chest discomfort, dyspnoea) did not differ between COPD, myocardial ischaemia and normal findings. Except for smoking, no clinical factors were consistently associated with previously undiagnosed COPD.

Conclusions

Among middle-aged outpatients evaluated due to suspected myocardial ischaemia, previously undiagnosed COPD is at least as common as reversible myocardial ischaemia and the presenting symptoms do not differentiate between these entities. Patients going through a coronary ischaemia evaluation should be additionally tested for COPD, especially if there is a positive history of smoking.
Predicting achievement of the treatment targets at 6 months from 3-month response levels in rheumatoid arthritis: data from real-life follow-up in the NOR-DMARD study
Authors: Norvang Vibeke , Sexton Joseph , Kristianslund Eirik K , Olsen Inge C , Uhlig Till , Bakland Gunnstein , Krøll Frode , Rødevand Erik , Wierød Ada , Kvien Tore K , Smolen Josef S , Aletaha Daniel , Haavardsholm Espen A
Published: October 2018

Objective

When initiating a new therapy in patients with rheumatoid arthritis (RA), current treatment recommendations suggest escalating therapy in case of poor clinical improvement by 3 months or if the treatment target has not been reached by 6 months. We investigated which disease activity improvement levels at 3 months predicted achievement of the treatment targets at 6 months in a real-life clinical setting.

Methods

We included 1610 patients with RA enrolled in the NOR-DMARD study between 2000 and 2012. Analyses were performed for the total group of patients and repeated for subgroups stratified by baseline disease activity, disease duration or treatment with methotrexate or a tumour necrosis factor inhibitor. We used a diagnostic test approach to explore the associations between 3-month response and 6-month outcome.

Results

Not achieving 50% improvement in Simplified Disease Activity Index (SDAI) by 3 months significantly decreased the likelihood of reaching remission at 6 months in all subgroups (negative likelihood ratios (LRs−) 0.15–0.36). Patients with high disease activity when initiating treatment were likely to fail reaching remission if they achieved less than SDAI 70% response by 3 months (LR− 0.25 and negative predictive value 0.98). Achieving a major response (SDAI 85%) at 3 months significantly increased the likelihood of reaching remission at 6 months (LRs+ 6.56).

Conclusion

Levels of 3-month disease activity improvement can inform clinicians when deciding to continue or adjust ongoing therapy in a treat-to-target strategy aiming for remission or low disease activity within 6 months. The required levels of 3-month improvement varied with baseline disease activity.
Patient-reported outcomes and safety in patients undergoing synovial biopsy: comparison of ultrasound-guided needle biopsy, ultrasound-guided portal and forceps and arthroscopic-guided synovial biopsy techniques in five centres across Europe
Authors: Just Søren Andreas , Humby Frances , Lindegaard Hanne , Meric de Bellefon Laurent , Durez Patrick , Vieira-Sousa Elsa , Teixeira Rui , Stoenoiu Maria , Werlinrud Jens , Rosmark Sofie , Larsen Pia Veldt , Pratt Arthur , Choy Ernest , Gendi Nagui , Buch Maya H , Edwards Christopher J , Taylor Peter C , McInnes Iain B , Fonseca João Eurico , Pitzalis Costantino , Filer Andrew
Published: October 2018

Background

We present a European multicenter study, comparing safety data and patient-reported outcomes (PRO) from patients undergoing synovial biopsy using ultrasound-guided needle biopsy (US-NB), ultrasound-guided portal and forceps (US-P&F) or arthroscopic-guided (AG) procedures.

Objectives

To describe safety and PRO data on joint indices of pain, stiffness and swelling before and after biopsy, procedural discomfort, joint status compared with before biopsy and willingness to undergo a second biopsy for each technique and compare the three techniques. To evaluate the impact on PRO and safety data of corticosteroid therapy as part of the biopsy procedure and sequential biopsy procedures.

Methods

Data were collected on the day of biopsy and 7–14 days postprocedure. Joint pain, swelling and stiffness indices were recorded as 0–100  mm Visual Analogue Scale; qualitative outcome variables on five-point Likert scales. Groups were compared with linear regression, adjusting for disease activity, corticosteroid therapy and prebiopsy PRO value and accounting for repeated measurements.

Results

A total of 524 synovial biopsy procedures were documented (402 US-NB, 65 US-P&F and 57 AGSB). There were eight adverse events (1.5%) with no difference between biopsy methods (p=0.55). All PROs were improved 2  weeks postprocedure, and there were no differences in postbiopsy change in PROs between biopsy methods. Corticosteroid administration, whether intramuscular (n=62) or intra-articular (n=38), did not result in more adverse events (p=0.81) and was associated with reduction in postbiopsy swelling (p<0.01). Sequential biopsy procedures (n=103 patients) did not result in more adverse events (p=0.61) or worsening in PRO data.

Conclusion

Overall, our results do not suggest a significant difference in safety or patient tolerability between US-NB, US-P&F and AGSB sampling. Further, corticosteroid therapy as part of the biopsy procedure and sequential biopsies is safe and well tolerated in patients.
Hemoglobin oxygen saturation targets in the neonatal intensive care unit: Is there a light at the end of the tunnel?
Authors: Vali Payam , Underwood Mark , Lakshminrusimha Satyan
Published: October 2018

The optimal oxygenation target needed to prevent the extremes of hypoxia and oxygen toxicity in premature and sick newborns has been the subject of much research and debate. The advent of the pulse oximeter has allowed the continuous monitoring of oxyhemoglobin saturation and the delivery of oxygen with greater precision. Well-run, large clinical trials to determine the safest oxygen concentration have led to several revisions in guidelines for neonatal care. However, monitoring of oxyhemoglobin saturation has its limitations and does not provide a comprehensive assessment of tissue oxygenation. To identify optimal oxygen therapy, various other factors (partial pressure of arterial carbon dioxide, hemoglobin concentration, blood pH, and tissue metabolic demand) that influence perfusion and tissue oxygenation need to be considered.
Just-In-Time Scheduling with Generalized Due Dates and Identical Due Date Intervals
Authors: Choi Byung-Cheon , Park Myoung-Ju
Published: October 2018

We consider a single-machine scheduling problem such that the due dates are assigned not to the jobs but to the position at which the job is processed. We focus on the case with identical due date intervals. The objective is to minimize the weighted number of early and tardy jobs. First, we show that the problem is strongly NP-hard and has no [Formula: see text]-approximation algorithm for any fixed value [Formula: see text]. Then, we investigate polynomially solvable cases. Finally, we show that the preemption version is weakly NP-hard through its equivalence to the problem of minimizing the weighted number of tardy jobs.
Noncommutative negative order AKNS equation and its soliton solutions
Authors: Riaz H. Wajahat A. , Hassan Mahmood ul
Published: October 2018

A noncommutative negative order AKNS (NC-AKNS(-1)) equation is studied. To show the integrability of the system, we present explicitly the underlying integrable structure such as Lax pair, zero-curvature condition, an infinite sequence of conserved densities, Darboux transformation (DT) and quasideterminant soliton solutions. Moreover, the NC-AKNS(-1) equation is compared with its commutative counterpart not only on the level of nonlinear evolution equation but also for the explicit solutions.
The A4, S4 and A5 flavor symmetries in light of data on neutrino mixing
Authors: Petcov S. T. , Titov A. V.
Published: October 2018

We consider the [Formula: see text], [Formula: see text] and [Formula: see text] discrete lepton flavor symmetries broken down to nontrivial residual symmetries in the charged lepton and neutrino sectors in such a way that at least one of them is a [Formula: see text]. Such symmetry breaking patterns lead to predictions for some of the three neutrino mixing angles and/or the Dirac CP violation phase [Formula: see text] of the neutrino mixing matrix. First, we perform a statistical analysis of these predictions, which uses as input the latest global data on the neutrino mixing parameters. We find 14 phenomenologically viable cases. Further, we assess the viability of these cases taking into account the prospective uncertainties in the determination of the mixing angles, planned to be achieved in current and future neutrino oscillation experiments. We find that only six cases would be compatible with the assumed prospective data. We show that this number will be further reduced by a precision measurement of [Formula: see text].
Lump solutions of a new extended (2+1)-dimensional Boussinesq equation
Authors: Wang Hui , Wang Yun-Hu , Ma Wen-Xiu , Temuer Chaolu
Published: October 2018

Through symbolic computation with Maple, two classes of lump solutions, rationally localized in all directions in space, are presented for a new extended (2[Formula: see text]+[Formula: see text]1)-dimensional Boussinesq equation. Analyticity of the solutions is naturally achieved, and particularly, taking special choices of the involved parameters will guarantee the positiveness of the constant term in the quadratic function f. Moreover, it deserves a note that one parameter in f plays an important role in order to maintain the positiveness of the quadratic function f. As illustrative examples, two particular lump solutions with specific values of the involved parameters are worked out and their three-dimensional plots, contour plots, x-curves and y-curves are made.
Video Highlight Detection via Region-Based Deep Ranking Model
Authors: Jiao Yifan , Zhang Tianzhu , Huang Shucheng , Liu Bin , Xu Changsheng
Published: October 2018

The video highlight detection task is to localize key elements (moments of user’s major or special interest) in a video. Most of the existing highlight detection approaches extract features from the video segment as a whole without considering the difference of local features spatially. In spatial extent, not all regions are worth watching because some of them only contain the background of the environment without human or other moving objects, especially when there is lots of clutter in the background. To deal with this issue, we propose a novel region-based model which can automatically localize the key elements in a video without any extra supervised annotations. Specifically, the proposed model produces position-sensitive score maps for local regions in the spatial dimension of the video segment, and then aggregates all position-wise scores with position-pooling operation. The regions with higher response values will be extracted as key elements. Thus more effective features of the video segment are obtained to predict the highlight score. The proposed position-sensitive scheme can be easily integrated into an end-to-end fully convolutional network which aims to update parameters via stochastic gradient descent method in the backward propagation to improve the robustness of the model. Extensive experimental results on the YouTube and SumMe datasets demonstrate that the proposed approach achieves significant improvement over state-of-the-art methods.
Automatically Proving Plane Geometry Theorems Stated by Text and Diagram
Authors: Gan Wenbin , Yu Xinguo , Zhang Ting , Wang Mingshu
Published: October 2018

This paper presents an algorithm for proving plane geometry theorems stated by text and diagram in a complementary way. The problem of proving plane geometry theorems involves two challenging subtasks, being theorem understanding and theorem proving. This paper proposes to consider theorem understanding as a problem of extracting relations from text and diagram. A syntax–semantics (S2) model method is proposed to extract the geometric relations from theorem text, and a diagram mining method is proposed to extract geometry relations from diagram. Then, a procedure is developed to obtain a set of relations that is consistent with the given theorem with high confidence. Finally, theorem proving is conducted by using the existing proving methods which take the extracted geometric relations as input. The experimental results show that the proposed theorem proving algorithm can prove 86% of plane geometry theorems in the test dataset of 200 theorems, which is all the theorems in the popular textbook. The proposed algorithm outperforms the existing algorithms mainly because it can extract relations not only from text but also from diagram.
Quadratic Leibniz conformal algebras
Authors: Zhou Jinsen , Hong Yanyong
Published: October 2018

In this paper, we study a class of Leibniz conformal algebras called quadratic Leibniz conformal algebras. An equivalent characterization of a Leibniz conformal algebra [Formula: see text] through three algebraic operations on [Formula: see text] is given. By this characterization, several constructions of quadratic Leibniz conformal algebras are presented. Moreover, one-dimensional central extensions of quadratic Leibniz conformal algebras are considered using some bilinear forms on [Formula: see text]. In particular, we also study one-dimensional Leibniz central extensions of quadratic Lie conformal algebras.